Medical Evacuation and Repatriation

Function

The benefit responds when an insured person requires in-patient treatment abroad and the local facilities are, in the opinion of the treating doctor and the doctor appointed by the insurer, not suitable. The insurer or its assistance partner then arranges and pays for transport – air ambulance, scheduled flight with medical escort or ground transport – to the nearest suitable hospital in the same or a neighbouring country. Once treatment is complete, repatriation follows to the country of residence or a country for which the person holds a passport; in the event of death the benefit covers repatriation of mortal remains or local burial. Market practice requires the means of transport, timing and destination to be agreed in advance with the emergency assistance centre; self-arranged transport is not covered where local care would have been adequate. The AXA Global Healthcare handbook, section 1.8, for example, sets out these conditions and excludes evacuation from ships and offshore platforms.

Distinctions

A distinction is drawn between evacuation to the nearest suitable hospital (medically indicated, destination chosen by the insurer), repatriation after stabilisation (on request and where medically appropriate) and security evacuation for political or natural disaster reasons, which is a separate cover. In business travel policies medical evacuation forms part of the medical and additional expenses section; in IPMI it is frequently kept outside the annual limit and supplemented with costs for accompanying persons, accommodation and return travel.

Practical Note

For employers the evacuation benefit is a core element of duty of care for overseas assignments. Points to check are cover for pre-existing conditions, the exclusion of travel against government advice, cost allocation where family members accompany the patient and overlapping cover between IPMI, business travel and credit card assistance, which requires a clear lead arrangement for the emergency.