- What is the EPEME Scheme?
For many years the majority of the IG have instigated a medical scheme which allows for more thorough medical examinations of seafarers, compared to the requirements of the statutory medicals specified by the MLC and its predecessors, to address the escalating number of crew illness claims. These enhanced medicals are carried out during the same visit to the clinic as the statutory and any industry medicals owners/operators may require their crew to undertake, which means only one initial clinic visit is required.
In 2017, the Shipowners’ Club undertook a review of the crew illness claims it had handled over a five-year period. The review identified that crew injury claims accounted for a large proportion of the total claims. Furthermore, it was apparent that many of these claims were the result of illnesses for which the symptoms (early or otherwise) would not have been detected by the statutory medical examination. Therefore, the Club’s managers decided to implement an EPEME for the crews of Members entered with the Club.
Crew Injury claims are a separate issue and are not included in the scheme.
- How will the scheme be introduced?
The scheme will be implemented in phases, initially applying to Filipino crew employed on offshore vessels entered through our Singapore Branch.
The EPEME scheme will be a condition of entry with the Club and therefore will come into to full effect as the relevant Members renew their policies with the Club or new Members join the Club after the implementation date. However, the scheme will be introduced on a voluntary basis from September 2018 and all Members whose crew are due to undertake a statutory medical after this time are encouraged to participate in the scheme.
Whilst participating in the scheme on a voluntary basis, there will be no changes to the deductibles already agreed.
- Does the scheme apply worldwide?
Initially the scheme will only apply to Philippine (Filipino) seafarers employed by Members operating offshore vessels whose account is underwritten by the Club’s Singapore branch and thereafter Indonesian seafarers similarly employed. In time, it will be extended progressively worldwide once the full benefits of the initial programme can be assessed.
- How much will the EPEME Examinations cost?
For the Philippines the Club has negotiated a combined fee of USD 100 for the Department of Health (MLC Statutory Medical) and the enhanced Pre-Employment Medical with the accredited clinics.
For Indonesia the Club has negotiated a combined fee of USD117 (+USD57 if a food handler).
The statutory medicals are normally valid for two years, whereas the Club’s enhanced EPEME will only be valid for one year.
So as not to increase the operating costs incurred by Members, the Club will pay 50% of the combined fee at the time of the statutory medicals and 100% of the fee for the intervening medical. The Club’s 50% is the additional cost the Member would be liable for over and above the cost of the statutory medical and the 100% contribution is for the alternate years when the Member would not normally be liable for a statutory crew medical.
- How will payments be made?
To ensure efficient administration, our accredited clinics will issue one invoice per medical a copy of which, will be forwarded to both the Member and the Club along with a statement advising each of the 50% split fee (unless the Club is liable for the full fee). Payment can then be made by both via telegraphic transfer.
In Indonesia, it is usual practise for the seafarer to pay for the medical at the time of examination unless the Member has made alternative payment arrangements at the Clinic. 50% of the fee will be charged to him/her and the Club will then be invoiced for the remaining 50%.
In all cases the Club’s contribution will be assigned to the Member’s record but the fees will not be taken into account when assessing the Member’s loss record.
- Which Clinics should be used?
Only the accredited clinics listed on the Club’s website should be used for this programme. These clinics are audited annually by a qualified medical practitioner and their equipment has been tested and certified to the highest standard. We have also negotiated a standard fee with the clinics. By using non-Club accredited clinics there is no guarantee of the standard or costs. If a clinic is used that is not accredited by the Club then the medical will not be accepted, all costs will be to the Member’s own account and Club cover for any subsequent crew illness claims may be jeopardised.
The Club has tried to take a balanced view on the location of the accredited clinics. However, the Club will duly consider accrediting clinics in alternative locations where the necessity is identified.
- Does failing a EPEME mean fail?
Not necessarily. It depends upon what the medical examination determines is wrong. If the condition is treatable, e.g. Hypertension (high blood pressure) the seafarer could be prescribed medication and once the condition is under control be passed as fit, subject to continued medication.
If the condition is more serious, then the examination will result in a fail.
For borderline cases, the clinic will refer to the Club’s appointed consultant for their view but in all cases the Club’s decision will be final.
- Does the Scheme have any hidden benefits?
Yes. There will be numerous instances whereby crew members seek medical treatment, the cost of which falls below the deductible and is therefore a direct cost to the Member. The EPEME Scheme will go some way in assisting Members avoid such costs. Dental treatment is a good example - pre-existing dental conditions should be discovered by the examination and the certificate will not be issued until the condition has been successfully treated and confirmed by a follow up examination by the accredited clinic.
The Seafarers themselves should also have the satisfaction that their employer is providing them with a thorough medical examination which privately would be very expensive.
- What are the costs associated with crew illness claims?
Crew illness claims are made up of the costs for medical treatment and in many cases compensation, as defined in employment contracts. This can amount to sums considerably larger than the medical costs. In addition, if required there are repatriation costs, follow up treatments and loss of wages.
- Why the increase in deductibles for non-compliance with the programme?
Initially the Club will impose double deductibles on any crew illness claims where a seafarer is not in possession of an EPEME certificate (and who joined a vessel after implementation of the Club’s scheme and whose statutory medical was undertaken more than 12 months prior to the scheme’s implementation). After the first year of implementation, the double deductible will be applied for any seafarer not in possession of a valid enhanced EPEME certificate.
The purpose of the double deductible is to ensure the medicals are undertaken so as to maximise the potential for cost savings.
The aim of the programme is to reduce exposure to pre-existing conditions. However, it is not possible to reduce illness claims exposure to zero as many illnesses are unpredictable, such as an appendicitis.
Repatriations are very expensive and are the result of very serious illnesses and for such cases where a valid EPEME certificate is not available, to US$ 25,000, the increase in deductible reflects the high expense of medical repatriations.
- What if my crew have to undergo an industrial medical such as that required by Oil and Gas UK or an Oil Major?
Such medicals are within the scope of the Club’s EPEME and can be undertaken concurrently with the EPEME at clinics with the required accreditation. In the Philippines this certification is free but in Indonesia, clinics may assign an additional cost. However, this would be at a reduced rate compared with the cost of a separate industry medical. Please enquire at PEME@shipownersclub.com or contact the Clinic directly for the current charges.
- Are EPEME certificates from any Medical Clinic acceptable?
No. Only certificates issued by clinics that have been accredited by the Club will be accepted. This is so the Club can ensure the EPEME has been undertaken to the highest standards and agreed price.
- What if the services of a clinic that is not accredited by the Club are preferred?
If there is a pressing need for you to use a clinic that has not been accredited by the Club then please contact the Club’s EPEME team advising which clinic you would like to use and the reason for doing so. We will then review your request.
- Will the Club accept a valid Enhanced EPEME certificate from another Club?
Yes, providing the certificate is issued under an International Club scheme and will be valid for the duration of the seafarer’s tour of duty.
- What if my Company has its own EPEME Scheme?
In such cases, the Club can arrange for the medical facility used to be audited and, providing the results meet our requirements, we can accept the facility and the medical examinations.