ROUND TABLE: Defining International Assistance In 2014 And Beyond Part 1 - OUT NOW by iPMI Magazine Health and Medical Insurance Assistance News Magazine

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ROUNDTABLE SESSIONS 2014

1087 MILLION

TOTAL NUMBER OF TOURIST ARRIVALS 2013

52 MILLION

MORE TOURIST ARRIVALS IN 2013 THAN 2012

56.8 MILLION

TOTAL NUMBER OF EXPATRIATES WORLDWIDE BY 2017

50.5 MILLION

TOTAL NUMBER OF EXPATRIATES WORLDWIDE IN 2013

46 MILLION

TOTAL NUMBER OF EXPATRIATES WORLDWIDE IN 2009

2013 WAS AN EXCELLENT YEAR FOR INTERNATIONAL TOURISM Taleb Rifai UNWTO Secretary General

DEFINING ASSISTANCE IN 2014 AND BEYOND PART 1 EXCLUSIVE C-SUITE EXECUTIVE COMMENTARY FROM ALLIANZ GLOBAL ASSISTANCE, ATHENS ASSISTANCE, EUROP ASSISTANCE, MEDIC ASSISTANCE INTERNATIONAL, REUTER CONSULTING AND ROWLAND BROTHERS.

INTERNATIONAL ASSISTANCE ROUND TABLE BUSINESS FORUM SESSION 001

iPMI Magazine | International Assistance Round Table Business Forum

CONTENTS 14|

PLEASE INTRODUCE YOURSELF AND BACK GROUND IN THE MEDICAL AND TRAVEL ASSISTANCE INDUSTRY:

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WHICH AREA OF THE ASSISTANCE BUSINESS DO YOU REPRESENT?

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WHAT IS MOST IMPORTANT WHEN PROVIDING INTERNATIONAL ASSISTANCE?

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WHAT BENEFITS WILL AN OUT SOURCED ASSISTANCE SERVICE OFFER AN INSURER?

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HOW DOES YOUR BUSINESS DEFINE ASSISTANCE IN 2014?

VIP ASSISTANCE RT

iPMI MAGAZINE | MARCH 2014

iPMIM DO YOU FEEL ITS IMPORTANT TO KEEP UP TO SPEED WITH INDUSTRY NEWS?

WE HAVE YOU COVERED

iPMI Magazine | International Assistance Round Table Business Forum

CONTENTS 32 |

YOU HAVE HANDLED MANY MEMORABLE CASES. WHICH ONE WAS MOST UNIQUE AND WHY?

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GEOGRAPHICALLY SPEAKING, WHERE CAN YOU PROVIDE RELIABLE ASSISTANCE SERVICES?

WHAT POLICIES MAY BE IMPROVED BETWEEN PAYORS AND THIRD PARTY SERVICE PROVIDERS?

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PAYORS ARE BUILDING WORLDWIDE CUSTOM NETWORKS. WHAT CAN YOU OFFER?

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Q10

HOW IS YOUR ORGANIZATION LEVERAGING TECHNOLOGY IN SERVICE DELIVERY?

VIP ASSISTANCE RT

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iPMI Magazine | C-Level International Assistance Round Table Business Forum

Roundtable

ARRIVALS

iPMI Magazine | C-Level International Assistance Round Table Business Forum

ROUND TABLE DELEGATES

ALLIANZ GLOBAL ASSISTANCE

ATHENS ASSISTANCE

EUROP ASSISTANCE-GCS

MEDICASSISTANCE INTERNATIONAL

REUTER CONSULTING

ROWLAND BROTHERS

ERICK MORAZIN

FRANK REUTER

In A Closed Door Exclusive Round Table Business Forum iPMI Magazine Spoke With Industry Leaders From The International Assistance Market. The 1st In A Series Of VIP Assistance Round Table Business Forums, We Focus On The Definition Of Assistance In 2014 Including Service Capability, Geographic Reach, Memorable Cases, Custom Networks, The Benefits Of Outsourcing And The Adoption Of New Technology. Featuring C-Level Executive Commentary From Allianz Global Assistance, Athens Assistance, Europ Assistance, Medic Assistance International, REUTER Consulting And Rowland Brothers. A BIG THANK YOU TO ALL OF OUR SPONSORS AND SUPPORTERS ESPECIALLY EUROP ASSISTANCE WHO MADE THIS ROUND TABLE BUSINESS FORUM POSSIBLE.

FLORENCE JEAN

Roundtable

DR. SIDDICK MAUDARBOCUS

DR. DIMITRIS KOLINIATIS

STEVE ROWLAND

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FRONT COVER The foot prints of a missing expatriate traveller, lost in a blizzard on a ski expedition.

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iPMI MAGAZINE | MARCH 2014

iPMIM KEEPING YOU 1 STEP AHEAD AND ON THE INSIDE TRACK OF GLOBAL HEALTHCARE

iPMI Magazine | International Assistance Round Table Business Forum

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NUMBERS 1087 MILLION

TOTAL NUMBER OF TOURIST ARRIVALS 2013

52 MILLION

MORE TOURIST ARRIVALS IN 2013 THAN 2012

TOTAL NUMBER OF EXPATRIATES WORLDWIDE BY 2017

50.5 MILLION

TOTAL NUMBER OF EXPATRIATES WORLDWIDE IN 2013

46 MILLION

TOTAL NUMBER OF EXPATRIATES WORLDWIDE IN 2009

Roundtable

56.8 MILLION

iPMI Magazine | International Assistance Round Table Business Forum

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2013 WAS AN EXCELLENT YEAR FOR INTERNATIONAL TOURISM

â&#x20AC;&#x153;2013 was an excellent year for international tourism. The tourism sector has shown a remarkable capacity to adjust to the changing market conditions, fuelling growth and job creation around the world, despite the lingering economic and geopolitical challenges. Indeed, tourism has been among the few sectors generating positive news for many economies.â&#x20AC;? Taleb Rifai UNWTO Secretary General

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nternational tourist arrivals grew by 5% in 2013, reaching a record 1,087 million arrivals. Despite the current global economic climate, international tourism results were well above expectations, with an additional 52 million international tourists travelling the world in 2013. For 2014 the UNWTO forecasts 4% to 4.5% growth, above the long term projections. Demand for international tourism was strongest for destinations in Asia and the Pacific (+6%), Africa (+6%) and Europe (+5%). The leading sub-regions were South-East Asia (+10%), Central and Eastern Europe (+7%), Southern and Mediterranean Europe (+6%) and North Africa (+6%). The UNWTO forecasts international arrivals to increase by 4% to 4.5% in 2014, again above its long-term forecast of +3.8% per year between 2010 and 2020.

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PLEASE INTRODUCE YOURSELF AND BACK GROUND IN THE MEDICAL AND TRAVEL ASSISTANCE INDUSTRY:

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Florence Jean: I am the Chief Commercial Officer of Europ Assistance - GCS. I have 18 years of experience in the Travel Assistance and Insurance industry with various management positions from the Operations to the General Management of a Business unit. I joined the Europ Assistance Group in 2006. After working in business development within the regions of the Indian Ocean, Lebanon and Tunisia, I was appointed Head of the International Network Department. During the 4 years I spent as Head of the International Network Department, I accomplished several projects including improving the Europ

Assistance Group network’s dynamic and efficiency, the Cost Containment Global Program and the Operational Knowledge Management sharing database. I joined the Sales and Marketing team of Europ Assistance - Global Corporate Solutions (GCS) in 2010 as VP Business Development for Africa and Central Asia. As GCS’ Chief Commercial Officer since 2011, I am responsible for the development and integration of the 3 business lines across GCS’ entities. My strong entrepreneurial sensitivity brings a dynamic and structured growth approach to GCS.

ROUND TABLE DELEGATES

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PLEASE INTRODUCE YOURSELF AND BACK GROUND IN THE MEDICAL AND TRAVEL ASSISTANCE INDUSTRY:

Steve Rowland: Managing Director, Rowland Brothers International. People often ask how on earth did I get into this industry – the simple answer is that I was born and bred to serve in the industry – I am the fifth generation of the Rowland family to manage Rowland Brothers which was founded in 1873. We have four generations of the family working in the company today – including my grandmother at the grand age of 96yrs young who ran the company when her husband and brother-inlaw were fighting in Egypt and France during the WWII - I don’t think too many family businesses have achieved that milestone. Family is very important to us all at Rowland Brothers. I started working for Rowland Brothers during my school holidays from the age of 12 helping to make coffins and cremation urns. When I left school, I took my father’s advice and worked elsewhere for a number of years.

I started in the claims department of an insurance company and learned much about handling clients who find themselves in difficult circumstances – however my true calling couldn’t be denied, so started my training with a corporate funeral directors. I learned a great deal, in how to arrange funerals and how not to! I then took a business degree at the University of Buckingham, did the usual gap year travelling around the world and in 1990 returned to Rowland Brothers to work from the ground up including chauffeur/bearing, arranging and conducting funerals, repatriations, funeral plans, memorials, etc, working my way through all departments. In 2007 my sister Melanie and I purchased the company from our uncles and then implemented a series of improvements which continue to this day helping us to develop professional services to the families we serve.

ROUND TABLE DELEGATES

iPMI Magazine | C-Level International Assistance Round Table Business Forum

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Roundtable

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PLEASE INTRODUCE YOURSELF AND BACK GROUND IN THE MEDICAL AND TRAVEL ASSISTANCE INDUSTRY:

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iPMI Magazine | C-Level International Assistance Round Table Business Forum

Dr. Siddick Maudarbocus: I am Director of Medic Assistance International Ltd Mauritius and trained as a doctor in Dublin, Ireland. I worked in several positions and during an overseas contract as an emergency doctor for Exxon Oil Exploration project in Central Africa in 1986. I got passionate about helping save lives in difficult circumstances and assisted MSF in Chad and Darfur. I came back in Mauritius in 1988 and started my own assistance company in 1991. To serve the tourist industry mainly. Since then I have been involved on all fronts within the travel and medical industry. Mauritius has become a

sought after tourist destination and the government has kept the Haut de gamme image. When we first started in 1991, we selected a team of the best specialists on the island and we helped many patients/clients to access first class medical care by using this network. In Mauritius government hospitals offer free service and medication but the standard of care may vary greatly depending on the healthcare facility and which doctor one come across. Hence we provide insurers and assistance companyâ&#x20AC;&#x2122;s access to our own healthcare provider network of professionals and clinics to deliver a UK standard of care and service.

iPMI Magazine | C-Level International Assistance Round Table Business Forum

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Erick Morazin: I am the Chief Sales Officer Asia-Pacific at Allianz Global Assistance (AGA) since August 2012, managing AGA Sales and Marketing activities across AsiaPacific, the AGAâ&#x20AC;&#x2122;s fastest growing Zone. AGA B2B and B2B2C distribution model covers all markets with dedicated solutions for Insurance companies as well as Banks, Travel & e-Commerce (for Travel insurance mainly), Automotive (for roadside assistance) and other retailers (for specialty assistance services such as home and

life care assistance services). Previously, Global Accounts Director at Allianz Global Assistance since January 2009, managing global partners in the Automotive, Bank & Insurance, Health & Life Care, Telecommunication and Travel markets worldwide. Appointed by Allianz Global Assistance in September 2005 as International Sales Director Travel. Recently launched the Space Travel Insurance & Assistance concept at AGA.

ROUND TABLE DELEGATES

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PLEASE INTRODUCE YOURSELF AND BACK GROUND IN THE MEDICAL AND TRAVEL ASSISTANCE INDUSTRY:

Roundtable

iPMI Magazine | C-Level International Assistance Round Table Business Forum

Dr. Dimitris Koliniatis: I am Founder, CEO and Medical Director of Athens Assistance since 1993. Born in Athens in 1959 and graduated from Athens University Medical School in 1983. After two years as a general practitioner on a remote island, I specialised in Athens in general surgery, laparoscopy, emergencies and ICU. Since then offered services as a general surgeon and as a medical officer in cruise boats and emergency depts. of private clinics. In 1993 I was a founding member of SOS Doctors (offering in-house extra- and pre-hospital care with continuous educational programs for the doctors)

plus a founding member of Athens Assistance, offering full range of medical and travel assistance services. As a medical director in these structures I established the assistance medicine as a distinct entity in the usual medical practice in Greece. I created the Medevac aeromedical team and in 2001 I installed the first telemedicine station in Metropolitan hospital. Today I manage Athens Assistance and our aeromedical services. In 1993 we joined International Assistance Group and in the last six years we were awarded 5 times, best assistance company in quality among all the partners of the Group.

iPMI Magazine | C-Level International Assistance Round Table Business Forum

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Roundtable

Frank Reuter: Owner of REUTER Consulting. I have been active in the field since 1989 and have worked for renowned assistance companies such as International SOS and Allianz Global Assistance. My team and I are experts within the International Health Insurance and Travel Assistance world. REUTER Consulting acts as independent consultant and Interim Manager for a number of international organizations within the area

of Global Mobility, Health Insurance and Travel Assistance. Includes professional consultancy services for Private Corporations including Business Travel Risk Management Plans, Global Mobility Planning; Occupational Health; Expat Security Management. For insurers we provide restructuring services, strategic advice focused on the current state of the market, distribution channels, market entry, and product positioning.

ROUND TABLE DELEGATES

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INSURERS REQUIRE ALL TYPES OF ASSISTANCE PROVIDERS. WHICH AREA OF THE ASSISTANCE BUSINESS DO YOU REPRESENT?

Florence Jean: Europ Assistance - GCS is the Europ Assistance Group’s division dedicated to International Corporations, Institutions and Global Organizations, Insurers and Health Carriers. Our 3 business lines form a comprehensive vertical approach to address all our clients’ needs: l Remote Medical and Security Services l Business Travel Risk Management l International TPA Services & Cost Containment

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Europ Assistance - GCS is part of Generali Group. With 80,000 employees worldwide and 65 million policyholders in more than 60 countries, including some of the World’s best known multinational companies and brands, Generali provides a broad and comprehensive range of insurance products, from property and casualty to specialty lines protection, employee benefits and global assistance services. As answering our clients’ needs is our priority, the Group has established a single platform comprising the corporate business and assistance services: Global Corporate & Commercial, Generali Employee Benefits and Europ Assistance: “Generali. Three Solutions, One Partner”. Steve Rowland: We provide International funeral, repatriation, exhumation assistance. We have recently developed mass disaster capability via world renowned partners to governments, airlines and Global corporations. We provide an excellent bereavement training service to the staff of our Partners. Frank Reuter: We advise across the whole value chain from from medical assistance, security assistance, remote medical services, occupational health services, up to all types of insurance

solutions from health, life, disability, K&R as an external expert and consultant. Erick Morazin: Allianz Global Assistance is the largest provider of assistance services worldwide, with a revenue exceeding 2.2 billion Euros in 2012. We provide all potential services insurance companies need. But assistance is evolving very quickly following consumer trends. We are constantly enlarging the scope of the services we provide. Home assistance, for example, is a growing need in many mature countries as well as life care services which include all potential assistance services a person may need during his life cycle such as baby siting for the youngest (especially in case or urgent needs), education assistance (in country or abroad), employment assistance (to help those losing their job), medical second opinion. Our services cover the full scope of our partner’s needs and their end customers’ expectations. Additionally, the way we propose assistance is evolving using more and more technologies including geolocalisation, the use of social media and mobile applications. For instance, we are selling more than 20 million policies online yearly and most of the claims related to those sales are processed through online applications. Dr. Dimitris Koliniatis: I am glad to say that we provide a full range of the assistance services including case management and cost containment. Further to these, we have an advanced medical profile offering aero medical services with our own internal resources in medical team, equipment and means. Dr. Siddick Maudarbocus: We cover most segments of the assistance business providing professional medical, travel and legal assistance services. We have a very competent network of professionals working in these fields and remain the main Assistance Company covering Mauritius and the Indian Ocean. l

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iPMI Magazine | C-Level International Assistance Round Table Business Forum

WHAT IS MOST IMPORTANT WHEN PROVIDING INTERNATIONAL ASSISTANCE? benefit ratio. Having highly trained and committed staff with strong operations procedures in place. Aiming for zero-defect. Three main things: Quality, Quality, Quality Erick Morazin: As a B2B and B2B2C provider, we have 2 main focuses: 1. First is to listen carefully to our Partners (insurance companies and others), understand their needs and provide the relevant suite of assistance services their end consumers need, 2. Second is 24x7 and 365 days a year to take most care of the individuals and their family when assistance services are requested. At AGA, our goal is to be able to manage well these 2 dimensions consistently and globally. Dr. Dimitris Koliniatis: Acting with a cool mind and great sense of responsibility to identify the situation and manage knowledge and experience, acting fast but not hastily. Dr. Siddick Maudarbocus: Over the years we have been working with various overseas assistance and insurance companies, and we have now perfected our mode of operations. We put high emphasis on good patient/client communications and relationship. Trust is very important, and once you can get the trust of the client, there is a mutual synergy in getting the right treatment/outcome and procedures. Sometimes we have to ask a patient to cancel a flight home on medical grounds and this demands a good trust in the relationship. We find that getting to the right treatment centre and specialist is more important to the outcome of the case, as falling into the wrong hands or channel can be very complicated. l ASSISTANCE SERVICES SECTORS + Home + Legal + Lifestyle + Medical + Technical + Travel + Roadside

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Florence Jean: Working with corporations and global organizations mainly, it is essential that we increase our clients awareness regarding their Duty of Care obligations and offer prevention and risk management solutions before an event occurs. In order to adequately assist organizations in meeting their duty of care obligations, and help employees fulfil their professional duties without any undue interruption, Europ Assistance - GCS has developed its strategy and services around 4 major cornerstones: Assess, Raise Awareness, Accompany and Assist. Our 24/7 Contact Centres and Global Networks allow for continuous service delivery to our clients’ members, wherever they are located. Assess: It all begins by defining the risk management strategy in order to identify and prioritise foreseeable risks, as well as prepare a tailored response plan. Raise Awareness: The second step is to spread the information, best practices and behaviours to concerned employees through education and training. Accompany: As risks constantly change, it is necessary to be equipped with tools that allow companies to remain in permanent contact with dispersed teams through tracking, emergency response as well as real-time monitoring. “Accompanied by GCS” means also to benefit from the experience of our experts in different fields (medical, HSE, logistics, security). Assist: When the risk cannot be foreseen or avoided, appropriate 24/7 response through on-the-ground intervention and evacuation is required. Steve Rowland: Seeing the big picture! It is essential to have an expert multilingual team with a broad knowledge providing regular communication and knowing where and when to provide cost containment measures. Frank Reuter: Understanding of the real requirement of the client (insurer as well as enduser). Having a wide range of integrated solutions on a high quality level and on a good cost

2008 2009 2010 2012 2013

5 QUALITY AWARDS IN 6 YEARS

MEDICAL ASSISTANCE AIR AMBULANCE REPATRIATIONS MEDICAL ESCORTS COST CONTAINMENT CLAIMS HANDLING ROAD ASSISTANCE TRAVEL ASSISTANCE

IN GREECE AND CYPRUS SINCE 1993

www.athensassistance.gr

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iPMI Magazine | C-Level International Assistance Round Table Business Forum

WHAT BENEFITS WILL AN OUT SOURCED ASSISTANCE SERVICE OFFER AN INSURER VS AN IN-HOUSE ASSISTANCE DEPARTMENT OPERATED BY THE INSURER? mainly by placing nonstrategic functions in the hands of outside experts and concentrating more on their core business and keeping customers satisfied. Outsourcing not only eliminates the costs associated with the assistance service but can also limit insurer’s risk. Additionally, the collective multitasking expertise and negotiating power of an outsourcing provider typically far exceeds what an insurer could acquire in house. Frank Reuter: Several aspects need to be considered relating to service capability and reach when selecting an assistance company for international services. Including: l Access to a global/regional network l Access to preferred partners and medical network l Access to local/regional market knowledge l Economies of scale l Branding opportunities while working with large/high quality partners l Cost containment l State of the art set-ups Dr. Siddick Maudarbocus: A well established local assistance company located where the insurance companies members are travelling is a must. We understand the local culture and provide access to the best medical facilities on the island. This is key and a decisive factor as falling in the wrong hands can complicate matters for all those involved. l OUT SOURCED ASSISTANCE SERVICE BENEFITS + Pre Established Provider Network + Local Language Capability + Local Knowledge and Contacts + Understanding of Local Culture + Local Presence + Established Infrastructure

Roundtable

Florence Jean: All large worldwide assistance companies found their success in providing services to a large number of clients belonging to multiple industries, even very specialized niche markets. The exposure to different operational models, different needs, situations, and locations enables assistance companies to build their experience, expertise and networks. There are no special training courses and certifications in higher education for assistance operators answering our clients 24/7. This can only be done through internal training and experience. Insurance companies’ in-house assistance services will never be able to compete with outsourced specialized assistance companies managing millions of cases every year. Steve Rowland: By out sourcing funeral assistance, assistance companies give themselves more time to focus on other critical matters, such as challenging and time sensitive medical casework and repatriations. With our focus on funeral repatriation, we benefit from working regularly with reliable agents around the world, who not only understand exactly what we need, but also recognise the importance of cost containment and enduring business relationships. Erick Morazin: An in-house assistance department will never cover the full scope of the assistance services insured need today (especially concerning life care services mentioned before) and will never be as global as required today. Most global insurers have already understood this and major global companies such as Allianz, AIG, AXA, Generali, Zurich… have their own assistance companies providing services to both their existing portfolio as well as third parties. At AGA, less than 20% of our revenues originate from our shareholder Allianz. Having said that, Allianz is by far our No1 Partner both in terms of revenues and scope of services provided. Dr. Dimitris Koliniatis: Over the last decade, insurers have increasingly embraced outsourcing as a strategic tool for enhancing their competitiveness,

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Roundtable

HOW DOES YOUR BUSINESS DEFINE ASSISTANCE IN 2014?

Florence Jean: The concept of Assistance is very mature in western countries. Benefit amounts within travel insurance policies are often “unlimited” except for medical costs. Another point is that Assistance has always been and is still typically associated to “24/7 Response”. Nevertheless, with the improvement in the quality of medical care provided worldwide, repatriation is now a second option, except for critical cases. Apart from the major logistical challenge to provide assistance in remote areas, today’s challenges include increased awareness, better prevention, and travel tracking. Organizations aim to mitigate risks and reduce the costs related to assistance services with better preparation. In emerging countries, the middle-class population is growing extensively year on year. In BRIC countries, the middle-class represents 50% of the population in Brazil and in the Russian Federation, 10% in China (83 million in November 2012, expected to reach 1 billion in 2030), 5,6% in India (estimated at 69 million in 2012, expected to reach 600 million in 2030). Africa as well is a continent where the middleclass is to become very important considering the growth of some countries like Nigeria, Angola, and Ghana. This population requires higher level of quality healthcare that they sometimes cannot find in their country or are requiring the same levels of benefits when they are travelling. Whatever the positioning in the market of Assistance companies, B to C, B to B to C, or B to B, these populations are new customers or members and their needs must also be addressed. Local international standards healthcare services or for business travel risk management solutions developed by Europ Assistance - GCS addresses the needs for all our clients’ employees: expatriates, business travellers and local employees whatever their nationality and location is. Steve Rowland: For us, assistance is a team effort. From our team of coordinators to our agents abroad, our drivers, in house workshop,

accounts team and our out of hours response. We all depend on each other. Frank Reuter: For us, assistance can no more be seen as a standalone set-up. We recognize a trend towards integrated complementary solutions, where international health insurance models are connected with a wide range of assistance solutions and further related services. This is also the demand from the market by the clients themselves. Topics such as self-insurance, global TPA services and telemedical services are solutions which are of importance not only for multinational organizations but also for many international active corporate entities that are looking for a better value proposition. Erick Morazin: Assistance is what our Partners need to make their product or service unique to the customer. We need to adapt to the ongoing trends of customer segmentation and one to one marketing activities our Partners are now developing, for instance: l Car manufacturers are now asking us to customized Roadside assistance services according to the brand and ultimately the model they are selling. We don’t provide similar roadside assistance at AGA for Toyota or for their luxury brand Lexus. Similar approach is applicable for all our other global partners such as BMW, Peugeot, VW and Volvo. The service can vary by region or country as well. l Travel insurance and medical assistance are now similarly customized depending of the Partner, the product sold or the type of trip. This customisation is now happening real time for online sales. As an example of our ability to adapt to these new demands, our Partners such as Delta Airlines, easy Jet or Expedia are proposing specific AGA travel insurance depending of the typology of the customer. A business traveller or a family visiting the same destination will have specific offers. We are able to manage hundreds of different products segmented on specific criteria’s such as the Partner’s site,

iPMI Magazine | C-Level International Assistance Round Table

number of passengers, the origin and the destination, the duration of the trip, the type of trip: flight only, packages, car rental or hotel booking path. The class - eco, business, first etc. Assistance is matching what our Partners are selling and how they are selling it. l For insurance companies with services such as life care or health assistance, the differentiation is more on the service part with increased demand for product innovation, segmentation and customer relationships management. Insurance companies need to develop constant interactions with their end consumers while creating products differentiation, we called it “Connected Assistance”. For instance, using AGA mobile applications and our online service tools we are helping our insurance Partners to achieve their objectives to increase their customer satisfaction index. As you can see, at AGA we evolve constantly according to the consumer desires. During the last 50 years, Assistance has been focusing on “Mobility”. In the last 5 years, “Proximity” has been a growing segment (home, personal assistance, life care services…) driven mainly by insurance companies needs. Assistance is a very dynamic and flexible concept. Dr. Dimitris Koliniatis: We think of Assistance as a wide multilevel network of mutual cooperation and in constant adaptation to the needs of the service user and an ever changing operating environment. It is a rather complex structure with almost infinite potentials of outstretch when it comes to personal assistance and that is what makes it so interesting. I consider that the current challenges are cost control within an environment of intense economic crisis, plus, offers with discounts and privileges in added value low cost basic services. Dr. Siddick Maudarbocus: Multi- team operations and good team work with sharp communication skills. The world is now an connected global village and we can talk to each other in real time with modern communications, hence response must be fast, effective with good communications between all parties involved. l

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Roundtable

YOU HAVE HANDLED MANY MEMORABLE CASES IN YOUR TIME. IN THE LAST YEAR WHICH ONE WAS MOST UNIQUE AND WHY?

Florence Jean: We accompany our clients from the energy and mining sectors in often very remote locations where international standards medical facilities do not exist to provide appropriate care to our patients. In these situations, medical evacuation is certainly the only solution and planning is essential to ensure the safe transport of the patient. Our dedicated Medical Emergency Response Planning Centre in Johannesburg designs these plans for our clients. To support our clients’ operations in remote sites, Europ Assistance - GCS builds adapted clinics, with our own medical staff and related services such as medical procurement. With this on-site support, patients can be stabilized up to 48 – 72 hours. Among hundreds of cases, we handled some memorable critical cases out of our Europ Assistance Medical Centres in N’Djamena (Chad) and in Luanda (Angola): After arriving from a client’s operations site by air or ground ambulance if no helicopter service is available, our locallybased medical teams provide emergency medical care and coordinate the evacuation of the patient to his/her home country or to the nearest suitable medical facility in the region, Europe or South Africa. We also manage cases like these in Asia, where Europ Assistance - GCS is expanding with a 24/7 Contact Centre based in Singapore, remote site operations in Sichuan (China) as well as in Myanmar. Steve Rowland: Every repatriation is unique with its own challenges and individual circumstances. In particular, we remember the Tsunami, after which we brought home all the British Citizens who were involved, and more recently, following the terrible situation in Algeria, we helped with funeral repatriation to a number of countries, including England. Erick Morazin: At Allianz Global Assistance, we handled more than 200 000 medical cases per year. During the last 60 years, our +1000 highly skilled people dedicated to medical have been involved in many major disasters including

the 2004 tsunami in the Indian Ocean and the 2011 earthquake in Japan to help and support customers. We have a lot of different stories to tell each showing how a good medical assistance cover can save lives. Images are always more powerful than words and I recommend iPMI Magazine readers to click HERE to watch a video on You tube or download HERE a PDF from our website “True Stories Dr. Dimitris Koliniatis: Although we do not see a case as unique, I can mention one because we arranged it safely in commercial flight that is not usual and shows our capabilities. An 8 month old prematurely born infant suffering from congenital dysplasias and complications, intraventricular hemorrhage among others, had to be transferred from Greece to the UK for urgent treatment. The family had not coverage and had to pay the full expense. We arranged commercial transfer with complete medical crew and equipment, monitoring the infant for days before the arranged trip. The girl is now alive and well. Dr. Siddick Maudarbocus: Memorable Cases? We have solved many. A British elderly lady came to holiday and on the very first day, she slipped and broke her hip. She was sent by ambulance to the nearest government hospital where she was kept a couple of days pending an operation date. I was contacted by her insurance company and when I visited her she was in a noisy common ward of 30 patients, many screaming all day and night. But she was so polite that when I asked her, are you ok? Her reply was a gentle “Yes doctor, I’m fine and they are looking after me well.” When I proposed to shift her to a private clinic with an en-suite room she looked at me and said, “Its ok doctor, I’m alright here.” She was shifted to a private clinic, we arranged for a nurse escort to fly in and she was repatriated to her home in Jersey to be operated upon. The other memorable one was a Manchester lady who flew in and had headaches on the flight down. We visited here and found some

iPMI Magazine | C-Level International Assistance Round Table

alarming signs that pointed to brain tumour. She had a brain scan on day 2 which confirmed a tumour and I escorted her back to Manchester on day 3. She was operated on successfully and back to normal work. Prior to visiting Mauritius she had seen her GP on several occasions with the same headache complaints!! Frank Reuter: A recent quite interesting case was as follows: Case Date: End 2013 Insurer Evacuation Rider confirmed: Yes Diagnosis: Acute Discogenic Back Pain with Radiculopathy Current Location: Djibouti Request Patient: Primary Repatriation to USA by Air Ambulance Assistance: Primary Evacuation to Dubai by Air Ambulance – for discussion with Insurer MD History: 55 year old female expat working in Djibouti as an air traffic controller Patient apparently injured herself while getting out of a taxi – a twisting motion with immediate onset of severe pain. She has been treated at the military base hospital, and is now in her own apartment. Reports that she is unable to sit for more than 60 seconds, able to mobilise, better on standing or supine – but still severe. Pain management

includes Toradol/Valium/ Vicodin – with limited relief. Base medical facility is limited, with no specialist care and no appropriate radiology. Upgrade in care is recommended by the treating doctor and by Assistance. Assistance Recommendation: Evacuation to Dubai by Air Ambulance as unable to sit for take-off and landing. Patient request is direct AA back to USA. MD Decision: AA Recommendation to USA is declined. AA Recommendation to Dubai is also declined – patient is not admitted in medical facility. MD RC (Dr. from Reuter Consulting) recommended Assistance to have her reviewed in the medical facility, and optimise pain management, then to call MD RC (Dr. from Reuter Consulting) back with a quote for escorted commercial flight to Dubai. Assistance should manage pat ient ex pec t at ion accordingly – Assistance agreed with MD RC (Dr. from Reuter Consulting) direction. Assistance called back with a quote for Commercial Evacuation to DXB with Doctor Escort for pain management: Approved. Cost impact: $23 500 Cost savings: $120 000 on AA to USA / $52 000 on AA to Dubai.

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iPMI Magazine | C-Level International Assistance Round Table Business Forum

GEOGRAPHICALLY SPEAKING, WHERE CAN YOU PROVIDE RELIABLE ASSISTANCE SERVICES?

Florence Jean: Europ Assistance’s services cover 208 countries and territories thanks to a network of 33 companies and 115 local emergency response agents. Europ Assistance - GCS has developed worldwide capabilities to accompany its clients where they expand their operations. The challenge is constantly and continuously evolving depending on the services we provide: l For expatriates, the key benefit will be our worldwide medical network comprising of 425,000 providers, 10,000 acute care facilities, 600,000 physicians, over 5,000 international facilities with cashless services, where they can present their membership card to benefit from immediate admission and cover. l For companies, important aspects are our logistics capabilities, our knowledge of the areas where they expand their operations and the quality of experts that will provide them with high value consulting services to assess the environment, health threats and HSE required solutions. Dr. Dimitris Koliniatis: Apart from Greece and

Cyprus, within the International Assistance Group and the global detailed sanitary information we have achieved being its members, we can provide and be active for all of our services all around the world, especially in remote areas, treating every case as an emergency. Erick Morazin: At AGA, we have local offices in 34 countries since the opening of our new Business Unit in New Zealand some days ago. We provide assistance worldwide and cover 180 countries. We work with our own offices in the relevant countries and with 135 correspondents. We have more than 400,000 providers worldwide and this is one of our main asset in order to be able to deliver services “Anywhere, anytime”. Steve Rowland: We pride ourselves on offering a worldwide service, to or from the UK and from one country to another around the world. Frank Reuter: On a consultancy basis we work with all the major assistance provider worldwide. We can achieve and implement global strong solutions while advising our corporate clients customized to their unique requirements. Dr. Siddick Maudarbocus: Mauritius, Seychelles and some parts of Madagascar. l

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iPMI Magazine | International Assistance Round Table Business

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WHAT POLICIES MAY BE IMPROVED BETWEEN PAYORS AND THIRD PARTY SERVICE PROVIDERS?

PAYOR PROVIDER POLICY IMPROVEMENT + Prompt Payment + Electronic Payment Systems + Clear and Concise Communications + Transparent Billing + Trust In TPAâ&#x20AC;&#x2122;s from Tour Operators + Efficient Decision Making Capabilities

Roundtable

Florence Jean: More than 20 years ago, Europ Assistance developed a very specific tool to accelerate payment to our local emergency response agents. This continuously improving and proprietary tool is unique in the assistance world. It is used by our local emergency response agents to re-invoice services they have provided on our behalf back to Europ Assistance - GCS. Furthermore, all our air ambulance providers within our network have the capability to invoice us electronically. This significantly accelerates the whole invoicing process (1 payment per week, pre-approval process), and therefore improve the relations with our local emergency response agents. Dr. Dimitris Koliniatis: Of utmost importance is the subtle balance between the payer, the TPA server, the provider and the end user. An old but still major problem. A key problem I think is the conformation of the tourist industry and more specifically of the tour operators, to the network and proposals of TPA servers through the payersâ&#x20AC;&#x2122; strict instructions and policies. Steve Rowland: Prompt payment guidelines benefit everyone, and can be incorporated in an SLA. We all have obligations to providers and suppliers, and in the current financial climate, we all appreciate prompt payment routines. Dr. Siddick Maudarbocus: Prompt payments are an absolute must. We do not have long lines of credit and as Mr. Steve Rowland said, we do all have obligations to providers and suppliers. Communication is also key. Frank Reuter: By far the most important factor is to detect and prevent fraudulent claims and over servicing. Internal efficiencies and a proven track record is the key criteria for choosing a suitable TPA partner. Erick Morazin: Please see my previous round table answers for ideas on this question. l

iPMI Magazine | C-Level International Assistance Round Table Business Forum

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PAYORS AND COST CONTAINMENT FIRMS ARE BUILDING WORLDWIDE CUSTOM NETWORKS BASED ON SPECIALITY. WHAT CAN YOU OFFER?

Roundtable

ASSISTANCE SERVICE Florence Jean: An Dr. Dimitris Koliniatis: Being FEATURES important component a partner in International of all our services is Assistance Group is I think our + Immediate Response Time that GCS can provide most distinctive advantage. + Always On Multilingual Service tailored cost containment There is on our disposal a + Service Uptime Guarantee solutions globally on complete and detailed service + Transparent Billing behalf of insurers and providers database (to which + Remote Location Capabilities corporate clients. we contribute by completing We have the highest our territory data) that fulfils net savings of medical expenses in the United the needs and expectations of every insurance States based on discounts, negotiated contracts company and is approved from long standing and specific networks’ organizations managed experience in diverse countries and levels of by our in-house ITPA Division based in Toronto demand. and in Miami. The cost benefit and service quality of preferred As an example, Europ Assistance - GCS has providers allow us to offer the “global solutions been entrusted since 2011 by the French Polynesia with local partners”. social security body, to follow-up the medical Dr. Siddick Maudarbocus: We are experts in evacuation of patients from French Polynesia sourcing the right specialist to handle the case to France and back. GCS’ cost containment in given to us- this is a decisive factor as falling in French Polynesia consists of: the wrong hands can complicate matters for all l 600,000 Euros saved in 2012 by avoiding those involved. 400 in-patient days As I said earlier our doctors have been trained l 460 travel for treatment patients each in various countries and we try to source those year who are excellent in their fields to attend to our l 120 patients monitored every week during clients/patients. their stay We have a group of doctors who deliver daily consults at most hotels on the island, and we Steve Rowland: Although we are primarily have a team of multi- specialist who work in concerned with repatriation, RBI is a full service most of the private clinics here. funeral provider. We look after the A- Z problems that tourists We share premises with our sister company face during their holidays We have also multiRowland Brothers Funeral directors which lingual abilities: English, French, Russian, Chinese, incorporates memorial masonry, bereavement German, Italian and Arabic. aftercare services, funeral transport, mortuary Frank Reuter: We do operation medical case workshop and funeral showroom. adjudications for iPMIs. We can offer to local/ Golden Leaves, our sister pre-need funeral regional assistance providers access to state of planning company, serves an increasing number the art medical assistance providers in other of expatriates in Europe who want the peace regions. of mind of pre-need funeral planning. Erick Morazin: We provide assistance worldwide Our business model encompasses pre and and cover 180 countries. post funeral arrangements, and we have recently We work with our own offices in the relevant embarked on bereavement education sessions countries and with 135 correspondents. We for assistance companies. have more than 400,000 providers worldwide We also provide full mass disaster capability and this is one of our main asset in order to be with the worlds most renowned partners. able to deliver services “Anywhere, anytime”. l

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iPMI Magazine | C-Level International Assistance Round Table Business Forum

Q10

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HOW IS YOUR ORGANIZATION LEVERAGING TECHNOLOGY IN SERVICE DELIVERY?

Dr. Dimitris Koliniatis: Technology - such as smart phone applications, shared dynamic databases, online and real time contacts with the clients and partners - sometimes can be found truly helpful in our services. But I believe that, apart from communication and delivering

information advancements, it does not play substantial role in the assistance field. The good old fashioned direct contact with clients and providers enhance trust, service quality and cost control and, above all, maintains the humane nature of our business. Steve Rowland: We are constantly updating our systems to provide secure (Military grade) and functional IT services - our disaster recovery systems are second to none and should we have a disaster we can be operational offsite within 1 hour. Our dbase provides our partners with a whole host of MI, dashboards and case specific information via a portal with access on 24/7 365 basis. Such technology is particularly useful when handling cases for clients in different time zones. Erick Morazin: As mentioned in my answer to Q2 the way we propose assistance is evolving using more and more technologies including geolocalisation, the use of social media and mobile applications. Plus, we are selling more than 20 million policies online yearly and most of the claims related to those sales are processed through online applications. Dr. Siddick Maudarbocus: Technology helps us accelerate processes and streamline admin. We find benefits in software apps including CRM and ERP. Technology is also playing a massive part in comms. l

Roundtable

Florence Jean: Innovation has always been part of the Europ Assistance culture as a way to increase the efficiency, the responsiveness and the personalization of the services delivered. The aim is getting closer to customers and their needs through new innovative and personalized assistance products. Our proprietary tools provide us with our undeniable competitive advantage. Our management tools for our networks of air ambulances, local emergency response agents and healthcare providers, as well as our proprietary clinic management system, amongst others, are an integral part of our value-added solutions, providing our clients with quality, time-efficient, and cost-effective services. l Medical Networks management with “e-GSD” l Claims & cases management with “SAX” l Itinerary tracking & assets monitoring with “TRIP” and “RMP” l Clinic management with “ManageMed2” l Air Ambulance Auction tool with “3AT”

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