ITIC Global 2026 | IPMI versus travel insurance: medical care provision (emergency versus chronic)

The ITIJ team are reporting from ITIC Global in Istanbul this week (1–5 November 2026), sharing the discussions that take place at the conference. Read all reports.

Dr Chanatip Ponglorpisit, Assistant Hospital Director, Bangkok Hospital Hua Hin, Bangkok Dusit Medical Services

Dr Ponglorpisit started his presentation by explaining the context of Thailand as a destination for tourists and retirement. He stated that there were 30.3 million international arrivals to Bangkok alone in 2025, making it the world’s most visited city for foreign arrivals. Dr Ponglorpisit also pointed out the statistics that show that Thailand is the “number one retirement destination in Asia” and came in at ninth in the world, according to data for 2026. Both of these factors, argued Dr Ponglorpisit, contribute to a healthy and busy healthcare environment, such that it is a daily reality for healthcare providers to look after a mix of short-stay visitors (on travel insurance) and long-stay residents (with IPMI).

Dr Ponglorpisit presented a case of an emergency patient, pointing out that the clinical duty was first to save the patient’s life then, secondly, only then, there was the administrative question about which policy covers them. The hospital in Hua Hin sees a higher number of both retirees and holidaymakers as “Hua Hin is one of Thailand’s leading retirement destinations”, he said, sharing that he often sees these two different populations side by side on the same ward. He added that the retirees and expatriates mostly are in hospital for comprehensive, ongoing care to treat chronic conditions that are investigated and treated locally, whereas the tourists are mostly treated for “emergency care and stabilisation” and then sent home abroad when it is safe to do so. Dr Ponglorpisit showed the difference between two conditions and coverage for IPMI or travel insurance, and whether a fit-to-fly clearance was given. A deterioration in this case meant that the clearance had to be recalled, with the complication that the financial limit of the policy was getting near. This required empathetic counselling and rolling guarantees of payment.

Regardless of the patient of the policy, clinical care remains identical, while a proactive provider-insurer partnership turns catastrophic medical events into managed outcomes

Dr Ponglorpisit concluded that regardless of the patient of the policy, “clinical care remains identical, while a proactive provider-insurer partnership turns catastrophic medical events into managed outcomes”.

Helen Jude, Head of Global Medical Network, APRIL International

Jude started by saying: “The key difference [between IPMI and travel insurance] is not the coverage but the key difference is when the insurer gets involved.”

Jude pointed out that as costs increase, taking action early on allows insurers to be more able to guide care and manage those costs. Jude said that there was going to be a 9.7% growth in gross medical trend, and that the Asia-Pacific region specifically was forecast to grow 11.3%.

Jude said that early intervention and assistance helps members to navigate the care path before key decisions have to be made. Having early contact with a member allows the insurer and member to review more options for care, so that the insurer is better able to help and to shape the treatment pathway, said Jude. She added that the value of this was that “earlier dialogue helps align treatment, cover, and member expectations”.

Earlier dialogue helps align treatment, cover, and member expectations

Jude concluded her presentation with examples from three case studies.

The importance of adaptable case management was illustrated by a member on an IPMI coverage who was severely ill with sepsis in Vietnam. The deterioration of their condition then resulted in a transfer back to Toronto, Canada, where there could be ongoing support for the member and their family.

Jude relayed the story of another case to show how early dialogue with the 32-year-old member who suffered a cardiac emergency permitted management of expectations regarding the “benefits, limits, and likely personal costs” that might be experienced before decisions are made, and that policy terms and clinically appropriate care options were applied fairly, highlighting the importance of good relationships with providers.

The final case study presented by Jude emphasised the importance of medical outcomes guiding care pathways. A member had a complex colon condition in Vietnam, where local care was at high clinical risk, while the recommendation to get treatment in Singapore was not covered, so assessment was reviewed and an appropriately aligned care pathway was found in Thailand, meaning that “quality was maintained and costs were better contained”.

“Healthcare is becoming more international and more complex,” she said, with earlier intervention leading to better outcomes.

In response to a question posed by moderator Ian Cameron to the panel, Jude stated that there had been a shift in IPMI in the last 10–15 years: where once the policies were straightforward, they are now much more modular and similar to domestic policies, which “helps to manage costs”.

Helen Love, Vice President, Strategic Partnerships and Network, UnitedHealthcare Global

Love introduced her presentation by arguing that travel insurance and IPMI are different products that operate over different territories and regions, with different systems, but should result in a fair outcome despite this.

Love then outlined the differences of risk between travel insurance and IPMI, whereby travel insurance is associated with episodic risk from “unforeseen illness or injury during a defined trip period”, and IPMI is associated with “planned, routine, chronic, and emergency care within the benefit design”. However, she said, there were four aspects of the healthcare journey that they both must get right: urgent need is not automatic cover; proportionate decision-relevant clinical requests are made; there are prompt confirmations of cover, limits, and personal liability; and service is timely and transparent.

Love said that fair and timely outcomes were only possible if all three stakeholders (the insurer, provider, and the insured) work together. Each has its own responsibilities and when eligible cover is available, provider exposure is controlled, and consumer liability is understood, then there is “one fair outcome”. Love called back to something that Jude said, by saying that “early intervention is fundamental to delivery of a fair outcome”.

Early intervention is fundamental to delivery of a fair outcome

The two types of protection have two legitimate funding pathways, but the product and local healthcare system can change the decision pathway, explained Love.

Love warned that global breadth doesn’t prove local compliance, pointing out that regulatory changes can affect entitlement after product design and pricing, citing the example of the Department of Health Abu Dhabi adding requirements for organ and tissue transplantation to be included in insurance benefits. Love said that different products and regional rules could lead to different care pathways.

Communication needs to be well intentioned between the stakeholders, said Love. Love concluded her presentation by saying: “The core difference and experiences [between IPMI and travel insurance] are what is bought, where it’s bought from, and how it’s delivered.”

Tracey Badger, Senior Vice President of Cost Containment, Global Excel Management

Badger highlighted that, when considering healthcare systems around the world, there are eight areas in which differences may be encountered: scale of the public health sector, role of private providers, government regulation of prices, consistency/standardisation of pricing, use of international coding, pricing of international versus domestic patients, transparency of costs, and incentives to deliver over-care. She added that a good strategy for cost containment must adapt effectively to the local system by tailoring provider negotiations, utilisation review, and case management, since a one-size-fits-all approach cannot work across diverse systems.

Badger then broke down how the tailored approach works differently between patients on travel insurance or IPMI, as entitlement to care for the same condition may vary. She said it was important to “apply objective clinical assessment consistently, distinguish clinical recommendations from contractual payment decisions, and avoid representing a coverage exclusion as a lack of medical need”. Furthermore, Badger noted the value of making sure you “escalate disputed or uncertain decisions to qualified clinicians and the insurer, with timely review”, and to “give patients understandable reasons, anticipated personal costs, alternatives, and relevant appeal rights”. Alongside this, she said that emergency care should always take priority over routine administrative, with a few caveats.

Badger pointed out that risk management was a broader issue than purely cost containment, and consisted of three parts: prevention, mitigation, and containment.

Badger said that she wanted to emphasise a point but not re-cover what had already been said.

Having a deep understanding of the healthcare environment is key

“Knowledge is very important when managing travel or IPMI cases or any other coverage for that matter, having a deep understanding of the healthcare environment is key.” She added: “I know it’s a cliché to say, but knowledge is truly power when it comes to these types of situations. The better informed you are, the better decisions you can make at the end of the day.”

In response to a question from Cameron about prevention, mitigation, and containment of healthcare and costs, Badger said that there were pressures on all of the stakeholders, and we couldn’t keep increasing and increasing and increasing costs, because the consumer would not be able to afford it.

Jude said that the final important note that she wanted to share was to ensure that consumers were informed and had the right level of insurance.