Over the last few years we have sent a fair few Derby riders to the International SOS Clinic in UB for treatment. This is a private hospital and riders need to pay for their care, and also the cost of evacuation to the Clinic should an ambulance be required.
In the past, the Clinic director and the Event Manager have worked together to help initiate evacuations from the field and involve your insurers so that your care is free at the point of delivery. In the case of a catastrophic trauma this is usually fast, seamless and straightforward.
However, in a less catastrophic case things are less clear; a rider is walking wounded but needs an X-ray and probable in-patient care for a day or two. Insurer is contacted and case opened. Once insurer has confirmed a case is open an ambulance is dispatched from UB and meets one of our medic crews on the road. We get both vehicles moving towards each other to get you to care as fast as possible, and our medics back onto the field.
Usually, the patient does not move until this procedure is finished, often involving calls from Beijing-based clinical experts working for the insurance companies. Remember they'll be trying to not spend a dime, so need to be sure you really do require medical care and that the nearest definitive care is in Ulaanbaatar. This requires co-ordination between attending medics, the SOS Clinic, the Derby Ops Room, and the insurance company, who often also want to speak to you, the rider in question, too. This process can take several hours, during which time, you are not moving any closer to medical care in UB.
Last year the SOS Clinic initiated two expensive evacuations (an ambulance ride staffed by Clinic doctors could cost $1,000s) on the promise that the insurer would pay. The insurer later reneged on the verbal approval, and there was no pre-payment from the rider. The riders in question then later discharged and left the hospital without paying for the transfer, or the in-patient care. The hospital was out of pocket and pursued the riders for 8 months to settle the payment. Meanwhile the riders were chasing their own insurers who had opened a pre-paid case for them and then queried the bill or the status of the patient.
The point is, from 2018, the SOS Clinic will no longer evacuate patients without a guarantee of payment, or an actual up-front payment, either from the rider, or from their insurer. And riders should expect to pay for their care, and recoup all costs directly from their insurer. In other words, you manage your own claim. The SOS Clinic will not do so on your behalf. The Adventurists cannot do so either.
All this sounds a bit scary, doesn't it. Actually, it's not such a big change and the principle is sound - the onus is on you, the risk taker, to be adequately insured so that your insurer either guarantees payment to the Clinic and pays your bill before you leave, or that you set up a claim and are reimbursed after the fact. Nothing punitive there. The main issue the Derby faces, and the reason we are writing this article, is that we have made a change to improve things. As an aside, we hope to save you a packet of money if it comes to it.
We've added a refundable deposit paid in advance of the Derby, specifically to cover the case of a non-urgent, non-medical transfer to the SOS Clinic. Basically, if you actually need a lift, a taxi, a steppe-based Uber (it doesn't exist yet, someone set that up please), we will cash in your refundable deposit, hire you a private driver and send them to come and get you.
We will a) probably get there faster than an ambulance (no insurance wrangling and a faster vehicle)
b) charge you the simple cost of a day's private vehicle hire. This fluctuates a little but we can assume $200 a day would get you a 4x4 and driver, and $100 would fuel it to almost anywhere on the course. The refundable deposit will be £300, paid via our online system.
If we don't use it to dispatch transport on your behalf you get it back, untouched, electronically, in the week after the race finishes. The time it takes to reach your account depends on the card used to lodge the refundable deposit, usually between 2 and 5 days.
1. If you are seriously hurt, you'll need to be medically accompanied. Our Iqarus Medics will have to make a call at the scene as to whether you require intensive care en route, a helicopter or aerial evacuation (if available - there is absolutely no guarantee of this in Mongolia, aircraft are scarce), or if one of our own crew vehicles can take you with one or more of our medics accompanying you. If our medics say you need car plus doctor, that's what you shall have. This refundable deposit covers the case where you need transport back to the city, not an emergency medical transfer.
2. The Adventurists won't be paying your medical bills. Please, the future of this event relies very heavily on cordial working relationships with the only international standard hospital in Mongolia. You are welcome to go to the public trauma hospital (and for life saving surgery you'd head there anyway) but you'll be wanting to get back to the clinic as soon as your stretcher bearer can bear it. Be prepared financially to cover the cost of outpatient care if that's what you are. Your insurers may well quibble the expense but you will have all the evidence needed to show the true cost of your care, so you need to take it up with them. Again, this deposit should save you and your insurance company a packet if it can help provide overland transfers.
3. You can retire from the race and use the refundable deposit in the same way. If you want to go home because you're not injured but you're retiring anyway, the crew vehicles are not able to do this as they are engaged in managing the race. However, with this refundable deposit we can arrange transport on your behalf to the city, and from there you can arrange onward transport, flights to the Maldives, a night at the Shangri-La, or whatever you need to get human again.
4. It is only for arranging transport from the race course to the city on your behalf. We won't be booking hotel rooms, dinner reservations, buying you spare jods when yours get wet and putting them in a cab for you.