Covid-19 has affected lives and businesses all over the world. Travel assistance companies are not exempt. With fewer people travelling due to government restrictions, closed borders and airlines cancelling the majority of flights, there is less of a need for repatriating tourists from the Himalayas or booking emergency doctor appointments for tourists in Egypt.
However, assistance companies are by their very nature prepared for the worst and, despite the global lockdown, there is still a need for transporting patients and repatriating citizens to their home countries. So how are these companies managing to carry on their operations amidst the restrictions? And have they still got enough business to stay afloat or are things getting difficult?
“We are certainly having difficulty in business,” said Sue Chung, Medical Team Manager at Global Assistance Partners (GAP) in South Korea. “It went down to a quarter compared to last year. Our revenue has not met the payroll costs so we, an assistance company, are taking financial assistance from the government.
“However, I do not think it has only a dark side. Thanks to the crisis, we are realigning our company internally and trying to be more active in assisting the foreigners that are currently still in South Korea. Just like it is always darkest before the dawn, our company is preparing to soar in the future.”
In South Korea, the government did not lock down cities; instead, it focused on early detection of infection by using epidemiological investigation and mass testing, so GAP has not had to close its offices. Elsewhere in the world, assistance companies have had to adapt their entire operations and adopt a new way of working to navigate lockdown.
“In addition to moving our entire network of employees to a remote work plan while continuing to provide all of our services, we had to address a large influx of claims and repatriation requests,” said Virginie Babinet, Chief Transformation Officer at Europ Assistance in France. “We have also seen a 70-per-cent increase in our teleconsultation business, showing how important our health services have been in this crisis.”
New lines of communication
Something that has been vital for business continuity across most assistance companies worldwide has been continuing clear communication with insurers and customers. Some companies have started newsletters updating their clients about the current situation in various countries. Europ Assistance is one of them: “As a company that operates in the healthcare space, we wanted to prioritise the communication of key medical information to both our clients and employees,” said Babinet. “We achieved this through a comprehensive newsletter detailing the situation as it developed, along with the latest recommendations from health authorities that came from our Chief Medical Officer three times per week starting in January.”
In the Middle East, Connex Assistance said it also started making preparations early when the virus showed signs of becoming a catastrophic event. “From our past experience during the Arab Spring, we anticipated that cash availability could become an issue due to banking capital controls, and indeed in some countries restrictions were placed on individual and corporate daily withdrawal. But, thankfully, we had taken safeguards in advance to ensure this would not become an issue,” said Lara Helmi, the company’s Managing Director.
Connex has also put communication at the top of its agenda.
As an assistance provider, we are proud to be busy
doing what we do best during this moment of crisis
“We had to provide insurers with as much information as possible regarding the situation on the ground, so we would translate any official daily announcements from the Ministry of Health, Prime Minister or indeed President’s Office as they became available. We also provided a list of hospitals, and their capacity and reports on their facilities, following discussions with representatives from the Ministry of Health,” said Helmi.
As clear and timely communication is always a vital part of assistance providers’ daily operations, however, this wasn’t the most difficult aspect of life after lockdown to navigate. “Communications have really been unaffected and, other than conducting more virtual meetings, we have continued to communicate with clients, both insurance and corporate, along with their staff and insured,” said Marise Caunter, Director of Operations at Healix International in the UK. “The very early development of our coronavirus report ensured our clients and interested parties were kept informed and up to date with the rapid progression of the disease across the world.”
Socially distanced care
With the availability of the internet and online communication tools such as newsletters, the shift to socially distanced operations has been possible for most assistance companies when it comes to keeping in touch with colleagues and clients. However, the act and process of actually repatriating patients has been more complicated. With different countries each having their own travel restrictions and some even closing their borders completely, planning and executing successful patient transports has had to change drastically.
Babinet explained some of the difficulties faced by Europ Assistance: “This truly unprecedented global crisis drew additional attention from the media, politicians, government entities and, most importantly, families who were anxious about the safety of their loved ones. Since there was no uniform global response, the situation was challenging to navigate as each country established its own set of rules procedures in terms of medical care and the repatriation of citizens. This level of additional coordination made each repatriation case more complex, with the additional scrutiny only adding more pressure.”
However, although travel restrictions are in place all over the world, patient repatriations have had to continue. Ensuring accurate assessment of each individual situation and monitoring related risks are all more important than ever in order to manage the complexities of repatriating clients across international borders.
We have also seen a 70-per-cent increase in our teleconsultation business
“In Egypt, for instance, we handled several cases where visiting tourists contracted coronavirus and passed away from the illness,” said Helmi. “With no way of knowing exactly how long the deceased would have to remain in Egypt, we had to organise temporary burial sites, essentially renting cemetery space. This was the first time we had ever organised this, and it was done with approval from the insurers and the relevant embassies of the deceased.” Helmi added: “In Egypt, normal commercial flights have been suspended; however, we are able to repatriate clients on dedicated charter flights by Air Cairo, returning them to their home countries. In the UAE, while commercial flights are very limited, we have been able to repatriate insureds on Etihad and Emirates airlines. Most countries in the Middle East are allowing air ambulances to fly regularly in and out of the country for critical cases.”
Nevertheless, it’s not only travel restrictions that are making repatriations difficult at this time. Rules regarding PPE have changed; and assistance companies have had to adapt their operations to new safety procedures.
Ahji Lee, an operator for GAP, recalled one particularly difficult mission, during which the safety rules kept changing: “We found out last minute that the patient would need to undergo Covid-19 testing upon his arrival in the hospital and wouldn’t be allowed to be admitted until the result was shown to be negative. The hospital wanted the patient to stay in an isolation room in ER for a night while waiting for the results. We tried to persuade the patient this would be ok, but it was hard for us to convince him, as he was already anxious and afraid.” Lee had to find a bigger hospital that would admit the patient immediately.
Difficulties like these have become commonplace during the pandemic, with different hospitals all over the world operating with different rules and regulations. At the same time, assistance companies have reported a lack of clear communication from some hospitals.
Busier than ever
All of this has already had an impact on business. Some companies are seeing a loss in revenue, even though they seem to be busier than ever. What seems to be keeping assistance companies afloat for now, though, seems to be expat portfolios.
Caunter explained Healix’s approach to assisting expats: “We continue to support a large population of expats resident in most countries of the world. Ensuring they have access to accurate information helps to reduce their anxiety, something we have seen increase significantly over the period of disruption.”
In addition to moving our entire network of employees to a remote work … we had to address a large influx of claims and repatriation requests
Connex Assistance has also been focusing more on its expat support. “As with the majority of businesses during this period, we are negatively affected by the worldwide halt in travel due to the pandemic and the effort to stop the spread of the disease; however, we do have a healthy expatriate portfolio in some countries, which we are thankful for, and our local corporate healthcare division that has not been affected,” said Helmi.
While operations have been made more complicated due to travel restrictions and safety measures, assistance companies are still very much needed in this crisis. Babinet concluded: “Due to the new complexity of the claims and repatriation requests we’re receiving, along with our endeavours to help the communities we operate in – we’re as busy as ever. As an assistance provider, we are proud to be busy doing what we do best during this moment of crisis.”
We all know that assistance companies are facing new and unprecedented situations presented by the pandemic. They are having to navigate unchartered territory, with ever-changing safety regulations, closed borders and limited transportation options, in the air and on the ground. Both insurers and insureds depend on these companies to organise safe medical treatment, hospitalisation and repatriations. And, doing just that – while keeping insurers updated and advising expats and travellers – has never been as important as it is at this time.
Assistance companies are often some of the unsung heroes of the international medical community and never more so than now. Once travel starts up again, it will be assistance companies that insurers lean on to build a new normal. So, we at ITIJ (and not doubt the rest of the industry) applaud you for the sterling work you continue to do. ■