The trip was planned to be the highlight of their year. A 30-something American tech executive stationed in Lusaka, Zambia, had invited her parents to travel from the US for a safari at Zambia’s South Luangwa National Park. On day three of their incredible adventure in the Park, her father started having serious breathing difficulties. Luangwa is located in the country’s remote eastern district. The closest town, Mfuwe, had no physicians, and flights from Mfuwe to Lusaka were irregular. Dad needed immediate attention. Fortunately, the family had a travel insurance policy that covered transport by air ambulance. Her father was transported to Lusaka and received the life-saving attention he needed.
Keeping promises made in policies
When people have the foresight to obtain coverage for accidents or illness with comprehensive insurance, they believe in their policy’s promise: 24/7 assistance anywhere in the world. That’s a big statement – one that in both the International Private Medical Insurance (IPMI) and travel insurance market, gets tested hundreds of times each day. How does a company deliver on that promise? What are the necessary steps to build a network that ensures VIP care in every corner of the globe?
Of course, no one can cover all facilities in the entire world. The challenge is to build a smart network in your areas of expertise, then supplement coverage for the rest of the world with strong local partners – companies that both know the area, and are known in it.
Simply stated, the challenge is twofold:
- Providing access to quality medical care
- Managing the costs for that care
Our team has done extensive research. We’ve created an illuminating map graphic showing standards of public and private hospitals across the globe, and evacuation services per country. This graphic conveys – in an instant – the challenges of delivering top-rated medical treatment and/or evacuation in areas where the quality and competency of facilities and providers can be vastly different, based on where a patient is located at the time of their medical emergency.
Local knowledge, global power
When building a provider network in remote regions, insurers and assistance companies count on local partners for guidance on:
- Which (if any) local facilities have doctors qualified in specific procedures necessary to successfully treat specific cases?
- Will the right medicines be on hand to treat these conditions?
- For each region, where is the referral facility to which more complicated cases can be evacuated?
Providers also have questions about partnering in new networks
- Does the potential partner have a reputation for solid guarantee of payment with the local facilities?
- How smoothly and expeditiously will direct payment to the designated facilities be handled?
Experiences with VUMI® and Epic have shown us that our most efficient approach is to tailor our strategy, market by market. Therefore, in the US and LATAM, we work on direct agreements. Elsewhere, strategic partnerships with local assistance companies or Third-Party Administrators (TPAs) act as our extended arm in more remote local markets. In these relationships, we look for complete transparency, total trust and a deep respect for those competencies a company can bring to the partnership.
Partners are selected for these strengths:
- Strong network management, including on-site visits to facilities
- Ability to advise on local standards
- and processes
- Local knowledge of usual, customary and reasonable (UCR) rates for billing and of local billing parameters
- The ability to arrange direct billing in their area
- Cost containment: the ability to obtain prices we could not obtain
- Critical language support
- Full TPA service, including initial contact to determine case parameters
The challenges of building successful networks for both the IPMI and travel insurance sectors have many similarities. As part of our core market in LATAM, we have insureds who work in Southeast Asia, but rely on their LATAM policy for coverage. Similarly, members of VUMI® Global (our Dubai-based division) may work in far-flung locations such as Vanuatu in Oceania or Chad in north central Africa, but they count on their VUMI® policy to cover them. VUMI’s promise is: ‘Treatment anywhere in the world, 24/7/365’. Thus, we are bound to build and maintain a comprehensive network to fulfill this promise. Concurrently, Epic’s travel assistance services must reach into wherever our members reside or travel, whether they’re working remotely as expatriates and must travel for treatment, are backpacking deep in the Andes, or, as mentioned earlier, on safari in Zambia.
Covid adds new layers of complexity to evacuations
Obviously, the Covid pandemic has added more complexity to the equation. Last year, one of our international clients asked us to assist in a complicated Covid case. The European insurer had a patient located between Mexico City and Cancun. The company was experiencing significant problems getting medical updates on their insured, establishing direct billing with the hospital, and ensuring the costs were UCR. We were able to create a working relationship with the local hospital, which had been reluctant to accept direct billing from an international payer. Their usual process had been to demand payment on site before discharge. Our medical team provided updates to the insurer, advised them on local standards, and continuously reviewed costs as they were posted. The end result was a happy expatriate who recovered and was discharged after two months in hospital, a very grateful spouse, and a satisfied insurer who benefitted from the significant cost reduction we were able to deliver as a local insurer, as opposed to exorbitant charges they might have faced at international price levels.
Great expectations insurers have of their assistance partners
To sum up, what insurers should expect of local partners outside their home turf is local knowledge and access.
To deliver top-tier 24/7 global coverage, whether for IPMI or travel insurance, an insider’s knowledge of the specifics of each market is required. Insureds seek prompt VIP service; partner companies want comprehensive care delivered at the lowest possible costs, and; providers look for fast, efficient payment. It’s a balancing act built on creating and maintaining strategic relationships in every corner of the globe.