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Dying abroad

Monday January 8, 2007

Saundra Satterlee

The grim reaper pays heed neither to time nor place of death. For a world awash with increasing numbers of expatriates dotted around the globe, inevitably more will die abroad. The British Foreign and Commonwealth Office puts the number of British passport holders who live abroad at 13 million. Of these, thousands die each year. 

On his deathbed, Bob Hope?s wife DeFina asked where he wanted to be buried. Hope replied: ?Surprise me.? Just so . . . it will be your relatives and friends left behind who ensure that you are not relegated to a pauper?s grave in a foreign clime. And lest we forget, the task of repatriating mortal remains to the homeland is costly and fraught with complexity.

Small matter of embalming

Cultural and legal aspects of death and dying are as varied across the globe as practices of marriage and divorce. No two countries are alike. Take embalming. In France a body cannot be transported without a police tag and the local mayor?s approval. After 24 hours, the body must be embalmed and placed in a wooden coffin.

In Islamic countries, it is common for the deceased to be buried before sundown or within 24 hours, without embalming. In the United States, embalming is common practice. In many countries ? when embalming does take place ? it is a qualified embalmer?s job, whereas in some countries, for example Portugal and Spain, it is against the law for anyone but a qualified doctor to undertake this procedure.

IATA (worldwide airline trade association) rules state that if moved from one country to another, a body should have an embalming certificate. Tony Rowland, senior partner at Rowland Brothers International funeral directors, warns: ?In many cases when embalming is not up to US or UK standards, the result is that a body is totally unviewable when it returns to its homeland.?

?If you are breathing you have freedom of movement; when you cease to breathe you lose that right,? says Michael Cashman, member of the European parliament. ?If a German dies in Strasbourg, prior to being transported from France to his German home a mere 10km away ? in addition to necessary documentation ? he?ll have to be embalmed and placed in a zinc-lined coffin before he can be dispatched.?

All down to money

Within the European Union there are moves afoot to consolidate laws that relate to the transport of bodily remains from one state to another. In 2004, and following a lengthy process for the body of a teenager who died in Spain to be returned to Britain, Cashman initiated legislation to harmonise standards and procedures for cross-border transportation of bodies within the EU. ?We need to remove the obstacles that cause trauma to hundreds of families every year,? says Cashman. The EU services directive will allow for cross-border funeral services to take place, and a new amendment has been added to remove obstacles relating to cross-border transportation. The vote is scheduled for November.

Cashman warns that people should make sure to have some degree of insurance, because wherever they encounter bureaucratic obstacles abroad, only money can speed the process of repatriation.

Going down like a lead coffin

One of the few widely recognised international rules relating to the transportation of bodily remains across national borders, according to Rowland, is the prohibition of lead ? once the metal of choice ? as a coffin lining. Because lead is not conducive to x-ray, anti-terrorist legislation across much of the English speaking world and the EU prohibits its use. ?It is not that every coffin will be subject to x-ray in the search for weapons or bombs; rather that any coffin in international transit could be,? stresses Rowland.

The cost of dying

Someone has to pay for your demise. If it is abroad where expenses can soar in cases of repatriation, multiple factors come into play. Coffins travel as international freight and must be hermetically sealed. The cost of moving mortal remains depends, for instance, on body weight, location of death and transport. To move a body from the US to Kenya, for instance, is estimated to cost between $6,000 and $10,000. There is no international tariff for fees levied by funeral directors across different countries.

Paperwork requirements, medical costs, mortuary charges and embalming (or autopsy if needed) fees will vary hugely. Apart from cross-border considerations, there is the expense of the burial or cremation itself in the country of final rest.

On average you can expect to pay around $6,500 for an all-in burial in the UK and $4,000 for a cremation, according to funeral directors Rowland Brothers International.  Australia and the United States cost more. ?In Australia this works out about one-third more expensive than England and for the US, it?s half again more costly,? explains Roland. ?The price of interment in Spain is about double that of England.?

Be warned though that burial is not necessarily a one-off expense.  

In Spain, of the two types of burial ? earth and over-ground niche (a type of stacking scheme) ? the widely practiced niche burial is only for a finite number of years. Individual cemetery bylaws determine the duration of a niche contract. They typically run for five, 10 or 15 years. Once a contract expires and if a new one has not been agreed, the coffin will be placed in a communal grave.

Rowland says: ?To find your loved one?s remains replaced by a stranger?s is highly distressing.?

Excluding the funeral, an example cost of repatriating the mortal remains back to, say, the United Kingdom from Australia is approximately $13,000 to $17,000, or from Spain, around $4,700 to $6,500. The final cost, however, is very much dependent on circumstances of death, local regulations and the amount of local bureaucratic red tape.

Insured to the last

International assistance companies such as Mondial, Europe Assistance, International SOS Assistance or First Assistance act as intermediaries or facilitators who are the direct representatives of an insurance company. They operate in conjunction with international funeral directors.

International funeral directors ? for example, Kenyan Christopher Henley or Rowland Brothers International ? work alongside insurers and assistance companies as brokers. They deal with all funeral-related matters, complicated paperwork and work with local coroners, magistrates, consulates and other local officials as required, including the police.

Police intervention is not uncommon. A rule of thumb is that death by a natural cause, say, heart attack or cancer, will not require local police involvement, whereas an unnatural cause ? ranging from traffic accident to murder ? will. In short, any suspicious death automatically goes to the police.

Evidence of foul play

?If it is a murder, in most countries the body is not allowed to leave the country until the defence lawyer no longer requires it for post-mortem,? says Rowland. ?Normally it takes five to seven days to repatriate a body from abroad ? in the case of murder it is 10 to 15 days but could take anything up to three months.?

A traffic accident should in theory be processed more swiftly than a murder, and often is. When a British citizen recently died in a South African road accident outside Cape Town, the family approached the British Embassy, but discovered that the deceased had been insured. It took only seven days, including police involvement, to repatriate the remains to England.

Repatriation of a ?natural causes? death should be relatively fast to process, but First Assistance reports the recent case of a New Zealander who died of a heart attack in Beijing, where, although the police were not involved, it took two weeks to get the body returned to New Zealand.

Death by bureaucracy

Requisite documentation includes a death certificate, embalming certificate, ?no objection? certificates from various government ministries and a ?sealing of the coffin? certificate undertaken in the presence of an embassy official from the country receiving the body.

At International SOS, senior operations manager Veenu Karir points out that the international transportation of ashes is a much less complicated affair than moving a body. ?There are various methods for returning the ashes, which include air freight, courier service or even as hand luggage on the aircraft with an accompanying person as long as all the documentation is in order.?

Relevant documentation includes death, cremation and sealing certificates, according to Rowland. ?While this documentation may not be legally required, it provides a safeguard in case an individual is stopped at customs under suspicion of drug trafficking.?

Finding the right policy

Most travel insurance and international private medical insurance (PMI) policies include death under a standard repatriation clause or as an optional extra. The repatriation of mortal remains typically covers body preparation, paperwork, associated certificates, coffin and transportation of the body or ashes of the insured from place of death to home country, and thence to an agreed funeral home.

A policy will not normally include country of principal residence unless by special arrangement. An example where this is covered as standard, however, comes from Axa-PPP, who cite the case of a US lawyer who died in Argentina on holiday but was buried in Rome where she had worked and lived for 10 years.

Policies tend to cover reasonable expenses. ?Most policies have an upper limit of cover, although there are some which do offer 100% cover,? says Marco Gantenbein, managing director of Swiss Insurance Partners in Zurich. IHI Denmark, for instance, pays a full refund up to the policy maximum of $2.5m. Policies from Interglobal vary from £15,000 to full refund.

Beware, though, that some policies may not pay out if you die from a pre-existing medical condition. Malcolm Tarling, spokesman for the Association of British Insurers warns: ?Always check to make sure you know what you are covered for.?
A travel or PMI policy will almost never pay the cost of burial or cremation in the home country. A pre-paid funeral plan will.

Best laid plans

An alternative approach to what is covered within the repatriation clause of a PMI or travel policy is a pre-paid funeral plan. Although these plans are long-established in the United States, they are relatively new to the UK. Pre-paid funeral plans are mainly domestic, not international.

Golden Leaves is unusual in that it provides two expatriate plans. The first covers repatriation from place of death to any other destination you choose in the world. The second plan caters to expatriates living in Cyprus, Malta, Portugal or Spain, and in addition to repatriation, it covers either burial or cremation in the destination of your choice, be it principal place of residence, place of death, home country or elsewhere. Because this is not an insurance policy, you pay up front in instalments in preparation for your eventual demise.

?Your funeral can be as simple or elaborate as you wish,? explains Golden Leaves managing director Steve Rowland, ?from a chorus singing Aïda or a recording of ?My Way?, to the release of 100 doves or a thousand balloons.  Whatever the deceased stipulated . . . it will be done.? 



Europe Assistance

European Parliament

First Assistance

Golden Leaves

IHI Denmark


International SOS

Kenyan Christopher Henley


Rowland Brothers International

Swiss Insurance Partners


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