Estelle Bibby explains why expatriates need special policies designed to cope with local conditions

During 2005 British nationals made over 60 million trips abroad. A staggering percentage of travellers are still leaving without adequate insurance.

According to Mintel, one in five people aged 18-24 who took a holiday last year did not take out travel insurance. The corresponding figure for people aged 45 - 64 was only 6%. If you aren't properly prepared before you go on holiday it could end up costing far more than you think. Here are some figures from the Foreign and Commonwealth Office of the cost of treatment for typical medical conditions:

- pounds 600 - Two days in a general ward, Mediterranean

- pounds 400-600 - Gastro-enteritis, Mediterranean

- pounds 10,000 - Broken leg, US

- pounds 20,000 - pounds 30,000 - Heart attack, US

- pounds 15,000 - Bronchitis requiring seven days in-patient treatment, Far East

- pounds 20,000 - Bronchitis requiring seven days in-patient treatment, US.

What is now worse, for guaranteed sunshine or because of securing better value, we Brits are buying property abroad and staying for significant periods of time without adequate medical cover.

In the past decade, the value of foreign property owned by UK residents has increased by around pounds 16bn to just over pounds 23bn in 2004, a staggering increase of over 300%. In the past five years, the value of properties abroad owned by Brits doubled, says the Office of National Statistics (ONS).

Over the past two years the number of second homes owned by British residents in Spain stood at 69,284. Second most popular is France, where UK residents owned 51,322 last year. The ONS says that Spain and France now make up over 70% of European property investment by UK households. The US ranks third in the popularity stakes, and Portugal fourth, with Italy fifth most popular among UK buyers.

This significant rise in the purchase of second properties and the relocation of Brits abroad has brought a new lease of life to the expatriate insurance market.

So what's the difference between expatriate healthcare and travel insurance?

Chris Isaacs, of Acumus Insurance Solutions, explains: "Expat healthcare has been designed specifically for those living overseas for significant periods of time, whereas travel insurance will provide basic cover for the length of stay specified.

"People often get caught with medical insurance cover, they either assume that the country of residence is going to automatically cover them for their medical insurance needs, or they take out a policy with inadequate cover. It is important for expats to know that a standard travel insurance policy isn't going to cover them in the long-term."

Health insurance arrangements vary greatly from country to country. But even where well-resourced state schemes exist, entitlements may be restricted to the most basic care.

Isaacs says: "Elsewhere in the world, the standard of healthcare you might expect is just not available. And whatever the case, the cost of paying privately for even the most routine medical treatment is likely to be expensive.

"In previous years the expatriate market might have seemed like a minefield, but with market growth over the past 12 month companies have lifted their game and introduced accessibility and simplicity of products for brokers and consumers.

Affinity partners

Goodhealth, for example, one of the first organisations to launch expatriate healthcare online, also provides expatriate healthcare through affinity partners such as American Express.

Andrew Apps, of Goodhealth, adds: "While Goodhealth provides expatriate cover for all foreign nationals, we have seen a steep increase in business from the European and US markets. As overseas living has become the norm we have had to work hard to ensure that we provide an accessible, reliable and most of all cost-effective product.

"As soon as a prospect becomes a customer everything is then focused on ensuring that the customer receives the help, support and advice that they require.

"When expatriates move to a new country they will often have little knowledge of the local healthcare infrastructure - which can often be very poor.

We provide our customers with Global Health Data Bank (GHDB), an online tool that provides policyholders with instant access to vital medical information in most of the world's regions."

Coinciding with the introduction of this facility, Goodhealth has seen a 40% rise in the number of group (companies with staff in various locations around the globe) quotations it is receiving.

Apps continues: "While we recognise that GHDB is not the sole cause of this rise, it has proved to be a highly attractive unique selling point."

Goodhealth has recently signed an agreement with China Life Insurance Company to launch the first worldwide healthcare insurance plan in mainland China.

There's really no excuse for travellers not to purchase travel insurance, but every year it still happens.

One campaign that has really made a difference is an ongoing travel safety campaign run by the Foreign & Commonwealth Office called Know Before You Go, launched in 2001.

The campaign encourages British nationals to be better prepared for their overseas trips with a view to avoiding common travelling traumas, risks and dangers. There are currently over 180 partners who support the Know Before You Go campaign.

Companies sending staff aboard are usually prepared to pay for quality cover. Expatriate workers tend to be healthy and sensible, making them a better risk. Insurers and intermediaries are ever more active in this area, but let us not forget the growing number of early retired seeking a warm climate.

Now is the time to get into the expatriate market for profitable growth but customer service is just as important as price.

Play safe with bird flu

Although the death toll from bird flu remains relatively low, the World Health Organisation confirmed 169 cases of the virus in humans in Indonesia, Vietnam, Thailand, Cambodia, China, Turkey and Iraq, leading to 91 deaths. The disease is said to be a significant threat.

Currently there are no specific restrictions for travellers to any of the countries affected by bird flu, as the risk is believed to be very low. But if a client is planning to travel to the areas affected, it is worth noting these precautions: - Avoid visiting live animal markets, poultry farms and other places where you might come into contact with wild, domestic or caged birds - Avoid contact with surfaces contaminated with animal faeces or fluids - Avoid eating or handling poultry, egg or duck dishes, if any of these are undercooked or raw - Wash hands regularly - Do not attempt to bring any live poultry products back to the UK - Do not eat dishes made with fresh duck blood or any other raw or inadequately cooked poultry or egg products.

Most human cases are thought to have acquired their infection following exposure to dead or diseased birds. Evidence suggests that particularly risky exposure occurs during the slaughter, plucking and preparation of poultry for cooking.

Normal cooking destroys the avian influenza virus. No cases of avian influenza have been linked to the consumption of properly cooked poultry and egg products.

While there's currently no effective treatment for avian flu, most insurers will cover clients for the cost of treatment and evacuation but in pandemic situations this is not always possible.

A flu outbreak could escalate to a pandemic extremely quickly and with little warning. Some countries might close their borders, international transport could be severely disrupted or halted, and travel could become medically inadvisable.

In these circumstances, and because of the likely numbers involved, the Foreign & Commonwealth Office is advising that it will not be in a position to offer repatriation to British nationals. It is therefore vital that all expatriates and travellers take out adequate cover.