Global Residence and Citizenship Handbook. Christian H. Kälin

essential to seek out private hospitals to ensure competent medical treatment. There is no alternative to comprehensive insurance cover for anyone thinking of moving to, say, the US 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 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 to not only 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 you. So anyone who is 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 review 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.

      Checklist: 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 reasonable 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 in the event of a later permanent return to the home country

      •Guaranteed lifelong policy renewal, even in the event of a later change of residence, or illness of longer duration etc.

      •Efficient processing in the event of a claim

      •Multilingual emergency service manned around the clock throughout the year

      •Insurance company that is well known and has a good reputation as well as broad experience in the domain of international health insurance

      •Consult with an independent consultant who specializes in international health insurance

      1.8International residential real estate

      One of the key factors when changing residence is the question of where one will physically reside. Ownership of real estate satisfies a basic human need, and to acquire a piece of property in an attractive location is equivalent to gaining a desired quality of life, and it is often also a sensible asset diversification.

      However, it is recommended that initially you rent a comparable property in an area that could eventually be the location that you would settle. By renting, it gives you an opportunity to learn about the area before committing capital for the purchase.

      Many countries allow foreign nationals to acquire real estate without restrictions. However, there are countries where permits are required to purchase property as a foreign national, or where property acquisition is limited to nationals of the country. The acquisition and ownership of real estate in a new country raises legal and tax issues that are often unsuspected by those concerned. Private acquisitions of real estate are frequently made without any accurate knowledge of the legal, tax and economic background particular to the country.

      Value maintenance and capital growth will also play a vital role, so it is important to clarify these key factors before acquiring real estate in order to be protected from unexpected devaluation, legal and tax consequences. While this applies to real estate in general, it is particularly true for property located in a different jurisdiction, especially one with onerous legal systems and linguistic limitations.

      It is generally an advisable risk-averse approach to appoint lawyers, tax experts, architects and trustworthy real estate agencies familiar with local expertise. The costs incurred will almost always be offset by the smooth and correct handling of the issues and procedures involved.

      Other countries have different habits and different legal systems, especially in respect of real estate and tax law, which may assume very different forms in the various countries. So foreign acquirers of real estate should not let themselves be guided by their inherent feeling for what is right, but must inform themselves in an unprejudiced way about the circumstances prevailing locally. Still, the acquisition of real estate is safe in most countries as long as certain basic rules are observed.

      Finding the right property

      Although common knowledge, it is nevertheless worth remembering that location is the most important factor in the selection of any piece of real estate. Special care must also be taken to determine how the environment may change in the future. It is important to be aware of construction of projects for freeways, airfields, power lines, waste dumps or similar major developments that are planned in the area. One should also know in which construction zone the building plot and its surrounding plots are situated (might a neighbor add another level to his property and in doing so, obscure the marvellous lake view?).

      The best way to gain certainty about these factors is to buy an existing property in surroundings which are already well developed and in which re-zoning is unlikely. If there are still many undeveloped plots of land around a property, it is hard to estimate how the surroundings and perhaps the entire appearance of the locality may change. Many location factors must be considered, above all the quality of the local municipality. The improvement of the location is critical for any future gain on the value of the property. Improvements to infrastructure such as transport links and shopping facilities will have a positive impact whereas construction of freeways will have a negative impact. In making an estimate of the future potential growth in value of a property, it is always worthwhile clarifying the planned and future development of the residential area in which it is located as well as any changes in local infrastructure prior to the purchase.

      Also the quality of the location within the municipality where the property is situated is important as this will affect everyday life. Is the house located on a good street in a quiet area? Where are the nearest shops, banks, post offices, schools and kindergartens, high schools, location of evening classes, restaurants and sports facilities? Are there cultural facilities nearby?