Swine flu highlights need for good medical insurer

Expatriate populations in countries with health services below western standards would be particularly vulnerable in the event of a massive local outbreak of infectious disease. If services were overwhelmed a good medical international insurer could prove a life saver.

Whether swine flu becomes the scourge of millions across the world or is quickly forgotten, like bird flu, it should serve one purpose.

Sombre messages from the WHO might shake any expats who are complacent about healthcare provision to think again. Their safest route is to find an appropriate medical insurance plan.

Existing policyholders might check to see whether their insurer has a 24-hour multilingual helpline and a reputation for delivering when there is heavy demand on its services. That greatly depends on the insurer having a contract with a top-flight medical assistance company - the unit that supplies emergency care specialists, arranges ambulances (road or air) and alerts the receiving hospital to the incoming case.

Small print in insurance plans, specialist insurance brokers and other expatriates are all sources of guidance for people wanting to know how efficient an assistance provider might be.

Insurance adviser George Connelly, of Dorchester-based Health Care Matters, said most assistance companies were of a good standard. "The first thing to do is to check that your insurer actually has an assistance provider. If they’ve got one you can usually assume they’re pretty good."

Expatriate populations in countries with health services below western standards would be particularly vulnerable in the event of a massive local outbreak of infectious disease. Britain may boast that it has stocks of Tamiflu and Relenza to cover half the population, but that’s small comfort for the expat. It’s noteworthy that during the 2006 bird flu scare, the Department of Health in London made clear that expatriates would be left to fend for themselves.

Local health services should do their best to help any suspect cases, irrespective of nationality, not least because containment is a guiding principle of infection control. But if services were overwhelmed a good medical international insurer with first-rate assistance facilities could prove a life saver.

If it failed to get anti-viral drugs to the patient within the first couple of days, when they are most effective, it should give the best chance of getting the patient to a bed in hospital of the right standard.

In countries such as China this may be more difficult than it might appear. Mark Coleman, international sales director of US insurer CIGNA, described the standards in some hospitals in China as "fear-inducing" and said westerners needing immediate care faced a "complex delivery system", adding: "Over 16,000 public and 3,000 private facilities serve the country and the range of capabilities in the public system is dramatic. Top facilities in Shanghai and Beijing can rival any western facility, but the lowest rungs on the ladder can be fear-inducing."

In many cases the answer for a patient was an airlift to Hong Kong or Singapore, which could add £20,000 or more to treatment costs.

Bupa International paid £113,500 to medi-vac a customer from Mumbai to the UK by Lear Jet 35. The length of flight from India’s commercial centre necessitated two pilots, two doctors and two nurses. Also adding to the bill was a London stopover for the crew before returning, in order to meet flight regulations.