Who Pays for the Victims of Terror?

July 17 started out as a typical workday for Max Boon, a 33-year-old Dutchman, as he was attending a breakfast meeting for his company, CastleAsia, at the JW Marriott hotel in Jakarta.

Then a neatly dressed man walked into the Marriott’s lobby lounge, where the CastleAsia meeting was under way, and detonated a suicide bomb. Almost simultaneously another bomb exploded across the street at the Ritz-Carlton Hotel. Nine people died in the attacks and scores were injured.

Boon’s life was changed forever. With a degree in Indonesian studies from the Netherlands, after six years in Jakarta he was planning to make a lifelong commitment to working here. Instead he was critically injured and soon became a symbol of the deadly attacks carried out by a splinter group of the radical Jemaah Islamiyah.

“He always wanted to go to Indonesia since he was in high school, it was Max’s life goal,” said Charles Huijkins, a spokesman for the Boon family.

But what happened to Boon after the blasts remains a cause for debate. It has evoked bitterness among his friends and associates. It has also highlighted a little-known fact buried in the fine print of international health insurance policies: many policies don’t cover acts of terrorism, leaving survivors financially vulnerable.

Who Pays?
Given the number of terror attacks worldwide, many targeting foreign nationals, who should ultimately be responsible — governments, insurance companies, hospitals or victims — for paying the medical bills if health policies don’t cover terrorism? In the case of Boon, the Dutch government stepped in, but only after unflattering publicity turned the case into a public issue.

“Risks that are worth being insured should be on predictable conditions or situations, while terrorism falls in the category of disaster,” said Rosa CH Ginting, president director of InHealth Insurance Indonesia, one of the country’s largest insurance providers. “And, as such, the risk is incalculable. That’s why most insurance companies don’t cover acts of terrorism.”

Boon was rushed to MMC Hospital near the Marriott after the blasts for emergency surgery. On July 19, he was evacuated to the National University Hospital in Singapore with shrapnel wounds, severe burns, serious leg injuries, damage to one of his lungs and a broken right arm. Incredibly, Boon survived, but he will spend the rest of his life in a wheelchair as he has lost both legs below the knee.

“At the beginning, we thought he wouldn’t make it. He was in very critical condition in Jakarta, but the quick evacuation to Singapore saved his life,” Huijkins told the Jakarta Globe.

On Sept. 4, Boon was stable enough to be transferred to the Netherlands. Doctors at the University of Utrecht Medical Center, located near where Boon’s family lives, are still waiting for an opportune time to remove shrapnel lodged in his heart muscles.

For weeks, Boon and his family were in limbo about who would pay for Boon’s medical treatment in Singapore, which by the time he was transferred out had reached well over $100,000. This was primarily due to the fact that the Dutch government didn’t step in with a financial guarantee that Boon’s hospital bills would eventually be paid.

“The first few days were so chaotic because there was no guarantee on who would pick up the bill in Singapore,” Huijkins said.

The process of evacuating Boon from MMC Hospital to Singapore was also anything but smooth. Boon’s health insurance provider, Pacific Cross of Hong Kong, only covers a maximum of $100,000 for emergency treatment, but fortuitously that includes injuries suffered in an act of terrorism.

However, the evacuation costs alone to Singapore were about $30,000, and immediately upon his arrival, Boon underwent a second emergency surgery at National University Hospital. Within days, his hospital bills had surpassed his insurance coverage.

As the days passed and the bills mounted, so did questions about who would pay, not to mention the 24-hour care that would be required over the coming months, or years. CastleAsia, Boon’s employer, even sought private donations to cover his medical bills when it was unclear whether the Dutch government would be the final guarantor of payment.

Does Your Country Cover You?
Dutch newspapers and television stations quickly jumped on the story, reporting that Boon’s family couldn’t afford the medical bills, his insurance was exhausted and the Dutch government was making no commitments.

Public outrage soon followed, after which the Dutch Foreign Ministry informed Boon’s family that they would issue a guarantee for the bills at National University Hospital. Gonneke de Ridder, a spokeswoman at the Dutch Embassy in Jakarta, said she couldn’t release information about Boon’s case because of privacy rules.

So how do other countries respond when their citizens are injured in terror attacks?

After the July 17 bombings, the Indonesian government paid for the medical treatment of its citizens and offered to cover foreign nationals if they were treated in Indonesia.

However, badly injured foreigners opted to be evacuated to Singapore, which is known for its health care. In doing so they became responsible for their own medical bills.

“Citizens of one country, including Americans, who are present in another country, such as Indonesia, are under the laws, authority and benefits of that other country,” said Stafford A Ward, a spokesman with the United States Embassy in Jakarta.

The US Embassy, he said, will send staff to hospitals to check on the well-being of American citizens and help them to contact family members.

However, Ward said, the US government won’t pay medical bills or act as a guarantor for payment. “We monitor their condition if they are injured, but their medical care is a responsibility belonging to themselves, their employers or local sponsors and local authorities, not the US government,” he said.

Australian citizens are in the same boat. Their government doesn’t cover their medical bills overseas, even for injuries suffered in a terrorist attack.

“We encourage all Australian citizens to take out full travel insurance while they travel overseas,” said Michael Kachel, a spokesman at the Australian Embassy in Jakarta.

A total of 95 Australians have been killed in terrorist attacks in Indonesia since October 2002. This includes the 88 killed in the 2002 Bali bombings, four in the 2005 Bali bombings and three in the July 17 attacks.

What if the Worst Happens?
So what happens to foreign nationals if they don’t have insurance, or enough insurance, and are injured in a terrorist attack or other disaster? Will their governments help them out?

Don’t be too hopeful. The United States, like many other countries, doesn’t have dedicated funds for such contingencies and its embassy will only facilitate communications with family and friends.

“If the American is destitute we contact relatives, friends, others for a loan. If, after an investigation, no private loan is available, in dire emergencies we can ask Washington for a limited loan to repatriate an American,” Jeffrey S Tunis, the consul general for the US Embassy in Jakarta, said in an e-mail message.

Ginting of InHealth Insurance said governments should have a reserve fund for special situations, such as Boon’s.

“I think ideally, on occasions like that, a state or government should bear their citizens’ medical coverage,” she said.

That said, American Embassy staff were quickly deployed to the bombing sites on July 17 to help any US citizens in distress.

Among those they assisted, ironically, was Erik Stern, a 38-year-old Briton, who works as a management consultant in Jakarta. He had just finished breakfast at the Airlangga restaurant inside the Ritz-Carlton when a bomb ripped the place apart.

Stern was lucky enough to only suffer minor wounds. After staggering into an open field near the hotel, he said that staff members from the British Embassy were nowhere to be found.

“They simply didn’t exist, I didn’t see anyone from the embassy. I couldn’t imagine what would have happened if I were badly hurt,” he told the Globe. “Embassies should be there on this kind of occasion.”

Stern, who also holds a US passport, said he was amazed by the help offered by the American Embassy.

“Their representatives were around, offering help, checking if anyone was an American citizen,” he said. “In this kind of situation, we learn how things work. Embassies should be there to help their taxpayers.”

The British Embassy in Jakarta didn’t respond to requests for information.

Although the policies of each country may differ, the fact remains that foreign nationals can find themselves in major financial distress if they’re injured in a terrorist attack or a natural disaster in a distant land. In Boon’s case, the Dutch government did eventually issue a guarantee for his medical treatment in Singapore, but that does not mean other citizens would get the same treatment.

“It took diplomatic skills at first to finally have the minister of foreign affairs issue the guarantee letter,” Huijkins said.

“In the end, it was a diplomatic decision,” he said, playing down the Dutch government’s initial reluctance. “The process isn’t that important anymore to us.”

Nonetheless, some bitterness remains in the expatriate community here.

“I think it’s outrageous. I assumed a government of a civilized country would help their taxpayers,” said one foreign insurance expert based in Jakarta, who asked not to be named.

Boon and his family eventually received some good news after his arrival home in early September, Huijkins said. Boon was registered by a private Dutch insurance company, so his future medical and rehabilitation costs will be fully covered.

Although he is permanently disabled, Boon plans a return visit to Indonesia one day, a country he still loves, Huijkins said.


source : http://thejakartaglobe.com/home/who-pays-for-the-victims-of-terror/340147