Wednesday, August 01, 2007


This is long but you can just go to my tips at the end if you like:

It's holiday time so this evening I want to tell you about a very interesting job I had after I left full-time secondary teaching: at the time [1996] I had lost a lot of confidence, still felt I was in a “dark tunnel” following the manner of my mother’s death and was very frightened indeed of whatever the future might hold. Nevertheless, I’d had a month in my beloved Italy, returned refreshed, and soon realised I was going to need to take a computer course in order to get another job. [Very few people used the internet at that time; most large organisations did not use an intranet and, believe it or not, it was still acceptable, in a school, to give the Head hand-written minutes of departmental meetings, bids for resources or other administrative information. In teaching, you would go on an in-service training course about computer use, learn what to do, then come back and forget it all because you weren’t required to use one every day – nor, if you were, would you have access to one.]

Anyway, it was through the company who trained me to use a computer properly that I heard of a job going with an international [French, based in Cardiff] assistance company. I applied and was hired, for my language skills. What is an assistance company? Well, take a look at your latest travel insurance policy. Somewhere in that, probably at the bottom of the second page and in quite large print, is an emergency number that you can call if you are taken seriously ill or have an accident on holiday. [Note: this is usually quite different from the number you should ring if you have something stolen, in which case you will need a police report and usually have to make the claim upon your return – unless the item stolen is your passport, in which case you must contact the nearest Embassy or Consulate of your country.] So you call this number and you imagine you are speaking to your insurance company, right? Wrong, actually. You are speaking to a co-ordinator from an international assistance company which has contracts enabling it to act for many insurance companies. Yes, the person who answers the phone may well say, “Good morning. [Name of insurance company.] You’re speaking to [first name]. How can I help?” That is because the phone display light tells the co-ordinator which insurance company name to quote in the “welcome” message.

I was so afraid during my first few weeks in that job! After all, it is quite something to go from a field in which you were an expert [education] into one about which you know nothing [medical insurance]. And still another to go from being a Head of Department, a position of considerable power in British state schools, to one in which you are learning all over again. But I swallowed my pride, buttoned my lip and thought of the money [which was not great but was adequate]. It wasn't only the new nature of what I had to do that worried me: I was working with young graduates. How would they react to me and would their language skills, so recently acquired, be superior to mine? I needn’t have worried on either score: One day I just thought, “Hang on, I’ve worked with young people all my life so why should it bother me now?” And sure enough, once I lightened up and my colleagues realised I could curse and laugh just as they could, I was “accepted”. And, young language graduates that they were, I was an older one, so their grammatical grounding had been quite different from mine, and it wasn’t long before they were quietly asking me to check over their foreign language letters and faxes!

How does a medical assistance company work? If you are on holiday abroad and are taken ill or have an accident, after receiving emergency treatment [but maybe before if you are in the USA!] the first thing that will probably happen is that you will be asked for your insurance documents. Then a relative or one of your party or maybe the hospital administration office will call the assistance company. This is where the languages may first come in. If you have had an accident, once someone has faxed a copy of the policy to the assistance company or told us where we can verify that it was purchased, the procedure is usually fairly straightforward [unless you have been an idiot and fallen from a balcony dead drunk or something]. Once insurance is verified, the assistance company forwards a guarantee of payment. Our role does not end there, however: you may need an air ambulance to be flown home [only in the most serious of cases will this be considered]; you may need to be flown home in some other way [ if you have a broken leg, you may need 2 or 3 seats, for instance or you may need a stretcher]; and the assistance company doctor needs to speak to the doctor on the spot to ascertain the best course of action. That is where the interpreting skills of someone like me and my wonderful young colleagues were needed.

If you are taken ill, then there are probably going to be more checks. You [or your nearest relative if you are too ill to do so] will usually be asked to sign a “consent” form which we will have faxed through: this gives the assistance company doctor the authority to talk to your UK GP for, in most cases, if there is a relevant pre-existing medical condition, this could affect whether or not cover is provided. Do not panic! Note I have said “relevant” and see my notes at the end of this post. Again, the assistance company doctor then discusses your case with the treating doctor abroad and again, this is where someone like me interprets, where necessary, and becomes the "middle woman".

Occasionally – well, probably twice a day, sometimes more – there would be a death abroad. This was always very upsetting to deal with , especially where children were involved. I remember a school trip coach crash in France which we dealt with in which several children were killed. As a former teacher, I could imagine how the teachers on that trip felt and even now, 10 years later, I think of that school community every year when the anniversary comes up. Colleagues would pass on a lot of “death cases” to me: after all, they were young, mercifully had not yet had a bereavement and I had. I might not have had their speed on the computers but I like to think I knew how to talk to people in distress. Once insurance is verified, it is established that the death was not due to a pre-existing condition or carelessness [eg., skiing on a “black” piste] then the case could be passed to a firm of international undertakers , who dealt with it from there on. [These companies employ their own interpreters and, strange though it may seem, I wouldn’t mind working for one: I am drawn to the meticulousness of detail, for one thing, and, once it has happened, it has happened: you can’t change it but it is just possible that you can , at least, smooth matters for those left behind.]

“Why all these checks?” you may ask. Believe it or not, there are medical insurance cheats around: an example is someone who is waiting for a non-urgent operation in the UK, gets fed-up and then goes to visit a relative in the USA with the idea of pretending that the condition had its onset whilst there. The assistance company and the insurers who contract it will almost always find these misguided souls out. I have even known insurance company employees fly out to the USA to check the situation out.

What did I like and what did I not like about this job, then? I loved the “buzz”, working in an international setting, using my languages for life and death situations instead of “just” teaching them and I liked all that I learned every day. I liked working the night shift [we all had to, sometimes – it was an international, 24-hour service] once it was past about 2 am and American hospital administrators had stopped calling you about who was going to pay and when. I liked speaking at all hours to people all over the world and I liked thinking I was helping in some small way. There was also a perk of the job: sometimes a non-medical linguist escort was needed for a patient or to accompany a doctor in charge of a medical repatriation – I got a nice trip to Lyon that way. I hated being shouted at down the phone and people who would call up just to be “awkward”. [ Yes, people would ring on Xmas Day, not because of an emergency, but about some administrative question like “Who underwrites my policy?” – something only the insurers, not the assistance company knows and I used to wonder about these folk with nothing better to do. We used to have to page a manager who would have to call the big boss of an insurance company in the middle of Xmas dinner to pacify these nutters!] But most of all, stressful though the job was whilst you were doing it, for someone who had taught IT WAS A WONDROUS THING TO GO HOME AND NOT WORRY ABOUT IT AGAIN UNTIL YOU GOT TO WORK THE NEXT DAY. No marking, preparing or reporting till the early hours!

In April 1998 the company decided to amalgamate with a London-based assistance company and to relocate. Although I was offered a package to join them , I thought, “Wait .. I’m 48 now. What if I give up everything to go to a much more expensive city and then they decide to get rid of everyone over 40? How do I get another job then?” And even at that stage, I knew that if I was going to move, it was going to be the big one – to Sicily!

Well done if you’ve stayed the course. But even if you haven’t, here are my ESSENTIAL TRAVEL INSURANCE TIPS:

1. If you can, leave a copy of your insurance documents with someone at home, particularly if you are going somewhere off the beaten track where fax facilities may not be ubiquitous.
2. Do not assume that, because you are travelling within the EU, the E111 will cover everything. It will not. Ambulance transfers, for instance, do not come under the control of hospital administration offices in all countries. They are often charged for separately. If you are skiing, piste recovery is a separate charge. The UK has reciprocal medical agreements with Oz and NZ, but again, not everything is covered. GET INSURED!
3. If you have had a recent operation or illness, or suffer from a chronic condition, check the small print of your policy carefully. Also get a “Fit to fly / travel” note from your GP: this will save no end of enquiries if you do need treatment abroad.
4. Check what your policy says about outpatient / GP treatment whilst you are abroad. It may say that you should pay on the spot and claim upon your return [“pay & claim”] and, in this case, that is exactly what you will be expected to do.
5. If a family member is taken seriously ill or has a serious accident abroad [or less serious in the case of a child] most insurance policies will cover for ONE person to stay behind / be flown out. They will cover accommodation for that person but NOT the cost of meals or phone calls when they are abroad. Make sure you have sufficient funds / credit to cover such an eventuality if you are the one staying or being flown out.
6. If you have a “free” travel insurance which comes with, say, your credit card, read the small print very carefully. The chances are that it will cover NO pre-existing medical conditions.
7. If you need to take out an ex-pat policy, check the wording even more carefully regarding pre-exisiting conditions!
8. If you are skiing, make sure you have the RIGHT kind of cover and DO NOT TAKE SILLY RISKS! [We used to dread the ski season in that assistance company – it was busier than the summer season. “Why not just throw yourself off the balcony?” we used to say.]


CityUnslicker said...

yes quite right and you can buy very comprehensive insurance fro all holiday for a whole year for under £30 in the UK.

Jeremy Jacobs said...

You'd be mad not to have insurance.

Welshcakes Limoncello said...

Hi, c/u. Yes, you can - but if you have pmh [past medical history] you need to check the cover. JJ, yes, but people still risk it!

Lee said...

It's quite amazing when that moment of realisation hits, isn't it, the one you experienced in that new position. Suddenly out of no where it enabled you to let go of all those pent up fears regarding your new job.

It must have been a challenge for you to make such a radical change in the direction of your normal career...but what an interesting one it turned out to be. Faced with the "crossroads" an choosing which path to take is always intriguing. I often wish I could go back and try some of those other paths I've been faced with throughout my life...the ones I by-passed...just out of see where they would have taken me. I guess, I'm not alone in these thoughts.

jmb said...

When you live in Canada and travel a lot to the US you certainly never go without insurance. In fact I buy it by the year since we live near the border and can go across for the day. Unfortunately as you get older it gets much more expensive and our policies are getting to be hundreds of dollars a year each, even with a thousand dollar deductible.
Interesting post WCLC.

Anonymous said...

Good advice.

Anonymous said...

I am hoping I will get an invite to visit Sicily this summer.... I shall wait till then to take out insurance...

Great post.

Wolfie said...

I've found annual travel insurance a good idea. Especially because it covers me for skiing and for all those little trips over to Spain to visit my in-laws.

Another tip, when biking in Europe I get my motor insurance company to send me a copy of my cover in each European language. The French police really love to check your paperwork and rarely speak English.

You should see their look of disappointment when I pull out a leather folder with all my documentation neatly ordered in little pouches. No fine for you today boys!

James Higham said...


Like bobsledding just as it starts to rain and doing a Smith's fracture in the north of Finland? That sort of thing, Welshcakes?

Welshcakes Limoncello said...

Hi, Lee. No, you are not alone. I think we all wonder about "the path not taken" but we will never know. Thanks, jmb. Yes, I think annual policies work well for those who travel a lot. I know the price goes up as you get older, though! Mutley, Steve - thank you. That's a good tip, Wolfie. I'd love to see the faces of those police! Hi, James. I mean like the sad case we dealt with of a woman who died skiing on a closed piste in atrocious weather. Can you imagine telling her distressed family that the ins company wouldn't cover?

Anne in Oxfordshire said...

Thanks WL,very handy to know all that. But now the E111 has been replaced with the EHIC..

which you still get from the Post Office, but you have to have one person, and it comes as a small card...also this form as to be sent off, not stamped at the post office like the old E111, or you can apply online for it.

Welshcakes Limoncello said...

Hi, Anne. Yes, I did know about the card but the principle is the same - it won't cover everything!

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Mark McLellan said...

WL. Thanks for the tip. We travel to our Hovel in the Hills about every other month and never have our documenti with us. I will make sure I take a set of photcopies out with me next trip. Mark.

Mark McLellan said...

PS. Following on from Wolfie's comment. If you are in a hire car and are spot-checked by the Italian traffic police they, like the French police, will ask for your documenti. Ooops I thought where the h*** are they! But Avis very sensibly put a copy of their corporate insurance cover in with the car's manual. And I always carry my English driving licence with me. So that went OK. Mark.

Welshcakes Limoncello said...

Hi, Mark. A set of copies is a good idea. That's a very efficient move by Avis, too.

Rodger said...

Excellent post, I found it very informative, keep up the hard work. Europe Travel Insurance


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