IPMI for cargo ship and yacht crew

Policy choice

Teresa Evans, Life and Wealth Planning Expert at Yachting Financial Solutions, based in Ireland, gave ITIJ her insights on insurance for superyacht crews: “Superyacht owners are required to provide health and accident insurance onboard, typically through health insurers, but this excludes transport on land, to and from the boat.”

She suggested that crewmembers maintain personal insurance for greater control and coverage flexibility, likening it to insuring oneself rather than just valuables – “the golden eggs or the goose”.

Additional private medical insurance can be the preferred option for crewmembers, due to its more comprehensive and flexible coverage

Many crewmembers are on permanent contracts with some insurance coverage but this is often inadequate for their needs, she told ITIJ.

Yachting Financial Solutions acts as an intermediary, facilitating discussions between boat owners and insurers to tailor policies that cover time off the boat and international travel.

They work closely with Bupa and Expatriate Healthcare to streamline the insurance process and ensure crews have access to comprehensive coverage worldwide. Both insurers offer straightforward options, with Bupa providing a basic maritime scheme globally and Expatriate Healthcare offering personalised plans, including life insurance.

“These insurers provide 24/7 multilingual support and services like digital cashless payment for medical expenses,” Evans said. “Mental health coverage is increasingly included, reflecting growing industry awareness of crew wellbeing amidst the unique challenges of yacht life, which blends the work and living environment.”

Another option for crews is International Marine Medical Insurance provided by International Medical Group (IMG). Justin Poehler, IMG Chief Commercial Officer, told ITIJ: “This was specifically designed to provide continuous medical coverage to groups of two or more marine crew professionals who live and work on oceangoing vessels.”

He pointed out that crew leaders may choose from multiple plan levels, deductible options, and areas of coverage to tailor a plan that best fits their needs.

“In addition to medical coverage for illness and injury, these plans also provide benefits for preventative care,” he said, “plus options for vision and dental benefits, teleconsultation, remote mental health services, and group life insurance.”

Poehler explained: “We have an entire marine division of our company dedicated to better serve those travelling the world via yacht or vessel. Our team has expertise in marine claims, medical management, and international assistance services, and we are equipped to help marine crews properly prepare for injuries or illnesses that occur while on assignment.”

Cargo ship challenges

Cargo ships can bring their own health risks and difficulties for crews, as Vanya Jackson, Customer Service Manager at Charles Taylor Assistance, outlined. The company provides global medical and security assistance, travel risk management and claims solutions.

Jackson told ITIJ: “Challenges to assistance include sick and injured cargo ship crew being disembarked in isolated destinations. Adding to these challenges is the increasing number of cargo crews crossing dangerous waters like Bab al-Mandab and the Gulf of Aden, where attacks are common.

“Cargo ships rarely want to relinquish a crewmember, so, wherever possible, we’ll do everything we can to restore a patient to health and get them fit to work again as quickly as we can.”

The most common physical problems requiring assistance involve upper or lower limb injuries, Jackson said.

“For these patients, we’ll normally organise an onshore medical assessment and either arrange suitable land-based care or repatriation. For minor injuries, we may put in place a course of physiotherapy, which generally means the patient returns to sea and is referred for treatment at different destinations along their route.

“This can throw up the challenge of having to book several different physiotherapists in different destinations. But we make sure treatment plans are carefully managed and coordinated.”

Spending up to nine months at sea in cramped conditions can take a significant toll

Jackson added that she is currently seeing an increasing number of assistance cases involving mental health conditions for both cargo ship and yacht crews.

“These conditions can be exacerbated by the close confines of living quarters at sea and lack of activities outside daily work routines,” she explained.

“Sadly, we’ve also seen unpredictable crew deaths or serious injuries having a major impact on mental health, especially as crewmembers can become like family after being together for long periods. Every case is different and each patient’s care needs to be guided with extreme sensitivity, so our tailormade responses will range from setting up remote counselling to organising onshore mental healthcare or, if necessary, repatriating patients.”

Seafarer cover

Richard Yates is Director and Founder of Health Cover Now, a specialist health insurance broker based in Australia, which assists seafarers and superyacht crews.

He told ITIJ about the rising trend in provision for mental health support. “Seafarers play a crucial role in ensuring the seamless flow of global trade and logistics. Yet spending up to nine months at sea in cramped conditions can take a significant toll on their wellbeing.

“Recognising these challenges, shipping companies have taken steps in recent years to enhance crew welfare. Initially focusing on providing better access to Wi-Fi for regular communication with friends and family, they have since moved towards offering more comprehensive medical benefits. These include 24/7 access to medical practitioners and counselling services, which will go a long way towards improving the health and wellbeing of seafarers and crew.”

Yachts and private boats generally avoid dangerous areas, Evans told ITIJ, “although some expedition yachts venture to remote locations like the Arctic for scientific studies, requiring specific health insurance for activities such as deep-sea diving”.

However, most yacht crewmembers aren’t exposed to high risks. “The ‘Mediterranean milk run’ is a popular route for superyachts,” she said, “cruising through the French, Italian, and Greek waters. It remains the top destination for superyachts, with the route from San Remo to St Tropez bustling from May until the Monaco Yacht Show at the end of September.”

Nevertheless, medical situations at sea can be highly unpredictable. Poehler recounted the shocking experience of one client.

“In one case, an IMG customer was approached by two sharks in the South Atlantic Ocean and suffered multiple shark bites to the arm and leg, leaving the customer in a critical condition. IMG quickly coordinated an air ambulance evacuation for the patient to receive the proper and necessary treatment.

“Throughout this experience, IMG’s medical services team managed the patient’s visas and expedited their trip through customs and immigration, ensuring the patient received efficient treatment for their injuries. The team continued to monitor the case during the patient’s recovery period and return home as well.”

Jackson also highlighted an unusual occasion. “One repatriation we carried out involved a complex journey from Antarctica to Canada via Ascension Island,” she told ITIJ.

“There are the same high expectations of assistance no matter where crews are in the world. In every case, good teamwork is essential to ensure patients reach the most suitable care as quickly as possible.”

More common scenarios might include a crewmember suffering an injury or acute illness, Andrew Blomberg, Vice President of Global Benefits at International Citizens Insurance, told ITIJ. “While working on a yacht, a crewmember might slip and fall, sustaining a severe leg injury,” he said. “The yacht is in a remote location, several days away from the nearest port, with adequate medical facilities. Or a crewmember develops acute appendicitis while the yacht is crossing the Atlantic Ocean.”

In both situations, key considerations would include a need for immediate medical attention to prevent complications.

“Due to the remote location, arranging for an evacuation to a medical facility is logistically challenging and costly,” he said. “Coordinating between the boat, medical responders, and insurance providers can be complicated, especially with limited communication infrastructure at sea.”

Global disruption

It’s clear that yacht and cargo ship crews often face unique challenges. However, the Covid-19 pandemic brought unprecedented global disruption, prompting new approaches to crew welfare and medical care.

Poehler told ITIJ: “One of the primary changes that has occurred in this market segment throughout the past several years is the inclusion and expansion of telehealth services available to marine crew clients.

“Telehealth services for non-emergency medical issues, as well as mental health issues, have been embedded into the marine crew insurance products we offer. This allows marine crewmembers to easily receive non-emergency care anywhere in the world via phone or online video consultations.”

Many crewmembers are on permanent contracts with some insurance coverage but this is often inadequate

Further changes in response to the pandemic were outlined by Blomberg: “Policies now often include coverage for Covid-19 testing, treatment, and quarantine expenses. Repatriation provisions were improved during the global health crisis, including coverage for extended stays and special transportation arrangements.”

In addition, there was an increased reliance on telemedicine services to provide remote medical consultations and support, reducing the need for immediate evacuation in some cases.

Blomberg added: “Adoption of wearable health technology to monitor crewmembers’ vital signs in real time increased, as did the use of satellite communication systems to maintain reliable contact with medical professionals and insurance providers, even in remote locations.”

Overall, Blomberg said: “Yacht and cargo ship insurance for crewmembers is an essential component of maritime operations, providing critical protection for the individuals who work onboard. By understanding the various coverage options and selecting the right policy, both owners and crewmembers can ensure they are well protected against the unique risks of working at sea.”

It is clear that IPMI is rapidly adapting to meet the unique healthcare needs of cargo ship and yacht crewmembers. A rise in mental health support and the use of digital platforms is enhancing the healthcare offering for these groups in terms of both accessibility and quality.