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Since 2006, David Treal, the managing director of AG Cambodia, has been helping people get medical care in Cambodia – and he takes pride in his work.

At his office next to the tennis courts at the Cambodiana Hotel, Treal says expats living in Cambodia need to have health insurance because Cambodia is more at risk than European countries.

“Expats here need to feel secure about the health of their families,” he says.

Treal, originally from Nice, in the south of France, where he worked as a musician playing the drums, had been working for an insurance broker in Thailand when he visited Cambodia.

“I was the first agent to request a licence in Cambodia, and my aim was to serve the needs of the expat community, especially for health insurance, which is the first concern for expats when they come to Cambodia.”

He’s developed a reputation for helping people get the services they need, and most of his business comes from word of mouth.

Treal recommends that his expat clients have coverage that enables them to be evacuated to Singapore, Bangkok or Ho Chi Minh City.

“It's important have someone who can monitor if you need to be transported, and to have a link with  international insurance companies that are not in Cambodia,” he says.

“I had many requests from the expat community to have someone to handle insurance when health issues come up. The main part of my activity is providing counselling in providing the best cover with international insurers and providing coverage and local assistance.”

Treal sells health coverage that sends policy holders initially to the Naga Clinic or the SOS Clinic, which give a diagnosis. If the condition cannot be treated in Cambodia, the patient is flown abroad.

Treal says Cambodia doesn't have stocks of blood platelets, so if a patient’s dengue fever goes into a haemorrhagic stage, the patient has to be transported abroad. Other conditions, such as serious road-accident injuries and cancer treatment, also need to be done in hospitals outside Cambodia.

Easier ailments such as abdominal hernias, broken arms and broken legs can be treated in Cambodia, he says. “You would be referred to go abroad if it is more complicated.”

For emergencies, the first stop is normally Calmette Hospital.

“Calmette can handle an emergency, and is the one most appropriate to handle an emergency in the middle of the night,” Treal says. Another good local hospital is Royal Rattanat, which also has a hospital in Siem Reap.

“Royal Rattanat is good because they have international-standard equipment. If they cannot treat you here, they will recommend you go to hospital in Bangkok,” Treal says.

Treal works as an agent for Asia Insurance, which is a general insurance company in Phnom Penh based in Hong Kong, with offices in Indonesia, Hong Kong, Vietnam and Thailand.

“The main shareholder of Asia Insurance Cambodia is Bangkok Insurance,” Treal says.

“I’m the agent; I’m not the insurer. I’m an intermediary guy between the client and the company.

"Somebody who comes to me will get expert counselling in assessing the risk and finding the best solution to their needs. In many situations, foreigners here feel they are used to having an agent or broker handle their insurance needs.”

The difference with an agent, instead of dealing directly with an insurance company, Treal says, is that people have somebody dedicated to counsel them on their policies they need, and have a relationship with another Westerner who has a Western way of approaching the problem.

“That’s why they turn to me when it's about health insurance. I have a better knowledge of it, and clients like the fact that I contact the companies to deal with issues.”

Treal says it’s very important for an expat to feel they have someone to rely on.

“All my clients know me personally, and that’s why they feel secure in having me handle their insurance.

"What I’m providing is a professional service for the clients to get through with their claims. We can place a guarantee of payment worldwide.”

In addition to health insurance, Treal sells automobile insurance, property and company insurance for employees and factories. Among his clients is The Phnom Penh Post, whose printing presses and newsroom equipment he insures.

“I’ve had many big claims and  accident emergencies, and they were handled well,” he says.

“When people get back home, they tell stories to their friends, who ask for my phone number. People just walk into my office; I never go and find customers.”

Treal says an expat can expect to pay about $100 a month for hospitalisation and evacuation, which is what he recommends.

“My advice is to skip the outpatient cover in most cases.”

With outpatient care, the premium comes to about $200 a month, Treal says. “For coverage for hospital with strong medical evacuation, you would pay about $100 a month Outpatient care gets quite costly, and may double your premium.

"I'm here to respond to emergencies, and I give them counselling so they don’t spend extra money on things they don’t need. Most of the doctors and hospitals know me, and they know my office.

“I know personally the directors and people who handle guarantees of payment. I’m their client, and I pay them.”

As well as health cover, Treal sells cover for public liability, fire, accident business interruption, employee health and worker’s compensation. “That’s why insurance agencies use agents rather than dealing directly, because in the end what they're concerned about is controlling risk and controlling loss. They don’t want to waste too much time handling customers,” he says.

“Cambodia is very different from the rest of the world. Companies are selling and assessing the risk; in many cases, a person handles 5,000 accounts and they don’t even know their customers.

"I come in the middle of that spot, and I don’t want to be taking all the market. I’m not pushing in that sensitive political field. Some accounts, you don’t want to mess with.

"As long as I serve the expat community, they don’t worry about me."

Treal describes the insurance market in Cambodia as very overcrowded, with about $20 million in annual premiums, compared with $850 million in Thailand and $650 million in Vietnam.

“If you compare the population, Thailand has five times more people. We are 10 times less insured in Cambodia than the neighbouring companies. It's just like the telecom companies that are showing up; everybody is fighting for a stake.

"The problem is, the people here cannot afford to buy telephones or insurance, and there is nothing to insure.”

Treal says he’s very happy the insurance industry is developing, but he thinks the market is overcrowded, and in the end the insurance industry will have to have some mergers, as telecom firms have experienced.

“These companies are betting on the development of Cambodia, and they are here for the long run. Because these companies are here, little by little people will come to understand that it's better to have health insurance for your family than to have to sell your house when your mother gets sick.”