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iPMI Magazine

International Private Medical Insurance Magazine (iPMIM) is the ultimate Health and Medical Insurance Digital Media serving expatriate, corporate, health and travel insurance markets. Due to the nomadic nature of the international healthcare industry iPMI Magazine is an internet based news service, for worldwide healthcare professionals, who need to understand the impacts of healthcare and insurance policy, regulatory, and legislative developments. Combined with in depth health insurance industry analysis, best-in-class health insurance industry data, and exclusive, C-Suite Executive health insurance interviews and round tables, iPMI Magazine bridges an information gap between healthcare payor, provider and patient. Written by the health and medical insurance industry, for the health and medical insurance industry, iPMIM is supported and designed by leading international medical insurance companies and service providers.

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Speakers Announced For AMII AGM

The Association of Medical Insurers and Intermediaries (AMII) has announced the speakers for its AGM set to take place on 2 May 2019 in Milton Keynes.

Tracy Garrad, Chief Executive of AXA PPP Healthcare, in one of her first public addresses to healthcare intermediaries since taking on the CEO role at AXA PPP in January, will outline her view of the current healthcare market; the challenges and opportunities in the sector; and an indication on what future direction for AXA PPP looks like. 

Ted Townsend, Strategy Consultant in Private Healthcare and Author of the LaingBuisson Report: Private Acute Medical Care in Central London, will share the latest healthcare market statistics from LaingBuisson; give his thoughts on what is driving growth in the private healthcare sector, and asks whether this creates opportunities for specialist healthcare intermediaries to tap into this growing sector.

AMII Executive Chairman Stuart Scullion said: “The theme of this year’s AGM is Creating Certainty in an Uncertain World. Whilst there is continuing uncertainty around Brexit and what our future relationship with the EU and beyond will look like, there are also some certainties that lie ahead which we will all have to tackle, as well as continuing to advise our clients as their policies come up for renewal.

“An ageing population coupled with financial pressures on the NHS means waiting time targets are being missed while waiting lists continue to grow. According to the Kings Fund, the 18-week referral-to-treatment standard for elective care was missed for the full year 2016/17.

“Meanwhile the total elective waiting list in April 2012 was 2.5 million but by August 2017 this had leapt to more than 4 million – the highest level since 2007. The Chief Executive of NHS England Simon Stevens has even suggested the NHS Constitution right to access elective treatment within 18 weeks may have to be abolished unless more funding is provided.

“All of this leads to increasing demand for private alternatives, generating growth in self-pay and the rising availability of private GP services. 

“Plus, with the number of people employed in the economy at its highest level, an inevitable tightening of the labour market could feed through into an increasing demand for employee benefits, as employers compete to hire the best talent in a diminishing pool of available workers.”

Carl Laidler, Director of Screening Programmes at Health Shield, will present on Occupational Health and the role intermediaries can play in promoting and establishing occupational health programmes in the workplace, especially focusing on smaller and mid-sized companies.

Branko Bjelobaba, Director of Branko Ltd and AMII Compliance Consulant, will also provide an overview of recent changes to FCA Regulations, and an insight into what intermediaries need to do in preparation for the forthcoming Senior Managers and Certification Regime (SM&CR), which replaces the Approved Persons Regime in December.

The AGM is a free event for AMII member firms to attend, featuring presentations from key health insurance industry figures – to be announced over the coming weeks – on topics including the current healthcare insurance market; opportunities for business growth; preparing for the next wave of intermediary regulation; Brexit and international PMI; and opportunities for intermediaries in workplace health screening.

The event will also be an opportunity to update AMII members on recent activities and the year ahead for the Association, which is a not-for-profit body representing approximately 140 members across the health and wellbeing market.

Delegate registration is now open for the AGM at Hilton Conference Centre, Stadium:MK in Milton Keynes. Doors open from 9.45am for registration and networking, with the meeting commencing at 10.30am and finishing at approximately 3pm. 

For more information or to register a place at the AGM contact AMII General Secretary, Michael Payne on 07971 231869, or via this link:

Airlec Ambulance Appoints Dr. Cyrille Montesinos As Medical Director

Paul Tiba, Managing Director, Airlec Air Espace says, "We are proud and excited to promote Dr Cyrille Montesinos as our new Medical Director after his 4 years of air ambulance transports with Airlec. I fully trust both the man and his vast medical experience to succeed in this new challenge - from French hospitals to remote African areas."

Dr. Montesinos takes over from Dr Hamida Chaouky who is heading for new challenges, for which Airlec Air Espace wish him all the best.

Dr. Montesinos has been a regular on the front line as a medical team member since the birth of Airlec Medical. He has solid Emergency Medicine experience as a Head of SAMU-SAU (French medical emergencies) and worked as a specialist right in the heart of the Ebola epidemic crisis in West Africa.

Dr. Montesinos will be in charge of the medical regulation as well as the management of Airlec physicians and nurse teams in the pursuit of Airlec innovative services.

As Medical Director, Dr. Montesinos will work in close collaboration with Dr. Yann Rouaud, Group Medical Director. This will enable Airlec to keep providing patients and clients with strong human values as well as advanced technology in order to ensure achievement of each air ambulance mission.

About Airlec Air Espace

Airlec Air Espace was founded in 1958 and is the oldest business aviation company in France. The company has 20 years’ experience in air ambulance services through Airlec Ambulance.

With an aircraft fleet of 8 private jets based in Paris and Bordeaux, we transport over 1.000 patients per year.

  • Expertise, confidence, humanity
    • Ethical behaviour
    • Technical and scientific skills
    • French medical culture

Airlec Air Espace employs a team of 30 permanent staff (pilots, engineers and dispatchers) along with a roster of 55 healthcare professionals on a rotating basis to guarantee maximum flexibility.

To learn more about Airlec Air Espace air ambulance flights please visit:

Alternatively please contact iPMI Magazine provider request centre by filling the in the quick form here.


APRIL International Care UK Appoints New Business Development Manager

APRIL International Care, a leading international private medical insurance provider to the individual, student, SME and corporate markets, has announced the appointment of Amanda Barrett as business development manager to be based in their London office.

With over 15 years’ experience in the private medical insurance industry, Amanda previously worked at Towergate Employee Benefits and Aviva where she had responsibility for developing and driving the success of international sales and leading the company’s move into the IPMI market.

Commenting on her appointment, managing director of APRIL International Care UK, Joe Thomas said, “Amanda has a proven track record of delivering new sales and positive working relationships with brokers in our core IPMI market. She is an important hire for APRIL International Care, as we move to build upon our growing share of the IPMI market.

APRIL International Care offers brokers and clients a global platform combining expertise and proximity through a network of worldwide offices. Feedback from brokers tells us that this combination of a service and knowledge led approach is popular in the market and it is certainly contributing towards our drive to deliver high quality international private medical care to a worldwide clientele.”

Amanda adds, “APRIL International Care is well advanced in terms of delivering against its clear growth strategy. I am looking forward to continuing the success that the team has delivered by identifying new IPMI intermediaries and accounts for development.”

APRIL International Care offers a range of standout international private medical insurance plans delivered by 280 staff members, across 12 countries worldwide.

A Third Of Expats In The UK Are Worried About Domestic Politics

New research reveals that 14% of expats in the UK would consider returning to their home country for political reasons.

Research* from AXA – Global Healthcare has revealed that a third (31%) of expats living in the UK are concerned about domestic politics. It proved to be such a concern, that expats currently living and working in the UK reported feeling more worried by domestic politics than those in any other country surveyed; France (22%),  Canada (11%), the UAE (10%) and Hong Kong (7%).

By comparison, with just a fifth (18%) claiming to feel worried about global politics, UK-based expats seemed to be considerably more concerned about domestic politics than those on the world stage. They were also more worried by domestic politics than terrorism (18%).

Those expats who were most concerned by the local political landscape were aged 41-50 (36%), with residents aged 24-30 (29%) and 31-40 (28%) much less worried.

Tom Wilkinson, CEO, AXA – Global Healthcare commented, “There’s no denying that, with Brexit looming, we are in the midst of an incredibly turbulent political period. For months now, it has felt almost impossible to read or listen to the news without the UK’s political situation making the headlines. It’s understandable, therefore, that the impact of the local political landscape on their daily lives would worry expats who have made their home in the UK more than those in other parts of the world.”

Looking to the future, the research also found that expats living in the UK are more likely than any other surveyed to consider returning to their home countries for political reasons. The research revealed that 14% would consider leaving, compared with 12% in France, 6% in Hong Kong, 5% in the UAE and 3% in Canada.

Despite the current political uncertainty, it seems expats have more reason to come to the UK than they do to leave. While 14% would consider leaving for political reasons, a third (32%) of expats have moved to the UK for career opportunities and a fifth (20%) did so for better pay and benefits.

Tom Wilkinson concluded: “Speculation is rife over how Brexit will affect both British citizens who are living abroad and expats who have chosen to make their home here, in the UK. Whatever the future holds though, the skills, experience and investment that expats from all corners of the globe bring to the UK cannot be underestimated. It’s hugely encouraging, therefore, to see that large numbers of expats are still choosing to make their home here, in the UK. Likewise, it’s reassuring that the number of expats who would consider returning to their home country for political reasons remains relatively low.”

*Research conducted in February 2019 by Vitreous World. A total of 1,352 expats were surveyed (250 in the UK, France, UAE, Canada and China respectively, and 100 in Hong Kong)


MSH International Boosts Its Global Expansion With New Health And Travel Insurance Products And Services

MSH International (Americas) has announced that it is accelerating its international expansion and services to meet the growing demand for its comprehensive, global health insurance products. Adding to the company's great products and services a new suite of offerings addresses up-to-the-minute needs of leisure and business travelers alike and includes:

  • LivExpat, a new generation of flexible and cost-efficient international health insurance plans
  • MSH Navigator, a mobile application, with geo-tracking capabilities, security warnings, travel and city guides, two-way communication and single-touch access to emergency and provider networks
  • MSH ASSISTANCE, a comprehensive product offering with round-the-clock multilingual medical assistance, emergency evacuation, repatriation and risk management to travellers, worldwide.

Born of a 2017 merger between MSH International and Ingle International, a supplier of international insurance solutions for travellers, students and expatriates since 1946, MSH International continues to experience rapid international growth. Together with its continuous product innovation, tailored facilities, global capabilities, customized web and mobile sales/information portals for distributors and clients, MSH International offers tremendous benefits to its business partners and insured clients around the world. Its additional staff and new offices in Canadathe United States, and the United Kingdom, serve to complement its capabilities as a one-stop shop for client needs, from fully insured products to third-party administration to travel assistance.

Following the expansion of its international health benefit solutions for globally mobile organizations in the United StatesMexico, and LATAM market, the company's capabilities also include:  

  • 24/7 emergency assistance in every corner of the world
  • Worldwide inbound and outbound insurance products for travellers to any destination
  • Operations expansion in DubaiSaudi ArabiaGermany, and France
  • Industry-leading technological solutions, with global coverage
  • Growing agent and partner networks, worldwide
  • Travel solutions designed for international students, expatriates, global and special risk travellers.

MSH International (Americas) will continue to deliver and create products that give travellers the flexibility, value and peace of mind they want most, regardless of their destination.

CEGA's Medical Screening Solution Attracts Millstream Underwriting

CEGA, a Charles Taylor company, attracts Millstream Underwriting to flexible online medical screening solution.

Global assistance, risk and claims management provider CEGA, a Charles Taylor company, has partnered with Millstream Underwriting to provide its new automated medical screening tool, Antidote, to Millstream's high-net-worth and other travel insurance customers.

Millstream Underwriting, part of the Nexus Group, specialises in tailoring accident and health insurance solutions for commercial and retail customers in the UK and beyond. 

Antidote has been developed by CEGA to further enhance its innovative and end-to-end travel risk management, assistance and claims solutions for global insurers. It provides agile and accurate risk profiling and simplifies travel insurance customers' medical assessment journeys.

Specifically, the tool allows customers to self-declare pre-existing medical conditions easily via logical question sets and is supported by intuitive technology that recognises a comprehensive range of medical conditions. CEGA is fully involved in its implementation; integrating it seamlessly with Millstream's existing systems.

CEGA's head of proposition development, Angela Smith, says, "We're delighted to be working collaboratively with Millstream to offer this flexible, unique and truly customer-focused service that draws on our 25 years' experience of medical screening.

"We expect Antidote to pave the way for enhanced policy renewals and sales; providing Millstream with measurable algorithmic outputs and consistency in underwriting outcomes. Crucially, it also offers ownership of customer data."

Tim Brangwyn, managing director of Millstream Underwriting, comments, "We chose Antidote for its ability to provide a simple, fast and customer-centric medical screening process; enabled by straightforward questions and easy, well-supported technology. Its versatility also allows us to meet the needs of our clients who need a more tailored screening solution.

"CEGA's professionalism, flexibility and alignment with Millstream's goals were key factors in establishing this important partnership."

Read more news and articles from CEGA, visit their micro website on iPMI Magazine, click here.

About CEGA

CEGA, part of the Charles Taylor Group, is a world-class provider of global medical assistance, repatriation, travel risk management and claims services. 

We manage over 45,000 cases per year and have more than 46 years' experience of supporting a blue-chip client base that includes many leading banks, insurance companies, charities, NGOs and other global brands.

About Charles Taylor

Charles Taylor plc ( supports and enables the insurance market to meet the continually evolving challenges it faces.  We provide technical services to make the business of insurance work fundamentally better.  We have been providing insurance-related technical services and solutions since 1884 and today we employ around 3,100 staff in nearly 120 locations spread across more than 30 countries in the UK, the Americas, Asia Pacific, Europe the Middle East and Africa.

We are unique in our market in that our services support every stage of the insurance lifecycle and every aspect of the insurance operating model.  We develop and operate insurance vehicles on behalf of our clients, manage claims programmes and adjust losses. We handle legacy and run-off portfolios, provide a variety of specialist operational support services and offer solutions and support to drive insurance technology transformation.

Charles Taylor's breadth of services, technical skills and resources and global presence means the Group can manage and resolve virtually any insurance-related matter, wherever and whenever it occurs.

What’s Shaping The Assistance Needs Of The Globally Mobile?

Global movement is booming. According to the World Tourism Organisation (UNWTO), international tourist arrivals reached 1.4 billion at the end of 2018: two years ahead of forecasts. The Global Business Travel Association (GBTA) predicts a rise of more than 6% in corporate travel spend this year. And UNWTO anticipates that, by 2030, five million people will be crossing international borders for leisure, business or other purposes - every single day.

But what are the trends shaping the assistance needs of international health and travel insurance policyholders in this travel landscape?  Here are three of them.

Anxiety is everywhere

Annual increases in trips to traditional destinations like the US are being outstripped by those to South Asia, Sub-Saharan Africa and the Middle East. Corporate assignments overseas are increasingly synonymous with a risky cocktail of sub-standard medical care, inadequate infrastructure and unexpected health and security threats. And even traditionally safe global destinations are throwing up unpredictable risks.

No surprise then that the globally mobile are worrying more than ever about their travels and international assignments.

According to the GBTA, more than half of business travellers feel that, nowadays, any destination could be high-risk, almost half are worried about terrorist attacks abroad, and over 20% classify North American and Western European countries as only “somewhat safe”.

At the same time, the Association of Corporate Travel Executives reports that a third of travel managers are seeing a rise in enquiries about business traveller safety.

Meanwhile, Permanxiety is set to become the world’s new shared social experience. It describes the high levels of worry felt by today’s travellers - about everything from Trumpism to technology, terrorism to racial tension and culture wars to climate change.

Mobile connectivity is king

How wrong tech giants were back in the 1970’s, when they dismissed the desire for computers in every home. According to GSMA Intelligence, there are now more mobile devices in the world than people. And the 7.2 billion devices already used around the globe are multiplying a lot faster than we are.

It’s no secret that we’re hooked on our mobile connectivity. We’re using mobile devices for everything from tracking our partners to forecasting the weather, and even measuring our heart health. But they are also playing an important part in preparing, informing and protecting individuals living and working abroad.

Organisations with globally mobile workforces are giving their people access to mobile apps that offer access to complete online travel risk management programmes, worldwide. Often this incorporates real-time medical and security intelligence and alerts, risk mitigation and integrated global assistance: all available at the swipe of a screen.

By providing location-based monitoring, check-in and tracking tools, mobile technology is also giving employers a birds’ eye view of their global staff and assets in relation to threats on the ground; enabling them to locate and assist those in remote areas quickly, if emergency strikes. 

It follows that, in a recent GBTA survey, 44% of business travellers said they now expected their employers to use tools like GPS to locate them in an emergency overseas. And at least two-thirds would expect their company to proactively contact them within two hours of an adverse event abroad.

Customer-centricity is everything

The World Travel and Tourism Council (WTTC) says in its latest report on travel megatrends that “Consumers want to be treated as individuals by companies that share their values.” They also “value technology, but are uncomfortable with over-automation.”

Transfer this to the international health and travel insurance arena, and we see a need for bespoke, joined-up claims and travel risk management solutions that balance technology with the human touch – and that do not (in the words of WTTC) “seek to replace customer interaction with intelligent bots”.

In practice, this can mean offering 24/7 human case managers alongside automated claims. It can mean tailoring pre-travel medical and security risk assessments to specific destinations: preparing individual policyholders for everything from local cultural sensitivities and medical care, to terrorist attacks, hotel burglaries or muggings - before they even set foot on foreign soil.

It can also mean predicting and mitigating real-time threats to individual policyholders’ health and safety, once they are abroad; for example, the risk of illness to family members, adverse weather, or even a political coup.

This is because customer-centricity isn’t just about responding to emergencies abroad, it’s also about planning proactively, and reducing anxiety for the globally mobile. It’s about identifying and mitigating both health and security risks, and helping policyholders feel informed and supported at every stage of an assignment overseas.

About the author

Chris Knight is head of corporate services for claims and assistance provider CEGA Group, a Charles Taylor company. In his senior positions with the British Army and security services industry, Chris underwent numerous tactical deployments to Iraq and Afghanistan and specialised in operational planning and intelligence analysis. He also managed medical, security and natural disaster evacuations from complex and challenging environments.

Today, in his role at CEGA, Chris focuses on risk management and assistance for corporate travellers in the context of combined medical and security provision.

For more information, please see:

Read more news and articles from CEGA, visit their micro website on iPMI Magazine, click here.






ECMO Repatriation On The Air Alliance Challenger 604

A highly specialised medical team just accomplished the aeromedical ECMO repatriation of a 36-year-old male from the Canary Islands to the UK, using the spacious Air Alliance Challenger 604.

The previously healthy patient had been on holiday with his wife and young family in Fuerteventura when he began to experience vague intermittent chest discomfort. When the patient turned to a local hospital, the presumed diagnosis was acute myocarditis, probably viral in origin. Worsening heart failure over the next 3-4 days necessitated transfer to an Intensive Care environment. He eventually required the placement of an Intra-Aortic Balloon Pump (IABP) to help offload his left ventricle and optimise his coronary perfusion.  However, the clinical situation deteriorated further, and the local surgical and medical teams were required to initiate full mechanical cardiac support by commencing Veno-Arterial Extra Corporal Membrane Oxygenation (VA-ECMO). 

What is ECMO?

ECMO can be used for two main groups of patients: those with acute respiratory failure (Veno Venous ECMO) and those with some forms of cardiac failure (Veno Arterial ECMO). In acute respiratory failure blood is taken from one of the central veins, run through a membrane oxygenator and returned via another central catheter back into the venous circulation. In VA ECMO blood is taken from the venous side of the circulation and then through an oxygenator, as before, but returned under pressure to the arterial side of the circulation in order to generate adequate systemic blood pressure and flow to replace the function of the failing heart.


Given the complexity of this transfer we had a larger than usual retrieval team totalling nine people, including a Senior Air Alliance Flight Nurse (to provide aircraft familiarisation and logistical support), Two pilots, a consultant cardiothoracic surgeon, consultant intensivist, senior perfusionist, and two ECMO ICU nurses. 

Loading a patient with this level of life-supporting equipment onto a CL604 is extremely challenging. We needed to raise the patient to the doorway, in a horizontal position, in a manner where all monitoring equipment remained visible to the crew and the many tubes and wires remained secure. This was achieved by careful placement of equipment, crew positioning, and use of the Challenger’s electrically operated loading system.

The flight was busy but uneventful, due in no small part to the extensive preparation and planning by the crew. The patient was off-loaded onto a specially designed and equipped ECMO retrieval ambulance used by the ECMO team, with support vehicle, and continued onwards to the London hospital. 

This was an extremely successful transfer despite all of the potential pitfalls that were lying in wait. The mission was made possible by using all available time engaged in careful planning, the very high skill set of the entire team involved.

To read more news and articles from Air Alliance, click here.

RELATED READING: Special Transports With ECMO Worldwide By Air Ambulance and MICU Ground Ambulances


Claims Management Companies Enter FCA Regulation

The Financial Conduct Authority (FCA) begins regulating the claims management industry from 1 April 2019. All claims management companies (CMCs) in England, Scotland and Wales will now have to demonstrate they meet and maintain minimum standards set by the FCA. All existing and new CMCs will need to apply to the FCA for authorisation.

More than 900 CMCs have registered for 'temporary permission' to continue operating while they go through the FCA authorisation process.

Once authorised, the FCA has a range of tools and powers it can use if firms do not comply with the rules. This may involve requiring a firm to change its business practices (eg ensuring its communications with consumers are clear, fair and not misleading), imposing a financial penalty or refusing to authorise a firm if there is serious misconduct.

The new FCA regime aims to boost consumer protection and the professionalism of the sector by driving up standards in the industry. The FCA wants CMCs to be trusted providers of high quality, good value services that help consumers pursue legitimate claims for redress.

New FCA requirements will benefit consumers by ensuring that CMCs give people the information they need to make informed decisions. The new FCA requirements include:

  • due diligence on lead generation and rules to prevent firms encouraging customers to make fraudulent, frivolous or vexatious claims or claims which have no good basis
  • providing clear, upfront information to customers about the fees they charge and the services they will provide
  • giving customers a summary document about the services they will provide before the customer signs a contract
  • telling customers about free alternatives such as the Financial Ombudsman Service (FOS) or the Financial Services Compensation Scheme (FSCS), including in advertising
  • recording and retaining customer telephone calls for a year after their final contact with a customer will reduce the chances of high pressure sales techniques and support robust resolution of customer complaints

Jonathan Davidson, Executive Director of Supervision – Retail and Authorisations at the FCA, said:

'Today brings a new regime and rules for regulating the claims management industry. Many CMCs play an important role in helping to secure compensation for customers, including for those who otherwise might not make a claim. The new regime has consumer protection and CMC professionalism at its heart. It will mean that customers will be protected from claims management cowboys and get a better deal.'

If you're considering using a CMC, please refer to our page about using CMCs which has information about how to claim compensation (including for free yourself), what to expect from a CMC if you decide to use one, and how to check you are using an authorised CMC.

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