A recent wave of suicide bombings and localized regional tensions raises a fundamental question about the safety of employees stationed or traveling overseas: How can an employer protect the people on overseas assignments in the event of either a personal or large-scale emergency? Until only a few years ago, natural or man-made disasters that affected overseas employees were handled on a case-by-case basis. But as the frequency and severity of these events have increased, this approach may no longer be a responsible option for employers. Instead, today's benefit programs need to contemplate the potential impact of a disaster on overseas employees and have the capacity to deploy a diverse range of services to assist them. One solution is an accidental death and dismemberment (AD&D) program that incorporates a global network of travel assistance services as part of its risk and benefits management offering. 

Managing an Emergency Half a World Away

Confronting a catastrophic event is never easy. But doing so when the language, culture and social customs are unfamiliar may seem insurmountable to an employee coping without adequate assistance. Emerging markets - often the most attractive for the opportunities they offer - may also present an especially difficult set of logistical hurdles. Once a disaster strikes, attempts to assist employees are often hampered because of official responses such as border closures, grounding of air traffic and restrictions on mass transit. 

Evacuating overseas employees under these circumstances requires advance logistical planning that takes into account a wide range of governmental and military actions and builds in certain contingencies for these events. Such contingencies require a deep knowledge of the local medical landscape, access to a network of emergency transport services and established relationships with officials who can authorize transport. Contingency planning related to a catastrophic event, whether man-made or naturally occurring, is indeed a complex undertaking.

Dissecting the Issue

One way to think about the infrastructure needed to cope with a catastrophe effectively is to consider those resources that might be needed in a personal medical emergency. These may include:

Emergency medical referral

Employees traveling or stationed overseas typically lack a comprehensive medical referral system for emergency and even non-emergency medical conditions. An incomplete or faulty medical referral may result in treatment delays, inappropriate care, unnecessary travel, questionable health outcomes and additional cost to the employer. Having access to a global network of health practitioners and facilities helps offer your employee appropriate medical care. But developing a database of physicians, hospitals and clinics is not merely a matter of collecting names and addresses. It requires an understanding of what each provider's capabilities are and where an employee should be directed for needed care.  

Medical evacuation

If a local hospital, medical facility or clinic is unable to provide your employees with needed medical care, they will need to be evacuated to another facility. In today´s politically complex world, arranging for transportation is often more complicated than simply purchasing a ticket. Contingency planning for medical evacuation should contemplate logistical factors such as transportation restrictions between various countries as well your employee's actual medical needs.

In some circumstances, employee evacuation may also require the assistance of national government, local authorities or international relief agencies. Quite often the assistance these groups provide will hinge upon the understanding they have of the service provider requesting assistance. Having a relationship in place with these key bodies is invaluable in an emergency.

Medical monitoring

If employees do not speak the language in the country in which they are stationed, this may present a significant barrier in communicating medical information between patients and providers. Multi-lingual personnel should be available to facilitate appropriate care and communication with your employee and his or her family. 

Medical repatriation

Arrangements for special equipment, personnel or transportation often must be made to accommodate the needs of a severely injured or ill employee who needs to return home. This service may be especially important when an employee´s prognosis is unfavorable and every minute counts. 

Emergency planning encompasses a wide variety of services that, in addition to those mentioned, could include items such as arranging for transportation of your employee´s unattended dependent children or companion, providing legal advice and assisting with obtaining prescriptions. Helping to ensure the availability of these services requires a complex range of logistical, administrative and medical capabilities that are often too resource-intensive for any one employer to provide. One way of accessing leading-edge travel assistance services is through an AD&D specialist.

Organizing a Benefit Plan

Emergency assistance programs fall into three broad categories: travel assistance, catastrophic response and event management.

• A travel assistance program includes assistance for routine mishaps such as loss of luggage, ticket or prescription, but should also include access to a qualified support network for medical referrals, guarantee of hospital admissions, medical monitoring, medical evacuation services, medical and non-medical repatriation and assistance returning an unattended child home during a medical emergency, among other services that may help an employee through a crisis. When packaged with AD&D, these services can be offered on a fully-insured basis. 
• Catastrophe response programs recognize the need for well planned protocols, including a high level of communication with government entities, to deal with exposures as diverse as industrial accidents, natural disasters or terrorist attacks. Planning for these events may reduce loss of life and provide optimum level of medical care in time of crisis. 
• Specific event planning establishes a response plan for an individual event, such as a business function related to the Olympics or other high profile activity. Should a medical or other catastrophic emergency occur during the event, specific response protocols and procedures are in place that would evacuate attendees or provide access to hospitals or air ambulance services.

These services are designed to shift the logistical and administrative responsibilities of either a mass or personal emergency from the shoulders of a human resource manager to those of an AD&D insurer that can mobilize emergency professionals from a global network of medical providers, transportation agencies and local and national contacts to respond to your employees´ urgent needs.

Assuring a Quality Benefit

Of course, the core of an AD&D program is the benefit it would pay in the event of death, dismemberment or paralysis. Because of the level of risk associated with travel, the benefit level is often set up to $1 million. Simply setting a sufficiently high limit, however, does not ensure the best coverage will be available when your employees or their beneficiaries need it.

Some AD&D coverage may exclude high-risk exposures such as war, terrorism or nuclear, biological or chemical (NBC) attacks - precisely the coverage that many human resource managers seek in an AD&D program. These low-frequency, high-severity exposures require specialized underwriting expertise.

Indeed, all AD&D programs are not the same. Questions that may help you determine the value of your AD&D program include:

• Are acts of war or terrorism excluded?
• Are independent contractors, security personnel and local nationals covered?
• Is the insurer´s contract clear and easy to understand?
• What is the global reach of the travel assistance provider´s network?  
• How comprehensive is its medical database?
• What underwriting information does the insurer require?
• What funding options are available?

If an AD&D insurer only asks for the most general types of information, it may indicate a lack of technical understanding. Determining an appropriate price for your plan involves evaluating a range of factors related to the duration and location of your employees´ assignments, housing accommodations, pre-assignment training, local language skills and means of transportation, among other considerations.

Likewise, the funding options that an insurer offers tend to reflect its flexibility and level of technical sophistication. An AD&D specialist will be able to discuss a wide spectrum of funding options that can help balance your company´s benefit objectives with your budgetary requirements.

In evaluating an AD&D program, it is also important to determine the insurer´s ability to manage its catastrophic exposures. If the insurer has large accumulations of potentially catastrophic exposures in any one area or business segment, it may jeopardize the insurer´s asset base and ability to pay claims. Managing exposure concentrations is a critical component of financial stability for insurers.

Balancing Expansion with Safety

Overseas employees, the vanguard of a company´s new operations and expansion opportunities, are typically a highly resourceful group of individuals. However, today's global environment may place them in situations presenting risks that may be difficult to manage on their own. Ensuring an appropriate level of benefits for them requires substantial planning and the ability to access a global network of resources in any locale, no matter how remote or volatile. The most effective way to accomplish this is to work with an AD&D specialist that offers global reach, a broad range of services and a high degree of technical sophistication. Taken together, these may help you balance your employees' safety with your company's desire to explore overseas expansion opportunities.

Stephen Mueller is Senior Vice President of sales and business development at Zurich´s Accident & Health group. For more information, contact Zurich at 866 860 7292.