Why Getting This Wrong Means Extra Cost and Slower Response
A common question comes up with our global clients–many of whom already work with top-tier providers and carry robust insurance:
How do we best structure our travel risk management so that it actually works in a crisis, without unnecessary duplication or confusion?
After two decades advising on operational risk in MENA, Central Asia, and Africa-both in government and the private sector – we’ve seen almost every model in action. The systems that work are never the ones with the most logos or the biggest budgets; they’re the ones that keep it simple, integrated, and focused on the real risk – not just the ones that sound good on paper.
The Problem: Well-Intentioned Overlap
Here’s what we’re seeing at the coalface:
Multinationals invest heavily in high-limit travel insurance: Chubb, Allianz, Aetna, take your pick. At the same time, many are also retaining a separate medical assistance provider “just in case.”
The logic is understandable. No one wants to be exposed. The intention is solid: redundancy, global access, peace of mind.
But when something does happen -especially in a complex environment – the lines blur.
Employees aren’t always sure who to call. Local teams are left triangulating between the insurer, the assistance provider, and the security team. The net result: delays, duplication, and sometimes higher costs for the same outcome.
This isn’t a criticism of any specific provider or decision; it’s a reality that comes from how these services have historically been marketed and procured.
What Actually Happens on the Ground
Let’s cut through the process as it plays out in real time:
1. Employee gets sick or injured abroad.
2. First question: Are they insured? If yes, the insurer’s network and direct billing apply.
3. The key variable: local knowledge-which hospital, clinic, or provider can actually deliver, and is in-network?
4. The next step: arranging access and transport-usually possible through hotel partnerships or local support.
5. Where there’s no insurance, or if the case is complex, the right move is a specialist case manager-but only if required.
When this process is run through too many layers-a medical assistance provider, an insurance hotline, and a security operations center-the delays and confusion can be significant. The vast majority of incidents are resolved through local coordination and knowledge, not an international call center.
The “Medical Assistance” Model-And Where It Adds Value
There’s no question that firms like InternationalSOS, Crisis24, and Healix have helped set global standards for care and coordination. They’re good at what they do, and for organizations without strong insurance their case management capability can be essential to have to hand when needed.
But for companies that have already invested in top-tier insurance, and have Travel Risk Management partners with operational teams and vetted vendors on the ground, the value proposition changes.
Most of what these providers do in practice is:
- Validate coverage
- Recommend a local provider (usually from the insurer’s list)
- Coordinate logistics
- Provide updates
The overlap with what your insurer or Travel Risk Management partner can deliver is substantial. And in most cases, the insurer’s network is what dictates who can treat and who can bill direct.
Where the Costs and Delays Creep In
What we see across the industry–especially in the Fortune 500 and regional enterprise segment–is the hidden friction from having too many moving parts. This takes a few forms:
- Duplicate contracts: Paying for medical assistance on top of insurance, with both parties charging for similar coordination.
- Employee confusion: Not knowing which number to call, especially under pressure.
- Delayed authorizations: Assistance providers and insurers sometimes wait on each other for approvals, particularly for non-standard or high-cost cases.
- Local disconnect: The real “speed” comes from teams who know the ground, the facilities, and can coordinate in local languages.
All of this means response times are often slower than they should be, and overall cost creeps up–not because of bad actors, but because of legacy processes and overlapping roles.
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One point that doesn’t get enough attention: in every major city, premium hotels have existing relationships with local clinics and doctors–often with on-site or on-call services. For many medical events, especially after-hours, this is the fastest and most reliable route to care.
We regularly coordinate with these networks, arranging care and direct billing with the insurer–usually without the need for a third-party medical assistance firm.
One point that doesn’t get enough attention: in every major city, premium hotels have existing relationships with local clinics and doctors–often with on-site or on-call services. For many medical events, especially after-hours, this is the fastest and most reliable route to care.
We regularly coordinate with these networks, arranging care and direct billing with the insurer–usually without the need for a third-party medical assistance firm.
Case Example (Anonymized): The Hidden Efficiency Gap
We worked with a global technology company with a sizable travel footprint across Europe and Africa. They had top-tier Chubb insurance and a long-standing contract with a major medical assistance provider.
A review of twelve months’ worth of incidents showed:
- Over 80% of medical cases were resolved through insurer-approved facilities, coordinated locally.
- The medical assistance provider was only essential in two cases-both involving highly complex medical evacuations from remote locations – BOTH were outsourced by the medical assistance provider to a local provider… the same, that we use!
- Average incident resolution was 40% faster when routed through the in-country security/operations team in coordination with the insurer.
- There was a 25% annual cost reduction after streamlining protocols, with no decrease in outcomes or employee satisfaction.
So What Actually Delivers Value?
Based on 20 years on the ground, here’s what matters most for corporate travel risk:
- Know what you’re paying for: ASK: What do you do? What do you own overseas? What do you outsource? Who pays you? (are you paid a referral by insurers/clinics etc)
- Simplicity in crisis: One clear point of contact for the employee, with protocols that route medical cases to the insurer and security cases to the right team-without extra steps.
- Local intelligence: Partners who know which clinics and hospitals are trusted, have existing relationships, and can move quickly.
- Integration over duplication:. Security, logistics, and medical should be managed together, not as separate silos.
- Specialist escalation: For genuinely complex cases-multi-patient evacuation, or where standard insurance limits don’t apply-bring in the heavyweight case managers as needed. But make that the exception, not the default, and only pay when needed.
Key Questions for Decision Makers
If you’re reviewing your current model, or considering changes, these questions cut to the heart of efficiency and outcome:
- Are we paying twice for the same coordination service?
- Does our team on the ground know which local providers are in-network and trusted?
- In an incident, how many steps and approvals are needed before the employee gets care?
- Are we clear on which risks are actually uninsured, and how we handle them?
- Is our response time as fast as it could be-or are we adding steps that slow things down?
The Sicuro Approach: Integrated, Operational, Realistic
Our method is direct:
- For medical cases, we verify coverage, arrange access, and manage logistics using the insurer’s network and local partners.
- For security and uninsured events, we bring the full weight of our ground-level experience, intelligence, and crisis response capability. We also own assets and entities overseas… most of our bigger competitors actually don’t, unless you class “sales offices” as an asset that will assist you in crises?
- Only when needed-where complexity demands it-do we escalate to third-party case management – and that is very rare (like, twice in 20yr – and based on the associated post incident administration NOT the incident management).
This keeps costs under control, response times fast, and accountability clear.
Looking Ahead: Where Risk Management Needs to Go
The world isn’t getting simpler. Fragmented solutions, legacy contracts, and “just in case” thinking can cost more than they protect.
What leaders need is integration, operational clarity, and real-world outcomes.
- Use your insurance for what it’s built for.
- Leverage your security provider for on-the-ground intelligence and logistics.
- Reserve specialist medical case managers for when they’re actually needed.
The result: lower costs, faster resolution, and fewer headaches for everyone involved.
To any CSO or risk leader: If your current model feels more complex than it should, you’re not alone. Most of the inefficiencies I’ve seen are byproducts of good intentions and legacy decisions–not bad calls. But there’s a better way, and it starts with asking the right questions.
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