15/03/10

By Rachael Floyd, PMI Global’s Operations Director and registered nurse

Ensuring successful overseas assignments for employees is no easy task. The potential pitfalls businesses face are many — not least in terms of health and welfare.

Businesses frequently have to contend with a variety of issues from full scale medical emergencies to employees that fail to adjust to the cultures of foreign climes.

A study conducted by PMI Global, a new service which offers an integrated package of insurance and healthcare support for employees abroad, recently highlighted the need for a greater duty of care amongst many employers that assign staff overseas.

The survey of UK-based HR professionals revealed that 48 per cent of companies fail to conduct full health assessments of the destinations they send staff to, while 44 per cent don’t organise vaccinations for their employees, where required. A further 20 per cent of companies that send employees abroad for prolonged periods fail to provide them with international health insurance.

Good planning is everything and precautions taken at an early stage can, quite literally, save lives. She has revealed 10 things that will ensure your staff are fit for business before they jet off on overseas placements.


1. Check to see if health insurance is mandatory. Hefty bills can result from medical problems abroad and so adequate cover is vital. When sending staff abroad for more than six months, you should provide them with international health insurance — for some countries, particularly in the Middle East, it is mandatory. If an employee is being posted to Saudi Arabia or Abu Dhabi, for example, residency visas and work permits are dependent upon having appropriate health insurance.

2. Business travel insurance is no replacement for International PMI. For short business trips, business travel insurance will cover urgent medical treatment with the additional benefit of insuring personal possessions and including limited kidnap and ransom cover. Policies have a maximum number of days that individuals can travel under them each year. As with the EHIC — which covers emergency healthcare treatment — cover is restricted and it should not be viewed as a replacement for an international medical policy.

3. Don’t rely on EHIC. In the European Economic Area (EEA) and Switzerland, the EHIC (the European Health Insurance Card) has a number of restrictions. It is not normally available if you are living in another country; it will only provide access to emergency, state-provided treatment and it doesn’t pay for emergency evacuation or repatriation. It can’t be viewed as a replacement for an international medical policy.

4. Seek professional advice: not all health policies are created equal. When arranging employee health insurance, don’t assume all international policies are the same — take expert advice. The flexibility of cover benefits, for example, is a key consideration. Maternity cover accounts for around 15 per cent of a premium and will be unnecessary for single male assignees. Excluding the USA from a worldwide policy meanwhile can halve premium costs.

5. Forewarned is forearmed when making a medical claim. In addition to the numerous financial considerations employees have to deal with, from setting up local bank accounts to arranging money transfers, they should also be aware of the medical insurance claims process. For out-patient treatment abroad, the employee will in most cases pay the bill and then claim it back from the medical insurer. Be sure to check what the insurers’ procedures are for outpatient claims are - how long will it be before the claim is paid back by the insurer, for example, does the claim require preauthorisation and will it be paid directly into the employee’s account? If a claim is paid by cheque, this can take 6 to 8 weeks to process abroad and employees should be mindful of this.

6. Ensure employees are fit to travel. A pre-travelhealth check can go a long way to ensuring employees remains fit and healthy while they’re abroad. A report on their state of health can enable staff to take control of their own wellbeing before they pick up their passport. Underlying medical conditions can be identified and addressed before travelling, with medical care received from doctors in a familiar healthcare system without language barriers. A pre-travel screening can also highlight any recommended working adjustments and reduce the risk of a secondment being cut short due to illness.

7. Don’t expose your business to the risk of an uninsured claim. Check the small print of your Employers’ Liability policy. Standard Employers’ Liability insurance does not normally cover staff working abroad for extended periods and country-specific policies may be required. In many countries it is a statutory requirement for an employer to have liability insurance to cover employees who are injured or contract a work-related illness. It is also advisable to conduct full health risk assessments on the destinations you send staff and fully brief them on the local issues before they set off.

8. Take steps to avoid preventable illnesses. An array of tropical diseases lie in wait for employees travelling abroad, from Cholera and Typhoid to Hepatitis and Yellow Fever. Vaccinations and anti-malarial drugs should be arranged where required but be mindful of the fact that many vaccines take several weeks to become effective. In the case of Yellow Fever, some countries in Asia require a mandatory International Certificate of Vaccination against the disease.

9. Health mind — healthy business: look after employees’ emotional wellbeing. Industry analysts suggest that up to 40 per cent of placements abroad fail due to psychological distress. Employees and their families often fail to adjust to foreign cultures, feel alienated or isolated but some simple steps can be taken to help ease the transition. Employee Assistance Programmes can offer employees access to confidential support, practical information and expert advice throughout Europe, Asia, Africa and North and South America. Studies show that for every £1 spent on an EAP, an organisation can recover anywhere between £3 and £20. For vital international placements, the return on investment may be even greater.

10. Protect your assets against extortion. Kidnapping of company employees is a very real risk and generates hundreds of millions a year in ransom payments for guerilla and criminal groups around the world. With UK government policy not to pay ransoms, employers should seriously consider Kidnap and Ransom insurance cover when sending staff to volatile regions particularly areas of Latin America, Asia and the Middle East. Security consultants are made available to protect your employee and provide practical help on the ground should a problem arise.

Sending employees abroad can have a huge impact on their occupational development and help boost a business’s profile and standing oversees.

Moreover, it’s encouraging that, according to our research, a large number of UK companies are well equipped for sending employees abroad. However, for those that are not, the business and financial implications can be considerable.

Join us on