In major crises, there are typically a great number of people and organisations involved, often operating with limited knowledge of the situation and reduced resources. Within that storm of activity, government agencies and international bodies, as well as insurance and assistance firms, must find common ground.

While it is tempting to view disaster response as a singular effort, the reality is a complex interrelationship where governments, insurers, and assistance firms each serve in different roles, and must work with each other.

Bruce McIndoe, President of McIndoe Risk Advisory, began by explaining that when it came to the complex interrelationship between governments, insurance providers, and assistance firms, “each hold a very different layer of responsibility”.

“Governments provide sovereign functions and consular support: advisories, diplomatic engagement, border access, crisis messaging, and sometimes assisted departures,” he said. “Insurers provide the contractual promise and financial protection they sold. Assistance firms provide the operational execution – medical coordination, logistics, evacuation support, and case management.”

Alongside this, he noted that travellers themselves had personal responsibility to be informed and take responsibility as well.

“The mistake,” he said, “is expecting any one of those actors to do the whole job alone. Traveller safety in a crisis is a shared but distinct responsibility model.”

The relationship between companies and the government

When looking at the role of insurers in a crisis, McIndoe argued that they were “not the operator; [they] are the financial and contractual backbone”. The operational heavy lifting, he said, is usually the role of the assistance provider.

Where insurers can and should add value in a multi-agency framework, he said, is not in field execution but more in enabling scale – providing rapid funding decisions, policy exceptions, consolidated traveller exposure visibility, and coordination with their assistance partners.

To support this decision-making, “what they need from government agencies in return is helping to ensure timely, actionable information for the operators, and a clear liaison path to resolve issues”.

The operational heavy lifting is usually the role of the assistance provider

However, he noted, on a day-to-day basis, interactions would largely be between government authorities and the assistance provider, rather than the insurer itself.

Graeme Dean, CEO of Hotspot Cover, agreed that in a major crisis, “insurers are never going to be the lead agency … nor should we be”. However, he argued that outside of simply providing funding, they often played an important connecting role.

“We know where our insureds are, we have relationships with specialist response firms, and we can move quickly on authorisation decisions that might otherwise hold up a medical evacuation or security extraction while someone tries to get sign-off,” he said.

Regarding working with government agencies, Dean explained that where insurers found such relationships genuinely useful was in the field of “intelligence and access”.

“What we need from government partners in return is mostly that: timely and honest information sharing and, where possible, coordination that doesn’t treat commercial operators as an afterthought in frameworks that our clients are going to rely on,” he said.

Dean also noted that his company provided coverage primarily to people already travelling to “conflict-affected regions”. Consequently, when they are caught up in an additional crisis such as a natural disaster, it “doesn’t just mean damaged infrastructure and displaced populations … it means all that on top of an already compromised security environment, weakened state capacity, and response networks that are often already stretched”.

Radmila Sarkisian, Head of Operations and Network at AP Companies, reported that, as an assistance firm, one of the biggest challenges her company faced when coordinating with government authorities during a crisis was “balancing compliance and clinical urgency”.

“As cross-border evacuation usually means that a patient requires either urgent or emergent care, where time is critical, yet the approval procedures can be lengthy and vary from country to country, [we] need to engage with different government authorities to receive the over-flight and landing permits, ensure the patient is fit to be transported, [and] consider the patient’s and medical escort’s exit and entry requirements, including passport, visa, and sometimes other documentation, i.e. public health declarations. The time required to secure these approvals and permits may not be aligned with the patient’s medical condition, which creates both medical and operational challenges, as well as increases the risks and responsibility.”

Balancing commercial risk with rapid scale support

When it comes to balancing commercial risk with the need for rapid, large-scale support during a crisis, Dean noted that “this tension is real, and anyone who tells you it isn’t probably isn’t being straight with you”.

He argued that the best way for travel insurers to manage this tension was to be prepared prior to incidents, and being “genuinely selective” about what they cover and who they work with, so that these decisions do not get made under time constraints.

Dean added that the worst outcomes happen when insurers have taken the premium without doing the work to ensure that the response infrastructure is in place.

This tension is real, and anyone who tells you it isn’t probably isn’t being straight with you

Additionally: “On the commercial side, that means being honest in our underwriting about what is and isn’t insurable at a viable price point, and not writing risks we can’t actually support. On the response side, it means having the right assistance partners in place – vetted, experienced firms with genuine in-country capability – so that when something escalates, we’re not scrambling.”

McIndoe added that in the event of a large-scale crisis, the need for rapid support should always come before concerns about financial impact or policy wording.

He added that “best practice” dictated that assistance providers and insurers should have already established “crisis authorities, escalation thresholds, and vendor networks” prior to any disasters that might occur, allowing them to move quickly “without abandoning commercial discipline”.

McIndoe also noted: “I would think that firms that do this best separate response from reconciliation. In the first hours or even days, the priority has to be life safety, medical triage, movement, shelter, and continuity of care. The financial and contractual review can come afterward.”

He also highlighted that when it came to insurance, “insurers often condition coverage on policy terms and destination risk” and therefore “the balance is not achieved
 by pretending risk disappears, but by being explicit in advance about what support can be mobilised, under what conditions, and by whom”.

Filling the gaps

McIndoe also argued that when working with government agencies, the gap that most often needed to be filled in a crisis was “individual case management at scale”.

“Governments are built to handle diplomacy, public communication, and broad citizen support,” he explained. “They are not structured to manage hundreds or thousands of traveller-specific problems such as hospital suitability, medication replacement, specialist referral, family liaison, onward transport, or post-evacuation continuity of care.”

Governments are not structured to manage hundreds or thousands of traveller-specific problems 

This, he said, is where assistance firms can be a critical resource during a crisis, offering “medical coordination, vetted provider access, transport logistics, payment guarantees, travellers tracking, and sustained case support after the initial extraction”.

However, he added that the hardest work often lay after the evacuation, such as clinical handoff, records transfer, medication continuity, behavioural health support, repatriation, and claims administration.

Sarkisian explained that although there might be different kinds of gaps that require augmentation, they depend on particular case specifics. “The most common ones are usually related to logistics coordination and the continuity of care,” she said. “Logistical challenges are the limited resources in-country, such as fully medically equipped, intensive care unit (ICU)- ready aircraft and ground ambulance, necessary equipment: isolation units, incubators, oxygen cylinders, et cetera. Meanwhile, limitations related to the medical care are ICU-bed capacity, consistent clinical standards, a highly specialised medical crew.”

Conclusion

Ultimately, navigating a crisis is less about the elimination of risk and more about the explicit preparation for it. While governments may excel at broad diplomacy, the intelligence and access provided by the private sector fills the essential gaps in individual case management and specialised logistics that state capacity simply isn’t structured to handle. As natural disasters increasingly collide with already compromised security environments, the ability to balance commercial discipline with clinical urgency will remain the definitive benchmark of a resilient assistance network.