As already indicated, the type of medical problems experienced by UK travellers abroad varies considerably from region to region. A more detailed analysis by region and country is provided below but, as a general rule, claims originating in the Middle East are much more likely to be destination-related (DRDs) than those originating in other regions. DRDs account for 80% of all claims originating in the Middle East. They also account for high proportions of claims in Asia (51%) and Latin America (50%), but a low proportion in Oceania (27%).
The share of DRDs in Europe is also relatively low. This can of course be explained by the fact that the majority of UK residents travelling in continental Europe – at least in the EU and EEA member countries – carry the European Health Insurance Card (EHIC) and are able to receive medical care either free of charge or at reduced cost.
% shares of MAPFRE ASISTENCIA UK claims by type of diagnosis in each region, 2013/14
The proportion of TRAUMA cases is highest in Europe and Oceania, with Oceania also having the highest proportion of Other Non-Destination Related Diagnoses (ONDRD).
Not surprisingly, given the dominant position of Europe in the UK ranking of foreign destination regions visited, a significant share of the UK claims (50%) handled by MAPFRE ASISTENCIA in 2013/14 originated in Europe. However, the share was still well below the 78% share of actual trips taken to, or overnights (60%) spent in, other parts of the European region. Again, this can be explained by the fact that most UK residents travelling in continental Europe carry the EHIC, as described just above.
39 51 38 50 80 40 27 28 23 34 22 9 28 32 33 26 28 28 11 32 41
Africa Asia Europe Latin
America Middle East AmericaNorth Oceania
DRD TRAUMA ONDRD
Type and level of health risk vary by region
Half of all claims originate in Europe
MAPFRE ASISTENCIA UK medical claims by destination region, 2013/14
A comparison with the 2012/13 results shows that the breakdown has remained stable. Europe's share is down very slightly, as are Asia's and Oceania's, with North America showing the most appreciable increase, albeit a modest one, of two percentage points.
In order to avoid any distortion of the regional breakdown due to the impact of the European Health Insurance Card (EHIC) on claims originating in EU and EEA countries, the following chart excludes Europe from the world breakdown. This draws attention to the relative significance of the Middle East in the overall picture, especially when the share of claims is compared with that of overnights spent in the region in 2013/14 by UK travellers.
Share of nights spent abroad by UK residents vs. medical claims by region, excluding Europe, 2013/14 Europe 50% Middle East 21% North America 14% Asia 6% Latin America 5% Africa 2% Oceania 2% 5% 12% 10% 41% 28% 3% 15% 26% 14% 10% 28% 7%
Africa Asia Latin America Middle East North America Oceania Claims Nights
High share of Middle East-originating claims attributed to Egypt
t is therefore important to note that more than 50% of medical claims in the Middle East region originate in Egypt. Although the civil unrest and violence in Egypt over the past few years have undoubtedly taken a toll on demand for the destination, it remains a popular destination for UK outbound holidaymakers, accounting for some 4.8 million overnights from the UK in 2013/14. And, as other evidence will confirm later in this report, the incidence of DRDs is relatively high in Egypt's main tourism resorts.
The only region in which the shares of claims and overnights appear to be well correlated is North America, although Latin America comes close behind. For the purposes of this report, Mexico has been included in Latin America rather than in North America.
North America, which therefore comprises the USA and Canada for the purposes of this study, is not a region that is perceived as posing serious health risks for travellers. But because it is seen as a very expensive destination for medical treatment of all kinds, the British, like most other travellers, do pay particular attention to taking out travel insurance when visiting North America. And it would seem that the region's share of claims is in proportion to the overnight volume from the UK.
For Latin America, on the other hand, the fact that the share of medical cases per overnight volume is quite modest comes as a surprise, since local tour operators and suppliers usually recommend taking out good insurance coverage for any trip to the American sub-continent. The same is also true of Africa (another region representing a small sample) and the trend also begs the question "Why?" The most likely answer is that the destinations most visited by the British in Africa pose less of a health risk than general perceptions of the continent would lead some to believe.
In Oceania, i.e. Australia, New Zealand and the Pacific Islands, where the situation is similar, there is a good explanation. Under reciprocal healthcare arrangements between the UK, Australia and New Zealand, British citizens resident in the UK and travelling on a British passport are entitled to limited subsidised health services when visiting the two countries. So it makes sense to see a reduced incidence of medical claims in these destinations.