International private medical insurance provider, Expacare, has appointed Geoff Maggs to the role of Business Development Manager.

Reporting to Managing Director, Beverly Cook, Maggs will be responsible for developing IPMI business introduced by intermediaries based in the UK and Europe.

Maggs brings over 26 years’ experience in medical insurance and has moved from AXA PPP International, having previously worked for Bupa International and Allianz Worldwide Care.

Beverly Cook said, “We are delighted to welcome Geoff to the Expacare team. His experience and standing within the global health insurance industry significantly strengthens our position, as his relationships with intermediaries in the UK and Europe are second to none.

“Enhanced broker interaction is essential to ensuring our products and service levels remain at the forefront of the sector and right for their clients. This appointment will enable even greater contact with our network of existing and prospective partners.”

Typhoon Melor (Nona) forecast to bring hazardous sea and weather conditions to parts of the country from 14 December 2015.

Around 20 typhoons hit the Philippines each year. Most typhoons occur from June to December. There may be flooding and landslides. You should monitor the progress of approaching storms and follow the advice of the local authorities, including any evacuation orders. Typhoon Melor (Nona) is forecast to bring hazardous sea and weather conditions to parts of the country, in particular northern Visayas and southern Luzon, from 14 December.

Around 133,665 British nationals visited the Philippines in 2014. Take out comprehensive travel and medical insurance before you travel to the Philippines.

Global passenger traffic results for October 2015 showing continued strong demand growth for both domestic and international traffic compared to the year-ago period.

Total revenue passenger kilometers (RPKs) rose 7.5%, which was in line with the 7.4% year-over-year expansion seen in September. October capacity (available seat kilometers or ASKs) increased by 5.7%, and load factor rose 1.4 percentage points to 80.5%. Growth in air travel has been stimulated by lower fares, particularly for leisure travel. Data for the first 8 months of the year show a 5% fall in average fares in currency-adjusted terms. It is estimated that the fall in fares has supported approximately 3 percentage points of the rise in traffic year-to-date.

“The air travel story is generally a good one. There are some weak spots. For example the Brazilian air transport sector is caught in perfect storm of a deepening recession, high costs and a weak currency. In most parts of the world we see strong demand for travel—exceeding the growth in capacity. Load factors are averaging over 80% and consumers are the big winners with fares trending downwards,” said Tony Tyler, IATA’s Director General and CEO.

International Passenger Markets

October international passenger demand rose 7.6% compared to October 2014, with airlines in all regions recording growth. Total capacity climbed 6.1%, pushing up load factor 1.1 percentage points to 79.2%.

• Asia-Pacific airlines’ October traffic increased 8.6% compared to the year-ago period. Significant declines in trade activity to/from Emerging Asia and slower than expected growth in the Chinese economy do not appear to be impacting on passenger demand. Capacity rose 6.6% and load factor gained 1.5 percentage points to 76.7%.
• European carriers saw demand rise 6.7%, supported by economic recovery in the Eurozone. Capacity climbed 4.2% and load factor jumped 1.9 percentage points to 83.8%, highest among the regions.
• North American airlines’ traffic rose 4.6% compared to October a year ago, continuing the healthy trend of recent months. Capacity climbed just 2.2%, propelling a 1.9 percentage point rise in load factor to 82.1%. Expectations for better economic performance are supporting travel demand.
• Middle East carriers posted a 10.3% traffic increase in October. Capacity rose 12.7%, however, which caused load factor to slide 1.5 percentage points to 72.5%. The Middle East was the only region to see a decline in load factor for the month.
• Latin American airlines experienced a 10% rise in October demand compared to the same month last year. Capacity increased by nearly the same amount and load factor edged up 0.1 percentage points to 80.5%. Solid trade activity has provided a boost to business-related international travel, notwithstanding economic weakness in Brazil and Argentina
• African airlines’ traffic climbed 6.7% in October, marking a fourth consecutive month of improvement compared to the year-ago period. However, fundamental economic drivers remain weak, so the result could also reflect volatility in reported volumes. Capacity rose 5.2%, with the result that load factor improved 1.0 percentage point to 67.4%.

Domestic Passenger Markets

Demand for domestic travel climbed 7.3% in October compared to October 2014. There was a wide disparity in results, with Brazil and Australia both showing declines while China, India and Russia posted double-digit increases. Domestic capacity climbed 5.0%, and load factor improved 1.8 percentage points to 82.7%.

• US airlines reported a second month of strong demand with RPKs up 6.9% year-over-year. Part of the expansion in domestic air travel is related to an acceleration in capacity additions.
• Brazil’s domestic traffic fell 6% compared to the year-ago period as airlines struggle under the burdens of a deepening recession, sinking local currency and government policies that impose crushing costs on the industry.

The global economy is expected to strengthen moderately next year, supporting insurance premium growth in most regions, according to Swiss Re's latest publication, Global insurance review 2015 and outlook 2016/17. Demand for non-life insurance is expected to grow, led by an 8% to 9% annual gain in the emerging markets in 2016 and 2017. The life insurance sector faces challenges, in particular from ongoing low interest rates. Nevertheless, global life premiums are forecast to rise by about 4% in each of the next two years, led also by the emerging markets.

The global economy is expected to strengthen moderately next year. The US and the UK economies are currently growing by close to 2.5%, and real gross domestic product (GDP) growth in Japan and the Euro area are a more subdued 0.7% and 1.5%, respectively. The four economies are all expected to see slightly better growth in 2016. Emerging markets will grow by about 5% in each of the next two years, an improvement on the current 4% pace.

The global economy faces three main headwinds: slower growth in China, lower commodity prices and an imminent rate increase by the Federal Reserve. The headwinds pose a risk to the baseline forecast, but are unlikely to derail the improving growth momentum. With the overall improved outlook and expected monetary policy tightening in the US and UK, government bond yields (especially in the US and the UK) will likely rise.

"Global economic growth is a good sign for insurers," says Kurt Karl, Swiss Re's Chief Economist. "This is especially so in the emerging markets, where urbanisation and growing wealth will support overall sector growth. We've said for some years now that emerging markets are the growth engines for the insurance industry – and this is expected to continue for at least several years more."

Non-life premium growth will improve along with economic activity

Demand for primary non-life insurance should increase in the next two years. Global primary non-life premium growth is forecast to improve to 3% in 2016 and 3.2% in 2017, from 2.5% this year. Growth in advanced markets is expected to slow slightly due to the generally softening prices and only modest improvement in economic growth. The emerging markets will be the main drivers in non-life, with premiums up an estimated 7.9% and 8.7% in 2016 and 2017, respectively, after a 5.6% gain in 2015. Premium growth is expected to be strongest in emerging Asia (12% annually), and a recovery is expected in Central and Eastern Europe after contraction in 2014 and 2015.

Despite the challenging pricing environment, underwriting profits in primary non-life insurance have been sustained by low natural catastrophe losses and a continuation of reserve releases from past years. The non-life reinsurance sector underwriting result has likewise been strong so far this year, also based on low natural catastrophe losses. However, with falling prices, profit margins have eroded over the past two years. Property catastrophe reinsurance rates are currently close to bottoming out and the rate softening in most lines is expected to moderate or come to a standstill. In casualty and specialty, significant differences in pricing developments by market and line of business are expected.

Life insurers face major challenges but premiums will grow

Primary life insurers face significant downside risks in the short to medium term from the modest global growth outlook, persistently low interest rates, volatility in financial markets and regulatory changes. Nevertheless, in the advanced markets, real premium income is forecast to rise by about 2.5% in 2016 and 2017, up from about 2% this year. In emerging markets, premiums will grow by an estimated 10.7% in both 2016 and 2017. This improvement will in part be attributable to improved use of currently available technologies, such as wearable devices and cloud computing. Again, emerging Asia is expected to have the most robust growth of about 13% each year. A key issue in many emerging markets will be the implementation of risk-based solvency regimes.

In the advanced markets, life reinsurance premium growth is expected to decline slightly in 2016 and 2017 in real terms. In the US, regulatory changes – including increased scrutiny of the use of captive reinsurance and an expected move towards principles-based reserving – will impact business opportunities. In other markets, traditional life reinsurance will continue to record low, single-digit growth in line with the protection business on the primary side. Growth in emerging market life reinsurance premiums is expected to be about 7% to 8% each year in 2016 and 2017.

Economic headwinds in Sub-Saharan Africa

This year's outlook report covers Sub-Saharan Africa (SSA), which faces headwinds as commodity prices remain low and capital flows out of the emerging markets. GDP growth in SSA is forecast to slow to around 3.8% in 2015 from 4.7% in 2014, but the region is still the fastest growing after emerging Asia. Non-life premium growth increased to 4.5% in 2015 so far, after having been suppressed in previous years by the increased enforcement of the cash-and-carry principle. With this principle, insurers can only issue policies and book premiums after they have received payment. Premiums in South Africa recovered in 2015, despite a weak economy and intense competition, as insurers raised rates on the basis of past claims experience.

Demand for non-life insurance is likely to remain solid in SSA in 2016 and 2017, with premium growth of 4.5% to 5.0%, even though volumes are expected to stagnate or even contract in some of the oil- and commodity-exporting countries. Global and regional insurance groups continue to expand their footprint in SSA which will enhance expertise in the region.

Life premium growth in the region is estimated to have slowed to 4.2% this year from 5% in 2014, and will likely slow further to about 2.5% growth in 2016 and 2017. Growth weakened to 3.8% in South Africa in 2015 as the economic environment failed to improve and the rand was hit by capital outflows. Elsewhere in SSA (eg in Kenya and Nigeria), growth is estimated to have remained strong. However, given that South Africa accounts for around 90% of the region's premiums, the results for SSA overall were disappointing.

Thousands of travel insurance customers are now using Barclays Pingit to receive instant claims payments via their mobile phone numbers, according to CEGA, the global emergency assistance, risk and claims management provider.

CEGA, which partnered with Barclays to become the first corporation to offer Pingit payments for claims last year, reports that the service has now been rolled out to multiple travel insurance clients and that customer uptake nearly doubled in the three months to August.

Once they have downloaded the free Pingit app and registered, customers need only to disclose their mobile phone number to receive immediate claims payments into any bank account.

"The Pingit 'send a payment' service widens settlement options for our customers," says CEGA's operations director, Neil Heasman. " It offers a faster and more convenient alternative to BACS and allows customers who have signed up to the service to receive claims payments securely - within as little as an hour of their claim being approved."

"Mobile payments are just one of the ways Barclays is helping clients deliver better experiences for their customers," adds Jason Manning, Vice President, Global Cash Management, at Barclays. "We are very excited to be working with CEGA to provide quick and easy settlement of claims through Pingit. Nobody wants to have to make a travel insurance claim, so we are pleased we can help make the reimbursement process as simple as possible.

"Feedback from customers who have had their claims settled by CEGA directly to their mobile phone has been really positive and it is great to see more and more people choosing to receive payments in this way," concludes Mr Manning.

"Pingit is among several of CEGA's recent innovative claims initiatives to fast track travel insurance claims," concludes Mr Heasman. "Together, these initiatives have seen customer compliments increase by nearly 100% in the last year."

Air Methods Corporation announced that it has entered into a definitive agreement to acquire Tri-State Care Flight (“Tri-State”) for $222.5 million.  Tri-State generated net revenue of $81.5 million for the fiscal year ended Dec. 31, 2014.

The transaction, which was unanimously approved by Air Methods’ Board of Directors, is expected to be immediately accretive to Air Methods’ earnings per share by greater than $0.20 in year one and by greater than $0.30 in year two.  Upon closing, Tri-State will become a wholly-owned subsidiary of Air Methods.

“We are very excited about the acquisition of Tri-State,” said Aaron Todd, chief executive officer of Air Methods. “It represents an opportunity to integrate best practices and further extend Air Methods’ commitment to quality, patient outcomes and safety. We look forward to welcoming Tri-State to the Air Methods team.”

Founded in 2002, Tri-State is a critical care transport provider servicing Arizona, New Mexico, Nevada, and Colorado. Tri-State’s primary mission is to rapidly transport critically ill and injured patients for health care facilities and emergency medical services (EMS) agencies while providing the highest level of care available.

Dr. Blake Stamper, founder and managing member of Tri-State, said, “As a global leader in air medical transport services, Air Methods shares our commitment to superior customer service and the  best clinical outcomes for patients in need. By combining with Air Methods, we will be able to serve even more patients across our footprint.  We are confident that this will be a seamless transition for our employees, patients and other stakeholders.”

Air Methods expects to finance the acquisition through its credit facility, which was recently amended in August to provide for additional borrowing capacity. The acquisition is subject to customary closing and regulatory conditions. The transaction is expected to close in 30 to 60 days.

The Company will discuss this transaction during its third quarter earnings conference call, which is scheduled today at 4:30 p.m. Eastern. Interested parties can access the call by dialing (855) 601-0049 (domestic) or (720) 398-0100 (international) or by accessing the web cast at www.airmethods.com. 

Income available to common stockholders in the third quarter of 2015 totaled $7.4 million, or $0.71 diluted earnings per common share, compared with $14.1 million, or $1.23 diluted earnings per common share in the third quarter of 2014.

Gross premiums earned in the third quarter of 2015 increased 16.7% to $103.8 million from $88.9 million in the same period in 2014. The increase was primarily due to the assumption of approximately 6,000 homeowners multi-peril policies and approximately 30,000 wind-only policies from Florida's state sponsored Citizens Property Insurance Corporation in December 2014 and 4,000 primarily homeowners multi-peril policies from Citizens in February 2015.

Premiums ceded in the third quarter of 2015 were $41.1 million, or 39.6% of gross premiums earned, compared with $27.7 million, or 31.1% of gross premiums earned during the same period in 2014. The quarter over quarter increase is primarily due to higher rates implemented by the Florida Hurricane Catastrophe Fund and an overall increase in units of reinsurance purchased for the 2015/16 reinsurance program.

Net premiums earned (defined as gross premiums earned less premiums ceded to reinsurance companies) in the third quarter of 2015 increased 2.5% to $62.8 million from $61.3 million in the same period in 2014.

Investment related losses during the quarter ended September 30, 2015 totaled $0.8 million. In addition, the company recognized a net non-cash charge of $1.9 million due to declines in the fair value of securities owned by the company determined to be other than temporary. The losses are primarily due to material market declines and volatility that occurred during the quarter.  This loss compares with $4.5 million in investment related income in the third quarter of 2014, which included $3.3 million of net realized gains from investment sales.

Losses and loss adjustment expenses during the third quarter of 2015 were $26.2 million compared with $22.0 million in the same period in 2014. We experienced significant weather-related events during the current quarter, which contributed to an increase in the volume of reported claims and losses incurred when compared to the same period in 2014. We also experienced unfavorable development during the quarter attributable to the settlement and further development of older claims.

Policy acquisition and other underwriting expenses in the third quarter of 2015 were $10.7 million compared with $10.0 million in the comparable period in 2014. The increase was primarily attributable to commissions and premium taxes related to the policies assumed in December 2014 from Citizens that have renewed and are included in 2015 premiums.

Salaries and wages during the third quarter of 2015 were $5.0 million compared with $4.4 million in the same period in 2014. The increase is primarily attributable to an increase in headcount at the Tampa headquarters.

Other operating expenses, which include a variety of general and administrative expenses, totaled $4.7 million in the third quarter of 2015 compared with $5.2 million in the third quarter of 2014. The decrease was primarily attributable to a $1.0 million decrease in stock-based compensation expense.

Third Quarter 2015 - Financial Ratios

The loss ratio applicable to the three months ended September 30, 2015 (defined as losses and loss adjustment expenses related to net premiums earned) was 41.7% compared with 35.9% in the three months ended September 30, 2014. The increase is attributable to higher reinsurance costs, which impacted net premiums earned, combined with significant weather-related events as well as unfavorable development that increased losses and loss adjustment expenses during the quarter.

The expense ratio applicable to the three months ended September 30, 2015 (defined as underwriting expenses, salaries and wages, interest and other operating expenses related to net premiums earned) was 36.9% compared with 36.2% for the three months ended September 30, 2014.

Expressed as a total of all expenses in relation to net premiums earned, the combined loss and expense ratio to net premiums earned was 78.6% in the third quarter of 2015 compared with 72.1% for the three months ended September 30, 2014.

Nine months Ended September 30, 2015 - Financial Results

Income available to common stockholders for the nine months ended September 30, 2015 totaled $54.8 million, or $4.84 diluted earnings per common share, compared with $48.1 million, or $4.07 diluted earnings per common share, for the nine months ended September 30, 2014.

Gross premiums earned for the nine months ended September 30, 2015 increased 17.2% to $321.2 million from $274.1 million in the same year-ago period.

Premiums ceded for the nine months ended September 30, 2015 were $100.3 million, or 31.2% of gross premiums earned, compared with $83.8 million, or 30.6% of the gross premiums earned, during the same period in 2014.

Net premiums earned for the nine months ended September 30, 2015 increased 16.1% to $220.9 million from $190.3 million in the same period in 2014.

Investment related income in the nine months ended September 30, 2015 was $2.1 million, which was offset by a $3.9 million non-cash charge for declines in the fair value of securities owned by the company determined to be other than temporary. This income amount compares with $8.2 million in investment related income in the nine months ended September 30, 2014, which included $4.5 million of net realized gains from investment sales.

Losses and loss adjustment expenses for the nine months ended September 30, 2015 and 2014 were $65.8 million and $58.9 million respectively.

Policy acquisition and other underwriting expenses for the nine months ended September 30, 2015 were $30.9 million compared with $28.7 million for the nine months ended September 30, 2014.

Salaries and wages during the nine months ended September 30, 2015 were $15.2 million compared with $12.6 million in the same period in 2014.

Other operating expenses totaled $14.0 million for the nine months ended September 30, 2015 compared with $15.9 million for the nine months ended September 30, 2014.

Nine months Ended September 30, 2015 - Financial Ratios

The loss ratio applicable to the nine months ended September 30, 2015 was 29.8% compared with 31.0% in the nine months ended September 30, 2014.

The expense ratio applicable to the nine months ended September 30, 2015 was 30.9% compared with 34.1% in the same period in 2014.

Expressed as a total of all expenses related to net premiums earned, the combined loss and expense ratio to net premiums earned was 60.7% in the nine months ended September 30, 2015 compared with 65.1% in the same period in 2014.

Management Commentary

"Despite the heavy rains in parts of Florida during the third quarter, our geographically diversified book of homeowners' insurance business was again able to produce profitable results," said Paresh Patel, HCI Group's chairman and chief executive officer. "As we look to the remainder of 2015 and beyond, our capital position allows us to patiently seek opportunities to add shareholder value."  

Aon plc (NYSE: AON) reported results for the three months ended September 30, 2015.

Net income attributable to Aon shareholders was $295 million, or $1.04 per share, compared to $309 million, or $1.04 per share, for the prior year quarter.  Net income per share attributable to Aon shareholders, adjusted for certain items, decreased 4% to $1.24, compared to $1.29 in the prior year quarter, including a $0.09 per share unfavorable impact on adjusted net income from continuing operations if the Company were to translate prior year quarter results at current quarter foreign exchange rates ("foreign currency translation").  The prior year quarter included a $25 million pre-tax, or $0.07 per share after tax, gain related to the sale of a business.  Certain items that impacted third quarter results and comparisons with the prior year quarter are detailed in the "Reconciliation of Non-GAAP Measures - Operating Income and Diluted Earnings per Share" on page 12 of this press release. 

"In our seasonally weakest quarter, our results reflect organic revenue growth and operating margin expansion across both segments, effective capital management and significant free cash flow generation, despite the impact of unfavorable foreign currency translation and macroeconomic challenges," said Greg Case, president and chief executive officer.  "Driven by our industry-leading portfolio and investments across data and analytics, we expect a strong fourth quarter and finish to the year across each of our key metrics, further positioning the firm for free cash flow generation and shareholder value creation."

THIRD QUARTER FINANCIAL SUMMARY

Total revenue decreased 5% to $2.7 billion compared to the prior year quarter driven primarily by a 7% unfavorable impact from foreign currency translation, partially offset by 2% organic revenue growth.

Total operating expenses for the third quarter decreased 5% to $2.3 billion compared to the prior year quarter due primarily to a $162 million favorable impact from foreign currency translation and a $12 million decrease in intangible asset amortization, partially offset by an increase in expense to support 2% organic revenue growth.

Depreciation expense decreased 8%, or $5 million, to $56 million compared to the prior year period.

Intangible asset amortization expense decreased 13%, or $12 million, to $78 million compared to the prior year quarter, consisting of a $10 million decrease in HR Solutions and a $2 million decrease in Risk Solutions.

Foreign currency exchange rates in the third quarter had a $0.09 per share, or $30 million pretax, unfavorable impact (-$25 million in Risk Solutions and -$5 million in HR Solutions) on adjusted net income from continuing operations, if the Company were to translate prior year quarter results at current quarter foreign exchange rates.

Effective tax rate used in the U.S. GAAP financial statements in the third quarter was 14.0%, compared to the prior year quarter of 19.1%.  After adjusting to exclude the applicable tax impact associated with expenses for legacy litigation incurred in the second quarter, the adjusted effective tax rate for the third quarter of 2015 declined to 16.0% compared to 19.1% in the prior year quarter, due primarily to certain favorable discrete items. 

Average diluted shares outstanding decreased to 283.8 million in the third quarter compared to 296.1 million in the prior year quarter.  The Company repurchased 6.3 million Class A Ordinary Shares for approximately $600 million in the third quarter.  As ofSeptember 30, 2015, the Company had $4.5 billion of remaining authorization under its share repurchase program.

Cash flow from operations for the first nine months of 2015 increased 22%, or $192 million, to $1.1 billion driven by working capital improvements and a decline in cash paid for pension contributions, taxes, and restructuring.

Free cash flow, defined as cash flow from operations less capital expenditures, for the first nine months of 2015 increased 21%, or $146 million, to $850 million driven by an increase in cash flow from operations, partially offset by a $46 million increase in capital expenditures primarily due to real estate related projects.  

THIRD QUARTER SEGMENT REVIEW

Certain noteworthy items impacted operating income and operating margins in the third quarters of 2015 and 2014.  The third quarter segment reviews provided below include supplemental information related to organic revenue, adjusted operating income and operating margin.

Risk Solutions total revenue decreased 8% to $1.7 billion compared to the prior year quarter due to an 8% unfavorable impact from foreign currency translation and a 1% decrease in commissions and fees related to acquisitions, net of divestitures, partially offset by 1% organic growth in commissions and fees.

Retail organic revenue increased 2% reflecting revenue growth in both the Americas and International businesses.  Americas organic revenue increased 4% driven by growth across all region and product lines, including strong new business generation in US Retail andCanada and effective management of the renewal book portfolio in Latin America.  International organic revenue increased 1% driven by growth in New Zealand and across Asia. 

Reinsurance organic revenue decreased 4% compared to the prior year quarter due primarily to an unfavorable market impact globally, a modest decline in facultative placements, and unfavorable timing, partially offset by record new business growth in treaty placements.

Compensation and benefits for the third quarter decreased 7%, or $76 million, compared to the prior year quarter due primarily to an $84 million favorable impact from foreign currency translation and a $9 million decrease in expenses related to acquisitions, net of divestitures, partially offset by an increase in expense to support 1% organic growth.

Other general expenses for the third quarter decreased 12%, or $52 million, compared to the prior year quarter due primarily to a $46 million favorable impact from foreign currency translation.

Third quarter operating income decreased 6% to $324 million compared to the prior year quarter. 

Leading international private medical insurance provider, Now Health International (www.now-health.com) has analysed almost 120,000 claims made by its customers and can now reveal the top twenty diagnoses in terms of frequency since the company started trading in 2011.  

Topping the list is Acute Bronchitis followed by sprains and strains and then lower back pain.  The full list is as follows:

1. Acute Bronchitis
2. Sprains and strains
3. Lower back pain
4. Acute Nasopharyngitis (common cold)
5. Diarrhea and Gastroenteritis
6. Fever
7. Cough
8. Urinary infection
9. Conjunctivitis
10. Gastritis
11. Chest pain
12. Rashes
13. Headache
14. Cervicalgia (neck pain)
15. Vitamin D deficiency
16. Influenza
17. Asthma
18. Eczema
19. Abdominal and pelvic pain
20. Dizziness and giddiness 

The top ten claims accounted for 77% of all claims made and the top twenty, 17%. Claims for list-topping Acute Bronchitis/Bronchiolitis amounted to 16% of all claims spread across the four years.

Although it didn’t make the top 20, Now Health has also somewhat interestingly received 29 claims for dog/other mammal bites over the last four years.  

Now Health’s Marketing and Ecommerce Director, Alison Massey, said, “As an Asian-headquartered business, much of our customer base reside in this part of the world. The region often experiences poor air quality due to pollution and other factors such as haze that comes from crop burning so it seems logical that a respiratory illness should top our list.” 

Massey continued, “We were also initially surprised at the number of claims associated with Vitamin D deficiency. However, we have discovered that it is the most common nutritional deficiency worldwide for both adults and children. And with many of our members based in the Middle East who spend much of their time in indoors and out of the blazing hot sun, it’s more understandable.”

Now Health International is one of the fastest growing providers of IPMI solutions for Global Expatriates, High-Net-Worth individuals and Small to Medium Sized Enterprises.  Just four years old and with more than 130 years of collective IPMI management experience, Now Health already has offices in the UK, Dubai, Hong Kong, Singapore, Shanghai, Beijing and Jakarta, with Abu Dhabi coming soon.

Despite weeks of intense negotiations with Ansarallah (Houthi) officials, Doctors Without Borders/Médecins Sans Frontières (MSF) cannot deliver stocks of essential medical supplies to two hospitals in a besieged enclave of the city of Taiz, in southern Yemen.

"The hospitals in this besieged area are seeing a large number of patients with war wounds," said Karline Kleijer, MSF emergency manager for Yemen. "And yet we have been prevented from delivering essential medical supplies—including chest tubes, anesthetic drugs, IV fluid, sutures, and antibiotics — to help staff provide lifesaving surgery."

Residents of the enclave in Taiz speak of increasing restrictions to bring in water, fuel, and food supplies. Prices within the besieged area have surged dramatically and people struggle to find enough drinking water.

"It is very frustrating that, after weeks of negotiations, we have made no progress in convincing officials of the need to provide impartial medical assistance to the victims of the ongoing fighting within this enclave, despite the continued support we are providing to health facilities in Houthi-controlled areas," said Kleijer.  

MSF calls on all warring parties to allow humanitarian and medical supplies into all areas, to facilitate access to medical facilities for all the sick and wounded, and to protect health care infrastructure and medical staff in accordance with international humanitarian law and Yemeni traditions.

Ordinary Yemenis living in densely populated areas of Taiz live in constant fear of snipers; stray bullets; and mortar shelling, which is being used indiscriminately by both warring groups; while airstrikes hit Taiz city on a daily basis. People struggle to reach clinics and hospitals due to the fighting, the difficulty of crossing front lines and the lack of transport due to fuel shortages. People seek medical care by visiting known nurses or doctors in their private homes.

The arms embargo on Yemen implemented by the Saudi-led coalition and the UN has turned into a de facto general blockade and led to countrywide critical shortages of food and fuel, which are only available at extortionate prices.

"A large part of the population of Taiz is displaced within the city," said Kleijer. "They are battling for their survival on a daily basis, and fighting to get a hold of sufficient food and water, due to the steep cost of basic necessities and the prevailing insecurity."

Taiz formerly had 20 hospitals for its population of more than 600,000. Due to the conflict, only six of these continue to function, and often only partially. They lack health staff, fuel, and essential medicines, and are overwhelmed by the high numbers of wounded people seeking access to their emergency services on a daily basis.

"The situation in Taiz is dramatic and will only get worse in the coming weeks if no efforts are made to spare civilians from the violence and allow them to access basic services, including health facilities," said Kleijer.  

As an impartial and neutral medical humanitarian organization, MSF supports all hospitals in need of essential supplies in Taiz, whether they are in areas controlled by Ansarallah/Houthi-affiliated forces or by local resistance. In Taiz alone, where MSF has worked uninterruptedly since May, 3,644 war-wounded patients have been treated in MSF-supported hospitals. More than 15,500 war-wounded patients have been treated in MSF-supported hospitals in Yemen since the beginning of March 2015.