Health &
Life... Worldwide - Global Insurance for Expats
By Philip Morton, InvestorsOffshore, January 2010
IMPORTANT WARNING: The
contents of this article have been compiled in good faith by Investorsoffshore.com
to provide assistance to expatriates and their employers, but do not
constitute investment or other advice or recommendations. Investors
or buyers of insurance products should not rely upon the information
given in order to choose types or routes of investment or purchase but
should make their own independent enquiries before making choices. Investorsoffshore.com
has taken reasonable care in researching and presenting the information
herein but makes no representations as to its accuracy and accepts no
liability for actions taken or not taken as a result.
Insurance is one of those things that everyone hopes they'll never
need, and as a result, a frightening number choose to bury their heads
in the sand, hoping that their luck will hold. However, by far the most
sensible solution for those not willing to trust to fate, is to take
out some form of insurance, to protect themselves and their dependants
should the worst happen.
The
list of places you may be sent - or even choose
to go - gets longer every day, ranging from
fully civilized and safe places like Paris to
really scary and hostile regions such as Iraq
and Afganistan. The list of possible (and insurable)
contingencies is almost as long, including kidnap
and ransom, war risk, health insurance, accident,
liability and travel insurance.
Now
your company may have taken out a policy on
your behalf. If so, lucky you! Although insurance
providers and brokers such as Medicare
International and Axa
PPP Healthcare do offer corporate or group
policies for international employers (in addition
to individual international policies), the take-up
by companies is not as high as it once was,
nor indeed as perhaps it should be. Some companies
seem to feel that it is not cost effective to
provide a decent benefits package for more junior
expatriates, preferring to compensate them instead
with higher wages and expenses, but they might
do better to consider that for an expat, the
knowledge that they can turn to their employers
for help in times of crisis might sometimes
be a more valuable benefit than a slightly inflated
pay packet.
There
are in fact still many companies that do recognise
the importance of insuring all of their travelling
employees. Companies that do so will usually
look at an international package as opposed
to taking out policies for their expatriate
employees with local organisations, as the latter
can be problematic. Local insurance regulatory
regimes can be overly restrictive or exclusive,
there may be foreign currency restrictions which
prevent expats from receiving benefits in stable
currencies such as US dollars, and membership
of a local scheme may not be possible for some
employees due to the proposed length of their
stay.
However, in some parts of the world employers have no choice in the
matter. In mid-2006, for instance, the Abu Dhabi brought in the first
phase of a compulsory health insurance regime for employers. UAE employers
are now responsible for providing health insurance for employees and
their direct family including wife and three children below 18 years
of age. Initially, the regime applied to companies with more than 1,000
employees, but from January, 2007, it was extended to all expatriates
residing and working in the emirate. Expected extension of the scheme
to Dubai in 2009 has been deferred to 2010.
In Singapore, the Ministry of Manpower began requiring employers to
purchase and maintain insurance for the medical expenses of foreign
workers from 1 January 2008. At the same time, the Ministry of Health
withdrew its program of healthcare subsidies for foreigners. The new
requirement applies to all new and existing foreign workers on Work
Permit or S Pass and to all foreign domestic workers.
Other countries which have introduced compulsory health insurance for
expatriates include Saudi Arabia, Oman, Bahrain and Vietnam.
Of course, the levels of benefit offered may not seem high enough for
you, so you may want to supplement such mandatory cover where it exists.
Whether you are completely on your own, or supplementing your employer's
cover, you can take advantage of a multitude of international brokers
and insurers, and nowadays of course you can obtain cover through the
Internet wherever you are.
The bottom line is that whether you are looking for private health and
life insurance, or whether you are lucky enough to have found a forward
thinking employer who is willing to include insurance as part of your
benefits package (and remember, the time to negotiate this is before you
go away, rather than when you actually need it several years down the
line), international insurance is undoubtedly the most appropriate option
for international travellers. In the following sections, we will look
at some of the reasons why
International
Health Insurance
Although
it is possible to insure yourself, your family
and your property against almost every eventuality,
in this article we will focus on the two main
areas of concern for those with financial obligations
and responsibility for dependants - health and
life insurance. Many providers and brokers offer
access to both types of insurance, and varying
degrees of cover are available to suit your means
and needs. However, if you are obliged to travel
as part of your job, or simply enjoy globetrotting,
a domestic policy may not be enough to cover you
in the event of an accident or illness overseas.
If this is the case, there are an increasing number
of brokers and insurers offering international
services that may be able to help
National
health policies can vary widely from country to
country, and the last thing you need, should you
or a family member be taken ill, is to discover
that as a foreign national you are not eligible
for treatment, or that you must pay through the
nose to receive it. In the vast majority of cases
(with some exceptions, for example treatment of
a pre-existing condition) an international medical
insurance policy could be the answer. Private
medical insurance is designed to ensure that you
can obtain the treatment you need, whenever, and
wherever you need it, and as an expat, this flexibility
will be invaluable to you.
Your
first decision needs to be whether you are interested
in a basic scheme, which will usually cover emergencies,
in-patient treatment, nursing at home and repatriation,
or a comprehensive scheme which will usually cover
you for all of the above, as well as out-patient
care, specialist treatment, routine dental, and
complementary care. (Yes, this aromatherapy massage
is medically necessary
) For example, one
international health insurance provider details
three policy tiers, offering GBP250,000 (USD500,000),
GBP1,000,000 (USD2m) and GBP5,000,000 (USD10m)
respectively, while others offer tailored packages.
Although obviously prices vary from provider to
provider, it is probably wise to opt for the most
extensive cover that you can reasonably afford,
for greater peace of mind.
International
insurance brokers will usually offer a wide
variety of policies to suit the needs and pockets
of most expats, including international medical
insurance, travel protection plans, single and
multi-trip policies, annually renewable international
plans, and group plans from a variety of providers,
with a wide range of online tools to help you
choose the most appropriate one.
As
mentioned previously, there are several conditions
and situations not usually covered by health insurers
(international or otherwise). Different companies
may disallow slightly different things, but here
are a few of the common ones:
- Risks
inherent in war, riots and insurrection are
rarely covered. Very occasionally you will find
a provider who will cover these risks automatically.
-
Drug abuse
- Self-inflicted
injury (and by the same token, injuries as a
result of dangerous hobbies. If juggling knives
helps you to relax after a hard day at the office,
you are usually on your own
)
-
Cosmetic surgery
-
Pregnancy treatment, unless you have taken out
a comprehensive policy which includes this.
-
Pre-existing conditions such as cancer, and
HIV/AIDS, and conditions arising as a result
of these.
-
Organ transplants, again unless you policy specifically
includes this.
-
Preventative
treatments
-
Sex change (be careful of employers who require
this).
You
also need to be careful about any possible geographical
restrictions on the policy that you take out.
US and Canadian citizens who are planning to expatriate
need to be especially aware, as certain types
of policy impose restrictions on the amount of
time that they can spend revisiting their home
country, whether for medical or non-medical reasons.
Cover
is usually offered via premiums throughout three
zones of the world, with Area 1 covering Western
Europe, Area 2 offering world-wide cover (with
the exception of the United States and Canada),
and Area 3 offering total global cover. Some insurers
and brokers offer world-wide coverage with all
of their policies, but as previously mentioned,
restrict the extent of US and Canadian coverage
to accident and emergency treatment only, and
the length of the stay to approximately 30 days.
Accident
and illness can occur at any time, and in any
country, and most of the circumstances covered
by international policies are similar to those
covered by domestic insurers; the policies just
have the advantage of being 'mobile' in a way
that domestic policies are not. However, there
are some issues which are of particular importance
to expatriates, and it would be wise to make sure
that your international health insurance covers
them.
Emergency
help and the possibility of medical evacuation
can sometimes be invaluable in time of crisis,
and a good policy, such as those offered by Medicare
International and AXA
PPP Healthcare will provide you with access
to high speed and quality international assistance.
If
you will be expatriating to a difficult or inaccessible
location, or are unsure of the standard of medical
care available locally, it is highly recommended
that you check that your preferred policy makes
provision for this. Bear in mind, however, that
the evacuation must be necessary, rather than
just preferable; if there is no way that the emergency
can be dealt with locally, then you will be evacuated
to the nearest facility able to deal with it,
rather than one of your choosing.
Many
international insurers claim to be online, but
in truth the whole process is unlikely to be conducted
entirely via the Internet, at least not yet. The
majority of brokers and providers provide online
quotes, or quotes by e-mail, and there is usually
a facility for downloading application forms for
policies, but having downloaded the forms, you
may have to resort to slightly more low-tech methods
to get the information to them.
There are, however, an increasing number of exceptions to this rule.
International Life Insurance
There
are many different reasons why taking out a life
insurance policy should be considered a priority
for those with dependants and responsibilities.
Life insurance is principally concerned with providing
for the living, and with a great many whole life
policies, it is possible to provide yourself with
a reasonable level of retirement income by borrowing
against your own assets, and provide for your
loved ones in the event of your death or incapacitation.
Below are some of the more common ways that personal
life insurance can be used:
-
Can be used to take care of your dependants
when you are no longer there to do it.
-
Can remove the immediate financial burden of
your death from them (e.g. estate taxes, funeral
costs, etc)
-
Can be used to pay off any debts outstanding
at the time of your death
-
Can provide money to fill in for lost income
or pay for treatment should you be diagnosed
with a terminal illness
-
Can supplement retirement income, and often
provide tax benefits.
Whether
you are an expat or a professional looking to
buy a domestic life insurance policy, your concerns
will undoubtedly be the same - the welfare of
your family in the event of something unexpected
happening. However, as an expat, you are probably
in a position to take advantage of the greater
benefits available through international life
insurance, in a way that a stay-at-home policyholder
would not usually be able to.
Policies
sold within the jurisdiction of a specific government
are often in a strait-jacket of taxes and regulations
which defines the types of investment the insurance
companies can hold their assets in, the types
of investment they are allowed to offer their
customers, what reserves they have to retain on
their policies, the mortality assumptions they
have to make, and the commissions they have to
pay to those who market their products. This amount
of regulation serves to make their returns unattractive
when compared with international policies in the
vast majority of cases. International policies
also have the advantage over domestic policies
for expatriate professionals in that they are
payable in US dollars or other stable currencies,
medical examinations can be conducted wherever
you are, and it is possible to pay premiums in
a greater variety of ways, for example by cheque,
wire transfer, or in some cases by credit card
over the internet.
Although
policies often vary in their details, there are
three basic categories of personal life insurance
available, all with different advantages and disadvantages.
These are:
| 1) |
Term
Insurance. This type of insurance is taken
out for a specified period of time, for example
5, 10 or 20 years, and if you stop paying
the premiums, the coverage ends. No cash value
accrues in a term insurance policy, so you
can't borrow against it in later life, and
like the rent on an apartment (because in
effect you are 'renting' the cover in a similar
way), the premiums can go up at the end of
the specified term. This may not sound ideal
(what if you get hit by a bus the day after
your cover expires?), but in the short term,
it provides the highest amount of cover for
the lowest price. |
| 2) |
Whole
Life Insurance. This type of policy is usually
more expensive, both in terms of initial costs
and annual premiums, but has the advantage
that the premiums are usually fixed for the
duration of the policy, and you can build
up equity. It is essentially a blend of pure
life assurance and an endowment policy that
matures on death. Although 'static' citizens
can usually take advantage of tax privileged
domestic pension schemes (which often contain
an element of life insurance), this is probably
not so for expats, who are unable to benefit
in this way due to their mobility. Therefore,
an international whole life policy may be
worth considering from the point of view of
tax efficiency. |
| 3) |
Universal
Life Insurance. This type of policy is a combination
of term and whole life insurance, and offers
you greater flexibility about the amount you
pay each month and the amount of protection
you desire, which is great if your circumstances
suddenly change. Some insurers offer policies
whereby premiums can be increased and decreased
depending on your requirements and the desired
rate of return of the cash value in the policy. |
The other tax implications of owning international or offshore life insurance
(with particular reference to whole life policies) are several. As well
as serving the primary purpose of providing for your loved ones should
the worst happen, offshore life insurance policies will usually provide
substantial liquidity, tax free appreciation of investments within the
policy, and borrowing at below-market interest rates from the investment
account. (Although you need to be careful that you don't borrow so much
against your policy that there are no longer sufficient assets for it
to be classified as a life insurance policy.) Offshore and international
life insurance policies can also provide a certain degree of asset protection
for high net worth individuals, as confidentiality legislation is usually
much better developed offshore than onshore. Be aware of the regulations
regarding taxation and life insurance policies in your country of tax
residence, though, as they may have an adverse impact on the benefits
that you can receive.
Offshore insurance products are often known as 'wrappers', and can have
the effect of creating a portfolio structure within which individual investments
can be made rapidly and without additional 'kyc' hurdles. Such portfolio
bonds are offered by a variety of companies, often through subsidiaries
of well-established insurance companies in the Isle of Man, the UK Channel
Islands, Luxembourg, Ireland or Liechtenstein. The insurance law introduced
in Liechtenstein in 1996, and compatible with applicable European Union
directives, has made Liechtenstein an attractive location for business
with structured life insurance products. Policies concluded under Liechtenstein
law enable wealthy customers to invest their assets in life insurance,
and therefore benefit from attractive tax conditions and from the advantages
of wealth management and estate planning.
Many of these jurisdictions offer a combination of confidentiality, security
and legislative protection in the event of default of obligations by the
issuer. There are many specialist firms offering sophisticated life insurance
products for high net worth individuals.
The British HMRC usually treats such products as bona-fide Life Assurance
contracts; the situation varies in other countries.
A note of caution, however. Although international life insurance providers
(and their clients!) undoubtedly benefit from less stringent taxation
and regulation, it does make the waters a little more dangerous for those
expatriates looking for the right insurer and policy. However, if you
do thorough due diligence on the international provider or broker before
you deal with them, trying to obtain references from other customers,
auditors, etc, where possible, and ensure that they are a reputable, well
respected, and financially solvent institution, you shouldn't encounter
any problems.
|