Everyone knows why you purchase travel insurance. Your luggage is insured if its damaged or lost. You can obtain a quick-and-easy payment for your inconvenience if your flight is delayed a minimum number of hours. You can even schedule a medical evacuation if a situation goes bad.
But one aspect of travel insurance coverage most people forget about is the on-call, 24/7 medical staff that most travel insurance companies employ in case an insured finds themselves ill and in need of care far from home.
“Medical evacuation gets all of the attention because it has all of the drama,” said Dan Durazo, director of communications, at Allianz Global Assistance. “What most travelers probably don’t realize when they purchase protection is that we are staffed with medical experts to manage their cases at a time when they need us most.”
Take Lori Calavan, an Allianz senior medical consultant with 15 years of surgical critical care experience and training, and aeromedicine certifications. Calavan, who also works as a physician’s assistant at George Washington University Hospital, in Washington, D.C., collaborates with an Allianz team of physicians and nurses who handled more than 120,000 calls and more than 7,200 medical assistance cases in 97 countries last year – including more than 700 emergency evacuations.
The team also can tap into a network of 36 global offices and 120 “correspondents” to assist clients. Additionally, Allianz has evaluated and assessed more than 1,700 hospitals in 130 countries, to better serve their customers.
A lifeline home in a time of need
This kind of network comes in handy when the unexpected happens. In one recent case, Steven, a man from the Albany, New York area, was in Italy, exploring his heritage. Normally, he and his wife don’t purchase travel insurance, but this time the couple agreed that a $79 premium was well worth the peace of mind for the solo tour.
Two weeks into the trip, the client, a diabetic, became very ill. His wife flew to Italy to be with him. “He couldn’t speak, he didn’t recognize me, and he was put in a medically induced coma,” she said. “When he entered the hospital, his blood sugar levels were dangerously elevated, resulting in metabolic brain damage. The medical team quickly got to work and concluded he was suffering from both sepsis and pneumonia.”
The local Italian medical staff eventually reduced the coma, but while the client was regaining speech and memory, he couldn’t walk. “In fact, he could barely sit up without help,” his wife told Allianz.
During the six-and-a-half weeks the man spent in the hospital, Allianz leveraged its local international teams to communicate with the hospital’s doctors in Italian, regularly obtaining medical updates and records. This was crucial to stabilizing the man and preparing him to return to America.
Allianz even worked with the couple’s health insurance provider to ensure an Albany hospital could admit him, and found an airline (Lufthansa) to coordinate his safe transport to New York’s JFK International Airport, and then to Albany.
While Lufthansa agreed, after seeing the patient’s medical records, they required Allianz pay for and coordinate building a “medical pod” on their aircraft – something Allianz had never done before.
This meant purchasing 16 seats (four middle rows), and replacing them with “a private medical structure” that could fit the man’s stretcher, medical equipment, and accommodate the physician and nurse required to travel with him.
Allianz also had to arrange an air ambulance to transfer the patient from Italy to Frankfurt, Germany, where the aircraft was based. The total trip took 17 hours, and the man spent another 10 days on a medical floor in Albany, before being moved to a rehabilitation floor where he spent another several weeks before being discharged.
“Throughout the entire process, Allianz was our lifeline. I spoke with the assistance team several times a day and our case manager kept reiterating to stay positive and that they would bring Steven home,” the wife said.
Medical case management on the rise
While Steven was an extraordinary example of the kinds of cases Calavan and her colleagues manage, she said that her workload is growing, in part because more older travelers are emboldened to not let their age hold them back from traveling extensively.
She recommends that advisors consider the potential situations a client’s medical condition could lead to, and encourage their clients to purchase coverage, to at least provide some kind of medical assistance lifeline.
“The travel industry has made older travelers feel more capable of traveling where they want to,” she said. “Airlines and airports stock oxygen tanks. Destinations accommodate more older guests. So, people well into their 80s and 90s feel they can travel halfway around the globe, from Canada to the Maldives.”
But what older travelers don’t understand, said Calavan, is that their bodies will be hit harder by illnesses or minor injuries. As a result, their care could get tricky, especially if they are in a nation with facilities insufficient to treat their specific illness or injury.
“It’s only natural that, as you get older, you have fewer ‘reserves’ to battle an illness with. Thus, you’ll have more complicating factors than you would if you were younger,” she said.
Having experts on call can help in an unexpected crisis. Take, for example, a hypothetical situation where an elderly husband or wife gets sick on a cruise, and the physician is trying to confirm, perhaps immediately, medicines the sick spouse is taking, or details about past surgeries.
“The spouse may not know or remember precisely what medicines their partner is taking, the dosages, if a heart vessel was stented. We take that burden off of the spouse’s shoulders because we can work with the spouse’s doctors to obtain that information and pass it on accurately to physicians caring for the traveler,” Calavan told Travel Market Report.
Allianz medical case managers also can work with local hospitals and physicians to confirm their diagnoses, and to explain procedures to travel partners like spouses.
“The last thing someone in that situation needs is the stress of doubting whether they understand the procedure they are approving for their spouse or partner,” Calavan said. Allianz medical case managers can also facilitate doctor-to-doctor conversations, if the traveler has a primary care physician or specialist back home.
Finally, case managers are especially important if a patient is borderline needing to be evacuated. In many countries, doctors are not familiar with aeromedical decision-making, while Allianz case managers handle about two a day.
“Evacuation is a whole other set of complications,” Calavan said. Very often, local doctors don’t understand how flying interacts with the body to produce gases that could be painful, and even fatal for certain travelers with specific injuries.
“Someone with a collapsed lung has to follow a certain timeline and protocol for recovery in order to be cleared for air travel,” she said. “We have to make certain everyone at the hospital caring for the traveler is taking the right steps, in the right order, to allow that person to fly safely.” So, Allianz case managers will advise local physicians about procedures like leaving in a tube to allow air to escape.
While Allianz medical case managers have other jobs, they work together as teams, and are always on call in case a client they were caring for previously still needs care.
“We have daily calls, covering off on the patients in our care, especially the most acute cases,” she said. “I also can call a colleague who is off and ask him about how his patient’s condition may have changed and make certain we include any insight that primary case manager has on that patient.”
Sometimes this kind of assistance can be crucial, even within the U.S., as a Miami-based Allianz client discovered when his 88-year-old mother fell while visiting Morristown, New Jersey.
The CT scan at the hospital showed a hip fracture, requiring surgery that was scheduled for the following day. “I canceled our flight and then remembered I had purchased Allianz (recommended by our travel agent), and called them immediately to inform them about our situation,” the son said. “The representative helped coordinate what was needed between the hospital, physicians, social worker and rehab facility.”
The woman spent 17 days in rehab, but was eventually discharged for her flight home. The Allianz rep arranged for door-to-door transportation and first-class airline tickets. “The representative was compassionate, never dismissive, and kept up with everything that was happening with my mom’s care even after we returned home,” the son said.