How the Emergency Medical Insurance Service Works

For organisations who have people working overseas, whether they be staff, volunteers, trustees or their dependents it is important to understand how an emergency medical service will operate, if called upon.

Emergency Medical Helpline

Virtually all travel insurers include access to an emergency medical helpline as part of a standard package of cover. The Insurer doesn’t provide the service directly but outsources to one of a number of specialist companies who provide this arrangement and they all largely operate in the same way.

First of all they will seek to identify if there is an immediate medical emergency and these cases are passed to their specialist teams who have sufficient medical expertise to organise the required support. In some cases the initial call to the helpline may not be deemed an emergency and these will be handled much as a general travel insurance claim would be.

So What is an “Emergency”?

In the event of illness or accident it is important to get treatment underway as quickly as possible and for example in the case of a broken limb(s) you need to seek help which could involve getting to an appropriate accident and emergency facility. On arrival, the facility may need to contact the emergency helpline largely to confirm treatment and payment. In this example they would not regard the incident as an emergency but the Assistance team will monitor the situation especially if it may delay your normal travel return date.

In another example where the traveller may have suffered a serious heart condition the Assistance service would help get the individual to a suitable medical facility. They would then work with that facility, agree treatment which may or may not include a decision to oversee a transfer elsewhere. This incident would be managed by an experienced case handler.

In some cases individual travellers may contact the service out of hours to report a travel claim and set in motion submitting a claim having already arranged and paid for treatment locally. Although not the intention of the emergency service the Assistance team will offer some support / assistance including issuing a claim form.

What Should you do in the Case of a Medical Emergency?

1. Contact the Emergency Medical Assistance Team via the 24/7 telephone phone provided. You can contact by text or email but phone will avoid any unnecessary delays and any potential miscommunication. Verbal discussions are much easier to follow, and advice can be given in the first instance.

      a. If the mobile signal is weak and or you don’t have a satellite phone and do use e-mail, make it clear in the subject line that you need urgent assistance.

      b. Check coverage where possible. The Assistance Team will be able to confirm whether the treatment being sought is covered under the policy. It is important to note that no contact with the Assistance Team could mean some costs will not be covered.

2. Some expenses may need to be paid by yourself and then reimbursed by the Insurer’s  claims department. All documentation should be kept in this instance to support your claim. This is usually done when the illness does not require emergency treatment.  If the claims department are paying an overseas bank account, it can take a few days for funds to drop into the account.

3. The Assistance team may issue a Guarantee of Payment to the treating facility. This is where the Assistance Team pay the facility directly and the individual does not need to pay for the treatment up front. This is often used in the event of a serious illness that requires extensive treatment. Sometimes an Assistance Team will appoint a local agent to negotiate with the medical facility directly and to deal with the language in Country.

Case Studies:

Pay and Claim

A young child became unwell with Chicken Pox in China and required medical treatment to treat this condition. The parents of this child were worried; contact was made with the Assistance Team to seek some advice. Due to the condition not being severe, the Assistance Team confirmed the family would be able to go ahead with necessary treatment and follow the ‘Pay and Claim’ process. This resulted in the claim being dealt with efficiently and the family being reimbursed in full post treatment.

Guarantee of Payment

A gentleman started to suffer with chest pains in Africa, one night he was rushed to the hospital having suffered a heart attack. The Assistance Team were contacted immediately, and a Guarantee of Payment was issued to the Hospital. Treatment was received and payment was made, the gentleman made a full recovery and did not incur any additional charges.

The outcome was successful because the individuals followed the above process and the Assistance Team could act quickly which ensured the hospital proceeded with treatment. Contact being made with the Assistance Team was essential here as certain hospitals will not provide any treatment without being paid upfront or having a guarantee of the payment.