A Guide to Insurance for NGOs Operating in Violent Environments
Personal accident policies are not the same as health insurance policies. The former cover the consequences of accidents, including bodily injuries, disablement or death, whereas the latter is broader, as it covers medical expenses arising from illness, medical conditions or the consequences of accidents (except disablement or death caused by the accident).
It is vital that you ensure that you have adequate levels of cover. When considering this, remember that it is not necessarily the case that care and repatriation is more expensive in hostile and remote locations. The UK Foreign & Commonwealth Office estimates that a stomach bug or infection treated in a hospital in the United States with flights home could cost in the region of £100,000.
Many policies have an exclusion that relates to travelling (or intending to travel) against the advice of a qualified medical practitioner. For this reason, organisations must ensure that travellers confirm that they are not doing so prior to booking a trip. Policies or extensions are available that cover previous medical conditions should this be required.
Direct billing allows medical professionals and institutions to pass the bill for medical care directly onto an insurer. This means that the Insured Persons do not need to personally pay the bill and then claim the amount back from the insurer. Apart from avoiding the obvious inconvenience a claims process entails, direct billing removes the financial barriers to care and reduces the time it takes to access medical services, which is especially important in emergency situations.
Policies will commonly include an exclusion for travel to any country with a government advisory in place. For policies from British companies, this exclusion will normally apply to travel advice issued by the Foreign & Commonwealth Office that recommends against ‘all’ or ‘all but essential’ travel to a country or one of its regions. At the time of writing, this includes Central African Republic, South Sudan and Syria, for example. Organisations should check existing or prospective policies for this exclusion, and, if present, which foreign ministry’s travel advisories apply. As an illustration, one current policy states that ‘[The company] shall not be under any obligation to provide services or incur any expenses to or from a Traveler if, in [the company’s] sole discretion … [t]he Traveler has not heeded travel warnings issued by the State Department or appropriate authorities recommending that Travelers avoid that specific region or location.’ If your organisation intends to frequently travel to countries or regions against government travel advice, it should purchase a policy without such restrictions. There are products, such as battleface from Tangiers Insurance, designed specifically for people travelling to and working in conflict zones and hostile environments that might be useful.
Some policies will include exclusions that relate to ‘disturbed areas’, which are defined within the policy. These exclusions often mean that the insurer is not liable for injury, loss or expense suffered as a result of specific situations, such as war or terrorism, within the specified disturbed areas. As such, organisations should review their travel patterns against a policy before purchasing it in order to ensure that these exclusions will not impact upon them. Where they do, organisations should either seek a broader policy or buy specific polices for travel to disturbed areas when required.
Insurers are subject to laws, regulations and national sanctions restrictions that may prohibit them from providing cover or paying claims to certain individuals or entities and from insuring certain types of activities in or connected with specific countries and territories. These countries and territories change over time, so organisations need to regularly check with their insurers if they think they are likely to travel to such locations. As an illustration, the following countries and territories are listed on one major insurer’s policy at the time of writing: Iran, Syria, North Korea, Sudan, Cuba and Crimea.
Insurers will commonly not pay for any loss or expense where an Insured Person has failed to secure or maintain immigration, work, residence or similar visas and permits for the country where the person is travelling. It is generally good practice not to use tourist visas when travelling for work purposes. If organisations purposefully intend to clandestinely travel as tourists, this should be discussed with their insurer to add specific policy endorsements.
It is vital to remember that most travel policies only apply when an Insured Person is outside their country of residence. Organisations should also carefully consider situations in which employees are nationals of the country that they are travelling to, as, despite being resident in another country, many policies exclude situations where Insured Persons are a national of the country in which they are travelling. Conversely, if an Insured Person travels outside their Country of Residence for more than 90 consecutive days, most policies will not pay a claim on the basis that they are no longer resident in the country where the policy was issued. Finally, many benefits (e.g. psychological counselling or funeral expenses) are only covered if they take place in the Insured Person’s country of residence.
Many policies now come with cover for incidental holidays. This means that travellers are covered for holidays (usually up to seven days) in conjunction with an Insured Journey. There are two important points to note here. Firstly, the cover usually only applies to holidays in the same country as the Insured Journey. A common mistake is for employees to travel to a neighbouring country and mistakenly assume that they are covered. Secondly, while this is a nice benefit to offer to staff (for little cost), organisations need to very clearly communicate the point in time at which their duty of care obligations cease. It is unrealistic to expect travellers to follow an organisation’s standard operating procedures while on holiday. Therefore, it is also unrealistic to expect organisations to respond to situations on the traveller’s behalf during an incidental holiday (other than through their insurers if the incidental cover applies). Such dynamics should be clearly communicated to staff and other Insured Persons.
Most policies do offer adequate cover for psychological counselling. While provision is often made for bereavement counselling for families or trauma counselling for Insured Persons, it is commonly restricted to situations where there has been a bodily injury or an Insured Person has witnessed at terrorist incident. As such, organisations must ensure that they provide employees with access to psychological counselling for all other types of events and incidents.
All insurance policies have exclusions and conditions. As they will be different on each policy, organisations should ensure that they are fully aware of them, before they purchase a policy. Below are some common policy exclusions/conditions where insurers may state that they are not be obliged to provide response services:
When the insurer would have to breach national or international laws and/or regulations.
When the insurer is unable to obtain necessary authorisation required to do.
When the Insured Person has violated the laws or regulations of the country in which they are travelling.
When the Insured Person has not heeded travel advisories from the Foreign & Commonwealth office or other named foreign ministry.
When (in the insurers sole opinion) it will be impossible or reasonably impracticable to do so due to:
war and/or terrorism or other political or local conditions;
the Insured Person being in an inaccessible location or offshore; or
the Insured Person being in a predicament that may more reasonably be the responsibility of a search and rescue operation organised by the police or coastguard or other authority responsible for rescue services.
Type
Policy intention
Common areas of cover
Business travel
Business travel insurance policies cover major events while travelling overseas for business or charitable purposes.
Travel cancellation, curtailment, rearrangement and replacement.
Medical repatriation, political and natural disaster evacuation.
Legal expenses, personal liability, personal property, business equipment, personal money.
Kidnap and ransom (to limited amounts).
Personal accident
Personal accident insurance policies also cover major events while travelling overseas for business or charitable purposes. However, they are specific to losses that are caused by violent, accidental, external or visible events.
Accidental death.
Loss of sight, limbs, speech, hearing.
Permanent (total and partial) disablement.
Temporary (total and partial) disablement.
Medical expenses.
Funeral expenses.