The Global Residence & Citizenship Handbook. Christian H. Kälin

may have to be reorganized, liquidated or taken out prematurely (e.g. life insurance policies, pension claims, tied-up assurance funds etc.). It is particularly important to consider withholding taxes when receiving payouts from pension institutions and any tax concessions when drawing any benefits in the form of pensions or capital payouts. As a rule, different costs of living also change the provision requirement and usually make it necessary to adapt one’s cash planning.

      A move will also require careful examination of previous estate or succession planning (partnerships, foundations, trusts, family holding companies and the like). Here too, considerable scope may be available for optimization depending on one’s destination. Thus anyone moving for example to Malta, the United Kingdom, Ireland, St. Kitts and Nevis or the Bahamas, can structure their assets by means of suitable succession structures so that they – or lifetime enjoyment thereof – are transferred without restrictions and in many cases also in tax-neutral form to freely designated heirs. The situation will be quite different when moving to a country such as France or Spain, although here too various opportunities for optimization usually exist. In any case, existing estate-planning strategies should be checked and their adaptation to the new conditions and opportunities examined. Professional support is usually indispensable in this domain too.

      It is also important to include the aspect of asset protection, especially in the USA. In view of the peculiarities of the American legal system, which is characterized by a relatively low threshold of civil litigation, suitable measures to avoid excessive exposure of one’s personal assets are indispensable. But when moving to other countries, it may also make sense to structure at least part of one’s assets – perhaps including real estate – so that they are safe from seizure. Suitably designed asset protection trusts as well as specially structured Swiss annuities and life insurance policies are sensible options for this purpose.

      For many wealthy people, an alternative residence is an effective tool for international tax planning, and also facilitates more privacy in investment and banking.

1.8 International Health Insurance¹⁴

      International health cover is a highly relevant topic for anyone thinking of moving abroad, and yet it is scarcely considered by many people and in particular hardly mentioned at all by advisors. Admittedly, it is not the job of a lawyer specializing in international inheritance law or an international tax advisor to know all about insurance as well – and especially about international health insurance. There is consequently relatively little specialist competence in this sector available to private clients. Most advisors and insurance brokers worldwide with such expertise merely represent a single insurer. Only very few offer more than a small number of products and are able to provide really comprehensive advice.

      Trying to find ideal health cover is no easy task even without moving abroad, but it is of particular importance when moving to another country or even staying there for a limited period. The risks of sickness and accident must be covered comprehensively in an international context in order to avoid unpleasant surprises. A few important points must be considered in view of the wide choice of diverse solutions and different insurance products.

      Anyone who lives or works abroad, runs a company or retires there should arrange insurance cover that is as extensive as possible and applicable around the world. Health insurance in particular should allow the patient to choose his preferred doctor and hospital with as few restrictions as possible, and ideally none at all.

      A question of residence

      In the event of a temporary stay abroad with no change of residence, basic state insurance usually assures at least minimum cover within Europe in emergencies. In addition, almost all local health insurers offer the option of comprehensive cover for sickness and accident via private supplementary policies, even for temporary stays abroad. Before moving abroad definitely, however, it is useful to check out the insurance options in detail, from free choice of doctor and hospital to medication cover. Previous health policies normally terminate with a move abroad, and continuing insurance cover must be assured during the actual process of moving.

      Comprehensive cover with a free choice of doctor and hospital worldwide is strongly recommended in most cases. This is because even in many developed countries the public healthcare system satisfies only minimum requirements and it is essential to seek out private hospitals to ensure competent medical treatment. And there is no alternative to comprehensive insurance cover for anyone thinking of moving to, say, the USA or the Caribbean, or Eastern Europe, or to a developing country. Many countries have good local private health insurers, and some of them also offer international cover and a free choice of doctor and hospital. Although such a local insurer usually represents the least expensive solution, it is rarely the best one. It should be stressed that practically all insurers with a local or national scope of activity in the relevant country will only accept policyholders who are actually resident in the country. Anyone who leaves the country again will normally lose his/her insurance cover, which can become an insoluble problem with increasing age. It is also difficult to obtain a truly international and unrestricted free choice of doctor and hospital in many places. So the ideal insurance policy will be independent of residence and duration of stay and will also guarantee fully comprehensive cover as far as possible. Most local insurers offer only unsatisfactory solutions if at all, and very few offer private health insurance which can be concluded or retained even when the policyholder lives abroad. So it is vital to check these important aspects, and in most cases it is worthwhile consulting an independent insurance advisor specializing in international health insurance.

      Free choice of doctor and hospital, worldwide cover

      Although an extensive choice of private health insurance schemes with an international scope is available worldwide, only very few can really be recommended. When comparing the various offers, it is important not merely to look at a specific insurance product but also at the financial soundness and reputation of the insurer as well as the latter’s experience in international health insurance. The insurance product which best satisfies the individual requirements must then be considered.

      Private health insurers are not obliged to accept everyone. So anyone who is already over 55 years of age or is not perfectly healthy has little chance of obtaining private health insurance and still less comprehensive insurance with international cover. For this reason in particular, it is advisable to check out the insurance situation in detail before moving abroad. It may make sense to change over to an international health insurance scheme several years before a possible move abroad in order to be assured of the necessary flexibility later on. Even if no transfer of residence is planned, but one wishes to be optimally insured against sickness and accident, a detailed check of all options is worthwhile. It may even be of benefit to take out international health insurance in this case.

      Anyone staying abroad frequently or planning to move to another country permanently should arrange insurance cover independently of residence and sojourn – i.e. inclusive of any subsequent moves or even a return to one’s home country at a later stage. Such cover will ideally permit an unrestricted choice of doctor and hospital worldwide.

      Check list: International health insurance

      In selecting suitable health insurance, care should be taken to consider the following points, which are listed below in the form of a brief checklist:

       Worldwide cover at attractive premiums. It is also important to consider premiums in higher age brackets

       Free choice of physician and hospital worldwide without restrictions

       No restrictions on the policyholder’s residence and duration of stay, even