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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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Nepali Government In Collusion With Private Clinic And Helicopter Company To Close IPPG Volunteer Clinics

Written by Jonathan Bancroft, Managing Director of Traveller Assist.

For the past two-years, the Nepali government has vehemently denied their involvement in the helicopter rescue scam that has defrauded millions of dollars from foreign insurers and claimed the lives of several trekkers. In fact, the Tourism Ministry has not only denied that the fraud happens at all, but they have also gone as far as to accuse the accusers of lying to frame them, in what has been assessed by PR and legal experts as a coordinated media campaign attempting to cover up the governments involvement.

However, a new deal that has been announced in Nepal appears to show collusion between the Government, a private clinic and at least one helicopter company.

Two well-respected, volunteer mountain and travel medicine clinics that have saved the lives of hundreds of travellers have been forced to close down by the local government who have been pressured into ending their agreement with International Porter Protection Group (IPPG) and Community Action Nepal (CAN).

IPPG had in the past provided free care for porters and local people, as well as providing treatment for trekkers with acute mountain sickness. Only 5% of patients that they saw were evacuated by helicopter, and only then in life-threatening situations.

But, since the new clinic has taken over, it’s estimated that over 60% of patients have been evacuated to Kathmandu to a hospital that is partly owned by the same people who also own a helicopter company; and profits greatly from medical rescues.

Gokyo International Medical Centre is a relatively new private clinic set-up to replace IPPG clinics in the Khumbu Region on the Gokyo trekking route, but instead of treating patients in place as IPPG had expertly done in the past, a majority of trekkers are now lifted by helicopter and taken to a hospital in Kathmandu.

Who owns what?

On the face of it, Gokyo International Medical Centre is owned by Tenzing Sherpa who is the owner of Namaste Lodge in Gokyo, and he runs the clinic with his brother who is a junior doctor.

However, the clinic itself is partnered with ERA Health Centre in Kathmandu and is financed by Mr. Bhanu Dhakal (who also owns First Assistance Nepal), Kumar Thapaliya (also owns Mountain Heli Charter Service) and Tashi Lakpa Sherpa (also owns Seven Summit Treks, 14 Peak Expeditions and Sherpa & Swiss Adventures).

The clinic is partnered with Easy Heli Charter Service, a company also owned by Tashi Lakpa Sherpa.

Both ERA Health Centre and Easy Heli Charter Service have both been named by the Government’s own investigation in a Kathmandu Post article for billing exorbitant rates, being involved in unnecessary helicopter rescues, over-treatment of patients to increase medical billing and misdiagnosis of patients.

In 2019, Seven Summit Treks were also fined for issuing fake permits to climbers for Everest and in addition, lost seven climbers on 8,000m peaks in Nepal. The family of one trekker was asked to pay $750,000 USD to recover his body.

Nick Mason, Chair of IPPG, a UK-based charity said, “The business model for the new clinic would appear to be to evacuate as many trekkers as possible to Kathmandu where it is alleged they are often subjected to excessive or fictitious investigations and treatment.”

IPPG said its doctors faced hostility and abusefrom local lodge owners with close ties to the new private clinic.

Heli rescue scam

In 2018, medical assistance company Traveller Assist announced that after a 12-month investigation, they had uncovered a helicopter rescue scam that had defrauded millions of dollars from foreign insurers and had claimed the lives of several trekkers.

On one side, officials from Nepal’s Tourism Ministry admitted that the fraud was happening and promised to investigate it, while on the other side, other officials were denying that it happened at all and instead pointed the finger at Traveller Assist. They issued a press release to say that an international assistance company had used lies to frame the governments involvement.

Danny Kaine, Head of Assistance at Traveller Assist, who also spearheaded the insurance fraud investigation said, “Just when we started to gain the cooperation of Tourism Ministry officials to stop the fraud from happening, other government officials derailed these talks by issuing bogus press releases to the local media who of course printed them and by doing so, became complicit in enabling the fraud to carry on.”

Nepal’s Tourism Ministry said last year that it investigated the scams, issued a report and drafted new rules governing helicopter rescue and medical treatment of trekkers to stop the fraud, but the rules were never implemented.

A government official inside the Tourism Ministry who does not wish to be named has said that the new rules were not implemented because the media pressure was no longer on them to do so and he also admitted that the government does profit, both directly and indirectly from the fraud.

Since 2018, Traveller Assist has deployed expat medical and rescue staff to Nepal at the beginning of each busy season, based at common rescue points, but they have received hostility and threats against them from local business owners who are losing money due to the crackdown on unnecessary helicopter rescues and over-treatment at hospitals.

Between October and December of 2019, Traveller Assist provided medical assistance for 113 cases, 51 of which required a helicopter rescue from 17 different rescue points, and included three horseback rescues to lower altitudes.

Jonathan Bancroft, Managing Director of Traveller Assist said, “It's worth noting that in the same time period, our in-country team has stopped an additional 17 unnecessary helicopter rescues from happening whereby the travellers' said they were almost being forced by trekking companies to be 'rescued' and Guides were using 'scare tactics' to panic the travellers. Our company also investigated over 100 invoices from four different hospitals in Kathmandu that were considered exorbitant and also billed for unnecessary treatment and fictitious treatment.”

The fraud is still happening.

Visit Nepal 2020

In a year that is being promoted by Nepal as ‘Visit Nepal 2020’ where the Government hopes to attract over 2 million visitors to the country, it’s imperative that all travel insurance companies educate their travellers on how to avoid being caught up in the scams in Nepal, and for all assistance companies to implement measures to protect both travellers and insurers.

Teladoc Health To Acquire InTouch Health

Teladoc Health, Inc. has announced it has entered into a definitive agreement to acquire InTouch Health, the leading provider of enterprise telehealth solutions for hospitals and health systems.

This acquisition positions Teladoc Health as the partner of choice for health systems seeking a single solution for their entire virtual care strategy, and establishes the company as the only virtual care provider covering the full range of acuity - from critical to chronic to everyday care - through a single solution across all sites of care worldwide.

''Today marks a bold leap forward in Teladoc Health's mission to transform how high-quality healthcare is accessed and experienced, making virtual care available for patients with even the most critical care needs," said Jason Gorevic, chief executive officer, Teladoc Health. "Bringing these companies together will make Teladoc Health the clear virtual care leader across every front door of healthcare, further accelerating the adoption and impact of virtual care for millions of people around the world."

This announcement comes at a time when demand for virtual care services within the provider market is poised for significant growth, as favorable reimbursement tailwinds increasingly equip hospitals and health systems to fully realize the value of virtual care. According to 2019 JPMorgan research, 40% of hospitals surveyed reported planning to increase their budgets for telemedicine solutions. With 61% of hospital revenue forecasted to come from managed and value-based care models by 2021, (L.E.K. 2018 Hospital Study Survey), virtual care will be a crucial strategy to improve consumer engagement, ensure consistent quality and manage health care's rising costs.

Health System's Single Solution for All Virtual Care Needs

Partnered with more than 450 hospitals and health systems with more than 14,500 physician users globally, and supporting 40+ clinical use cases, InTouch Health provides an award-winning, integrated suite of technology, software, purpose-built devices and a secure global network offering a high-quality managed experience for global health care providers. Together with Teladoc Health, the newly combined entity will be uniquely equipped to meet the growing needs of the provider market with one single, integrated solution spanning both consumer and provider-to-provider applications.

"Now is the perfect time for us to join together with Teladoc Health and deliver to hospitals and health systems everywhere what they've been asking for - a single, enterprise solution to support their virtual care strategies and enable them to better engage with patients at every point along their healthcare journey," said Joseph M. DeVivo, chief executive officer at InTouch Health. "Whether it's extending clinical capabilities, augmenting physician resources or supporting optimized outcomes, we are that trusted single partner to support them."

Expanding Care Capabilities and Supporting improved Outcomes

Virtual care will increasingly be adopted to improve patient outcomes as the need for care is expected to increase, driven by aging populations and the increasing prevalence of chronic diseases. Teladoc Health will be uniquely equipped to redefine the standard for where critical and specialty care can be accessed through a single virtual care solution that delivers longitudinal patient care — from the everyday to the most complex — anywhere, anytime. From stroke care to cardiology and more, this unmatched range of capabilities will enable clinicians to provide the best patient care both in medical facilities, as well as new locations such as home, transport and retail.

"With a continued focus on extending virtual care to new settings, expanding access and improving care coordination, our unmatched capabilities will extend both inside and outside the four walls of the hospital and empower care providers and patients alike," added Gorevic.

Transaction Summary

The transaction is expected to close by the end of Q2, subject to customary closing conditions. Under the terms of the agreement, the purchase price of $600 million will consist of approximately $150 million in cash and $450 million of Teladoc Health common stock. Lazard acted as sole financial advisor and Latham & Watkins LLP acted as legal advisor to Teladoc Health in the transaction. J.P. Morgan acted as sole financial advisor and Wilson Sonsini Goodrich & Rosati LLP acted as legal advisor to InTouch Health.

Financial Reporting and Business Outlook

InTouch Health is expected to generate 2019 revenues of approximately $80 million, growing approximately 35% versus the prior year.[1]  Upon closing of the transaction, Teladoc Health will provide an updated full-year 2020 financial outlook and guidance for the combined company after adopting recent U.S. GAAP accounting pronouncements as well as completing valuation and related purchase accounting considerations for InTouch Health.

Management Presentation

A live webcast of the presentation and supplemental presentation materials will be available on the investor relations section of the company's website at


Fox Flight Air Ambulance Expands Lear 40-XR Fleet

Fox Flight Air Ambulance has recently welcomed a third Lear 40-XR to its fleet of specially configured air ambulances.

This aircraft features state-of-the-art avionics and has been custom fitted for dedicated aeromedical operation. It joins two other Lear 40-XRs that were added to the fleet in April of 2019. Company president David Fox says the addition of the third Lear 40- XR completes the company’s planned overhaul of its equipment.

“Just over a year ago we made a decision to update our aircraft and move on from our old Lear 35s and Lear 36,” Fox explains. “After researching our options, we determined that the best aircraft for us was the Lear 40-XR. The longer fuselage has room for a washroom and extra baggage, which means more comfort and convenience for the patient, their companions and our crew. Plus the taller and wider cabin makes it easier for the medical crew to load and unload the patient and provide in-flight care.”

In addition to improved cabin amenities, flight crews on Fox Flight’s new Lear 40-XRs have benefited from a roomier cockpit, the up-to-date cockpit display and the latest aviation technology. “Our pilots are really enjoying flying the Lear 40-XR for a lot of reasons; it’s a big step up from our old fleet and takes our standard of service to the next level,” says Katrina Rankine, Fox Flight’s director of operations and chief pilot.

In addition to improving the repatriation experience for patients, companions and crews, Fox says the impetus to move to the Lear 40-XR was also driven by the ongoing maintenance demands of older aircraft. Says Fox: “Newer planes are just more reliable, and they are easier to fix if you do have a problem because there are abundant replacement parts available; that means it’s easier for us to keep our planes in the air and available for our clients.”

The latest Fox Flight air ambulance will operate under the tail designation C-FEMT, which stands for “Emergency Medical Transfer.” It joins C-FEMF (Emergency Medical Flight) and C-FEMC (Emergency Medical Care) to round out the fleet.

REVA Raises The Bar - New Aircraft Purchases Begins Migration to Most Modern Fleet in the Fixed Wing Air Ambulance Industry

REVA, Inc., has announced that the company has taken delivery of three Learjet 45XR aircraft. The new jets expand REVA's current fleet of dedicated air-ambulance aircraft and are a significant step in the company's fleet migration strategy.

"The Learjet 45XR, with its speed, range, versatility and reliability will make an exceptional addition to our fleet" said Shannon Schell, REVA's Chief Executive Officer. "The transition to the more modern L45XR is a significant milestone for REVA and will further solidify the Company's market leading position in the fixed-wing air medical transport industry. REVA now has not only the largest fleet, but going forward, the Company will also have the most modern fleet in the fixed-wing air ambulance industry. The Learjet 45XR is a meaningful upgrade from the Learjet 35's and will provide for greater uptime, reliability, and consistency for our clients. We are extremely excited about this transition and what it means for our clients, our employees and the company’s future.”

The Learjet 45XR is a mid-size jet with an interior that lends itself to simple modifications for comfortable and accessible medical configurations. In comparison to the Learjet 35, these new aircraft come with an expanded cabin, more headroom and overall superior comfort for the patient and their family.

Additional space inside the aircraft means that REVA’s medical teams will have more room to maneuver while providing the best patient care possible. "The patient experience is a key focus at REVA," said Philip Spizale, Chief Sales Officer. "These aircraft will enhance REVA's ability to deliver on that experience, in addition to providing comfortable and accessible seating for our medical teams and accompanying passengers." Not only is the interior easy to modify to meet and exceed air-medical-transport requirements, but the jets perform in the air too. Their range is more than 2,000 miles and they're fast with cruising speeds approaching 440 knots.

"These are modern aircraft built by a company with a proven track record," Schell said. "The Learjet is a fantastic aircraft for the medical-transport industry. Its safety record and dependability have set the standard in the private aircraft industry as a whole. These additions to our fleet create even more value in our service offering, which is what our clients expect from REVA."

Schell continued, "REVA will proceed to move in a direction that results in the most modern and reliable fleet in the industry. This effort, coupled with continuous crew training and the latest technology available in medical equipment and aircraft, will raise the bar in the air-medical-transport industry once again."

The new 45XRs will initially be based at REVA’s headquarters in Fort Lauderdale, Florida. REVA also operates from bases in New York, Arizona and Puerto Rico.

REVA plans to transition various aircraft within the fleet and replace them with more of these modern, reliable, more efficient and extra spacious aircraft over the next 18 months. Additional upgrades and expansion for the company will be coming in the near future.


AXA - Global Healthcare Upgrades Virtual Doctor App

AXA – Global Healthcare is improving its virtual doctor service, Global Care for Expats, with the launch of an improved mobile app and by rebranding to Virtual Doctor from AXA.

Originally launched in November 2018, the service offers all AXA Individual and SME customers with out-patient cover convenient access to internationally qualified, multi-lingual doctors over the phone 24 hours a day, or via a video consultation between 8am and midnight UK time. Now, the new app – available on iOS and Android – will provide an improved customer experience when seeking medical advice. Customers will benefit from improvements such as a simpler process for booking appointments, a geo-location feature and the ability to add insured dependants’ details (under 18), so that appointments can be booked on their behalf.

The service, provided by Teladoc Health, a global leader in virtual care, has been well received, with users rating it an average of nine out of 10 for experience and 99% saying that they would recommend it to friends or family. Along with the speed of the service, in many cases, AXA’s members have reported that the doctor’s advice enabled them to confidently recover at home or avoid a trip to the emergency room, with others being guided to see a specialist the following day. Various AXA members have even been quoted as saying that “I couldn’t believe how quick it was,” and “The doctor was better than my own GP.”

Kevin Melton, Global Head of Sales and Marketing, AXA – Global Healthcare commented, “In the year since its launch, our virtual doctor service has been a great help for our customers; not just in their time of need, but also in proactively supporting globally mobile customers with health questions, such as vaccination advice. The confidence that comes from speaking one on one, to an independent doctor they can trust, for as long as they need to, in a language they’ve chosen, and who can help them navigate their local healthcare system, should never be underestimated.”

Since launch, the service has already connected customers with a doctor consultation in more than 75 countries around the world and supported a wide range of medical conditions, with more consultations happening every day. Users have reported using the service to receive a recommended treatment path after being involved in a car accident, advice for an injured knee when they were unable to walk or drive to the doctor’s surgery, and even a same-day prescription of antibiotics for a throat infection. AXA is confident that the upgraded app will continue to drive usage even further.

The virtual doctor service is now also part of AXA’s enhanced integrated care proposition, whereby customers can be supported by the same doctor from a primary care consultation into a second medical opinion, where needed. Their case can be reviewed from a global network of 50,000 medical experts across 450 specialties, and the member is offered clinical care management for ongoing cases.

Kevin Melton concluded, “It doesn’t matter where you are, feeling unwell or uncertain about a medical condition can be unsettling, but being away from home can add additional uncertainty. By offering our customers coordinated care from their primary consultation through after treatment support, they can receive independent, consistent advice throughout their healthcare journey.”

Carlos Nueno, President of Teladoc Health International says: “We are proud to work with AXA – Global Healthcare to offer a virtual care solution capable of serving patients globally. Our telehealth service aims to help patients to resolve their healthcare needs through on-demand or scheduled medical consultations with licensed doctors; delivering high-quality care through their smartphone, from the comfort of their home, at work or while travelling. With Virtual Doctor, AXA – Global Healthcare helps to improve waiting times, provides health outcomes faster and avoids unnecessary trips to the doctor."

A Post-Brexit Checklist for Expats

With Gordon Delaney, Regional Head of Europe, AXA – Global Healthcare.

For a long time now, travelling between Europe and the UK has been relatively pain-free. With Brexit on the horizon though, it’s time to start thinking about the various extra considerations that it may cause before travelling.

UK citizens considering moving to or travelling in the European Union (EU) from February onwards are likely to have a lot more to check off their list before they leave.

With this in mind, we at AXA – Global Healthcare have put together a checklist of some of the most important questions that you may need to ask yourself before moving to or travelling in the EU post-Brexit:

How will you access and pay for your medical needs?

Our own research* has found that 84% of expats living abroad have needed access to healthcare, but only one in ten (10%) prioritised preparing for this before they left. When moving to the EU, many Brits may rely heavily on their European Health Insurance Card (EHIC) for the first few months, until they’ve settled in, despite it only being designed to cover short term healthcare needs. In the event that it isn’t valid after Brexit, though, you’ll definitely need to take a look at your options and work out what type of healthcare cover you might need from day one of your time abroad.

Of those surveyed who have used healthcare whilst living abroad, a fifth (18%) needed emergency care. So, remembering that in some countries, you could rack up a hefty bill from just a trip to hospital in an ambulance is really important.

Do you travel for work?

Getting a new job is never easy, whether it’s at home or abroad, so it’s important to make sure you have all the right preparations in place. If you’re finding yourself a new job in the EU, think about whether you’ll need a visa and whether your job will require travel across borders. After Brexit, laws regarding your freedom of movement throughout the EU might change, so make sure to check whether or not you can travel between the required countries before attempting to do so.

Commuting is also a vital part of working life, so you’ll also need to check whether or not you can still drive throughout the EU and whether you’ll need additional insurance cover. One important thing to remember is that some countries might require you to have an international driving permit.

Are your finances in order?

We know that only a quarter (24%) of expats prioritise preparing their finances before moving abroad, but it’s certainly a good idea to make sure everything is in order before you go.

If you’re planning to work abroad, think about which account your wages will be paid into. Do you need to set up a local bank account? It’s worth researching whether any specific banks offer benefits or better rates for expats. After all, everyone wants to get that little bit more for their money.

More broadly, it’s worth considering what will happen to your pension, life insurance and mortgage. The best way to work this out is to contact your service provider and make sure that everything is in place before you move.

Tax is another area that could be impacted in a big way post Brexit, so making sure you’re up to date with any decisions that are made is vital. One thing that could have a big impact on your monthly income is whether or not tax-free pension transfers will still apply. Even if you’re a long way off retirement age, it’s worth taking some time to think about what will happen if you live in the EU when you eventually do qualify for your pension.

Are you taking your family pet?

Taking a pet abroad has always had its complications. From getting a pet passport, right through to signing up to a local vet once you’ve arrived, there can be a lot to consider. Making sure that your furry friend has the right vaccinations though is incredibly important, as well as thinking about whether they’ll need to be quarantined before entering the country.

But, after Brexit, there will probably be more checks that you and your pet will need to observe in order to travel to the EU. According to the government, the UK is likely to be categorised as an ‘unlisted’ country by the RU Pet Travel Scheme. If it is, all pet owners hoping to take their dog, cat or ferret abroad will need to make sure they’re microchipped and vaccinated against rabies. You’ll also need to remember to send a blood sample to an EU-approved blood testing lab three months before you can travel abroad.

Can you still stock up on home comforts?

Coming second only to family and friends, half (48%) of expats from the UK said that local food and drink was the thing they missed most about their home country.

Leaving the EU without a deal could mean tougher restrictions on taking certain foods into Europe. Animal products – meat, fish, and dairy for example – in particular could be subject to increased controls. So, if you were hoping to take a little bit of fresh British cuisine abroad to help with homesickness, you might need to think again.

What if you’re an EU citizen in the UK?

British expats aren’t the only ones with Brexit-related challenges to overcome. Our own research has found that a third (31%) of expats living in the UK are concerned about domestic politics, and it seems there are a number of reasons for them to feel distressed.

For example, if you’re an EU citizen and have been living in the UK for five years or more, you can apply for permanent residency status. This essentially means that you’ll be able to continue living and working in the United Kingdom for as long as you choose, as well as access the National Health Service. If you’re an EU citizen looking to make the move to the UK after Brexit though, there’s still no word on what this process might look like.

The weeks and months ahead are likely to be very confusing for both UK citizens moving to Europe and European citizens in the UK. The most important thing is to be prepared and do your research before making any commitments, and make sure you’ve considered every eventuality.


De Goudse Adds Value To Services In New Partnership With Healix International

Diverse client base, including NGOs, set to benefit from access to high quality medical and travel assistance services.

Healix International, the global travel risk management and international medical and security assistance provider, has been chosen by the innovative Dutch De Goudse insurance provider to deliver medical and travel assistance for its corporate clients.

Based in Gouda, the Netherlands, De Goudse has a proud history of innovation and delivering outstanding insurance and financial products for businesses and consumers. From its humble beginnings in 1924, the company now employs over 500 people, and offers a wide range of corporate and tailored business solutions, including business and personal travel insurance. In particular, the firm supports a number of NGOs which often face the challenge of sending workers to regions of the world where healthcare is less accessible or reliable.

Under this exciting new partnership, De Goudse’s clients will benefit from Healix’s extensive global experience in medical assistance should the unexpected happen.  With a wealth of expertise, Healix International can manage and co-ordinate the medical treatment, evacuation and repatriation of people taken ill or injured while overseas.

De Goudse clients will also have 24/7 access to Healix’s dedicated team of experienced travel assistance coordinators who provide a full range of services, such as travel and visa advice, embassy referral and visa assistance, as well as lost luggage and arrangement of interpreters.

Les Davis, Team Manager Expatriates & Travel, De Goudse, said: “Trust in our partners is very important to us. As an independent family business we are proud to have achieved the Customer-Oriented Insurance Quality Mark.  With Healix’s enviable reputation of being a leading provider of assistance services and risk management solutions, we are convinced they are the right partner for us.

“Healix International is helping us take our corporate offering to a new level. Because every sector is unique and has its own challenges, this agreement ensures we can give our clients the flexibility they need to offer their customers.

Through this partnership we are providing the reassurance that they will be covered for unexpected medical emergencies and will receive the best, vital support at a time of crisis.”

Juan Peña Núñez, Business Development Director, Healix International added: “We are delighted to be working with De Goudse to help extend its travel offering to corporate clients. The De Goudse name is synonymous with trust and it gives many major Dutch brands peace of mind that their clients are safe and fully supported in the event of an emergency.

“This agreement ensures De Goudse can continue to give its clients that assurance of quality and professional service for international travel.”


Pacific Prime Dubai Receives Cigna’s Individual Broker Of The Year 2019 Award


Pacific Prime has been awarded Individual Broker of the Year 2019. They received the award at the Cigna Partner Seminar (Middle East and North Africa [MENA] region), which took place on December 14th, 2019 in Cape Town, South Africa.

Richard Rilesone (Cigna’s Director of Sales and Client Management for the MENA region) and Jerome Droesch (CEO of Cigna for the MENA region) presented the award to representatives from Pacific Prime Dubai at the seminar.

CEO Jerome Droesch said, “I would like to extend my congratulations to Pacific Prime for winning the IPMI Broker of the Year award. This award recognizes their unique contributions and dedication which have helped us build our IPMI offering and broaden our services to our customers.”

RELATED: iPMI Magazine Speaks With Jerome Droesch, CEO, Cigna, MENA

“Pacific Prime’s approach with clientele in the SME and individual health insurance space has set them apart this year and we look forward to continuing our relationship to deliver excellence and meet our customers’ needs.”

Nageen Sattar, Director, Regional Client Services at Pacific Prime Dubai, was one of the recipients who received the award on behalf of Pacific Prime. “It’s rewarding to see the results of working closely with Cigna regarding their individual product in such a short time span. We have advised, and worked with, Cigna on their DHA plan since their initial launch in late 2017.”

“In 2018, we sat with Cigna numerous times to design a new plan that would be competitive in the marketplace, resulting in a complete redesign of their UAE product followed by a relaunch in February this year. We have now increased the policy count by 70%, and are getting close to USD $1 million in premium with them this year. We look forward to continuing to work closely with Cigna and achieving mutually beneficial results.”

Pacific Prime is a global health insurance broker that provides health insurance coverage to over half a million people in more than 130 countries. Along with health insurance, Pacific Prime also provides comprehensive company insurance and employee benefits solutions, with over 4,000 corporate clients around the world.

As a global health service company, Cigna offers a variety of personalized insurance solutions including health, dental, pharmacy, and supplemental. Cigna has over 165 million customers in over 30 countries, making it possible for them to make use of their insights to improve healthcare results.

Stable Passenger Demand Growth November 2019

Global passenger traffic results for November 2019 show that demand (measured in revenue passenger kilometers or RPKs) rose 3.3% compared to the same month in 2018.

This was unchanged from October’s result and below the long-term trend. Capacity (available seat kilometers or ASKs) increased by 1.8%, and load factor climbed 1.1 percentage points to 81.1%, which was a record for any November. All regions saw annual increases in traffic.

“November’s moderate result reflects the continuing influence of slower economic activity, geopolitical tensions and other disruptions, including strikes in Europe. On the plus side, positive developments in the US-China trade talks, in tandem with signs of improving business confidence, could support an uptick in travel demand. In the meantime, continued modest capacity growth is helping to maximize asset efficiency,” said Alexandre de Juniac, IATA’s Director General and CEO.

Total Market
Asia Pacific
Latin America
Middle East
North America

1- % of industry FTKs in 2018 2- Year-on-year change in load factor 3-Load factor level

International Passenger Markets

November international passenger demand rose 3.1%, compared to November 2018, which was a marginal increase from the 3.0% year-over-year growth achieved in October. All regions recorded traffic increases, except for Latin America. Capacity climbed 0.7%, and load factor increased 1.8 percentage points to 80.1%.

Asia-Pacific airlines saw November traffic increase 3.9% compared to the 2018 period, a slight decline compared to the 4.2% annual growth recorded in October. Capacity rose 2.8% and load factor rose 0.8 percentage point to 79.9%. While seasonally-adjusted volumes are increasing, the trend has moderated. Disruptions in Hong Kong, slowing demand in India and China and less supportive business confidence in several key economies are among the contributing factors.

European carriers experienced a 1.2% increase in November traffic, down from 1.6% growth in October and the weakest outcome since early 2013. Industrial actions (strikes) disrupted operations for a number of airlines during the month, contributing to the demand slowdown. Capacity dropped 1.1% and load factor rose 1.8 percentage points to 83.8%.

Middle Eastern airlines posted a 7.4% traffic increase in November, up from a 5.6% rise in October. Capacity was flat, and load factor soared 5.0 percentage points to 73.2%. The strong performance was driven by robust demand on to/from Asia and Europe markets.

North American carriers’ international demand climbed 2.3% compared to November 2018, down from the 3.6% growth recorded in October. Despite a slowing in economic activity, fundamentals remain generally sound for the region, although the rise in geopolitical tensions may impact international demand going forward. Capacity rose 1.6%, and load factor accelerated 0.6 percentage point to 81.2%.

Latin American airlines had a 0.3% traffic decline in November compared to a year ago, in line with October’s decline. Capacity slipped 1.8% and load factor increased 1.3 percentage points to 82.1%. Economic headwinds and/or social unrest in a number of countries in the region contributed to the lowered result.

African airlines’ traffic climbed 4.9% in November, up from 2.3% growth recorded in October. Challenges in the South Africa market have been more than offset by strong performance elsewhere in the region. Capacity rose 2.8%, and load factor climbed 1.4 percentage points to 70.3%.

Domestic Passenger Markets

Demand for domestic travel climbed 3.5% in November compared to November 2018, which was a marginal decline from 3.7% annual growth recorded in October. Capacity rose 3.8% and load factor slipped 0.2 percentage point to 82.8%.

Dom. Australia
Domestic Brazil
Dom. China P.R
Domestic India
Domestic Japan
Dom. Russian Fed.
Domestic US

1- % of industry FTKs in 2018 2- Year-on-year change in load factor 3-Load factor level

Indian airlines experienced a return to double-digit growth for the first time since January 2019, as traffic rose 11.3% compared to November 2018. However, economic growth in the third quarter was the weakest in around six years amid a broad-based slowdown that is affecting many sectors of the economy. This will present a more challenging environment for the industry going forward. 

Japan’s airlines saw domestic traffic climb 3.7% in November, more than double the 1.8% increase recorded in October. While growth has been volatile over the past six months or so, the bigger picture is that seasonally-adjusted volumes are trending modestly upward.


Stress-Related Illness The Biggest Health Expenditure In The UK Annually, Cigna Report Finds

More than 68 million GP appointments and 3 million emergency department visits were caused by stress-related illnesses, a new report by Cigna and Asia Care Group has revealed.

The report, titled 'Chronic Stress: Are we reaching health system burn out?', analysed the most up-to-date patient data to reveal the annual expenditure on stress-related illness across both the NHS and private care sector. This translates as the largest single area of spend in the UK health sector today.

The key findings include:

  • Stress-related illnesses (such as stress-related mental illnesses, stress which manifests as medically unexplained conditions, and stress which manifests as physical symptoms) were estimated to cost the NHS over £11billion, representing 6.8% of total health expenditure.
  • More than 3million emergency department visits were driven by stress-related illness
  • More than 9million outpatient attendances related to stress
  • Over 5.5million inpatient admissions were driven by stress-related illness; the largest proportion of stress-related healthcare expenditure, accounting for 23% of all inpatient spend
  • Stress also accounted for a third of primary care expenditure (33%), at a cost of £108billion and £238million to government and the private sector, respectively

Analysing the impact of stress-related illness in nine markets, including the UK, the US and Australia, the research was commissioned to obtain a global picture of the huge financial burden that stress-related illness is putting on health systems. As many as 25% of global hospital admissions, 19% of emergency department attendances, 35% of primary care visits, and 12% of outpatient attendances are likely to be the result of conditions driven by stress.

Dr Peter Mills, Cigna Medical Director, said, "This research highlights the massive financial burden that stress-related illness is putting on health systems, not only in the UK but across the globe. Although stress will always exist, we believe better awareness and indeed early diagnosis can help people to live happier, more productive lives, reduce physical illness and avoid these significant misdirected costs on our health systems worldwide.

"Action is needed to address the causes of stress in the UK, as well as support people to better manage stress and ensure systems are in place to identify and treat stress-related illness. As a country, our research shows that 72% of Brits suffer from stress, and we urgently need a better understanding of how stress can manifest itself and how employers can play a crucial role in helping their staff better identify and manage stress before it becomes a chronic condition. Luckily there are now a number of health and wellbeing strategies that employers can adopt to create healthier, happier workplaces and moreover, a more caring and open culture, where people feel they can discuss stress-related issues."

As well as analysing the health service usage by people suffering from stress-related conditions, the research analysed the usage by people who sought medical help for unexplained physical issues or symptoms and mental health conditions that are commonly associated with stress. The research concluded that managing and treating all these patients was extensive, with significant costs associated.

Hospital-led health systems were observed to spend considerably more on stress-related conditions than systems in which strong primary care is in place. This emphasises the need to consider how preventative, community-based services could be better used to manage-down the clinical and financial risks posed by excessive stress.

Dr Peter Mills, Cigna Medical Director, added, "Despite experiencing signs of mental illness caused by chronic stress, many people do not seek medical help straightaway, waiting until they experience physical symptoms. This is likely because in many countries, including the UK, mental health is still taboo and seeking help for physical symptoms has more cultural acceptability.

"Challenging and breaking taboos will encourage people to seek help earlier, potentially reducing the impact and related cost of stress. Healthcare leaders, government, employers and individuals have a role to play in breaking taboos and encouraging people to talk to someone early and finding solutions."

The research follows a global campaign by Cigna, See Stress Differently, which aims to raise awareness and encourage people to talk to their medical professional about stress, and help people create a clear plan to better manage stress and its side effects. As part of the campaign, Cigna partnered with doctors, technologists and renowned digital artist, Sean Sullivan, to create a first-of-its-kind stress visualisation technology, combining biometric data and digital art to create moving images showing the physical and emotional signs of stress in the body and mind.

To read the full report, "Chronic Stress: Are we reaching health system burn out?" please visit:

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