Travel Health Insurance

You’ve climbed Kilimanjaro, rafted the Amazon and traipsed Calcutta with nary a scratch to mark the occasions. Maybe you subscribe to the view all accidents are preventable. But maybe too, you got lucky. No typhoons to contend with, no tsetse fly getting under your skin. These things can happen, despite your best efforts. In the early days of adventure travel “people just ran their companies until something happened,” says Don Forster of Adventures Incorporated, a division of GoAway Travel. Until suddenly, tragically, something did. A truck on a tour in Africa had an accident, killing the driver and leaving one traveller a paraplegic. She sued the western-based company, he says, which wasn’t insured. And that incident “changed the industry, woke people up.”

Buying travel health insurance can be challenging for people from countries with nationalized health care, since it’s not something you’ve ever had to investigate. Yet so imperative is having the right kind that most travel operators won’t let you on the plane (so to speak) without evidence that you bought it. And many hospitals abroad won’t treat you unless you have it. Emergency medical and repatriation services are the two most important components to include, and you need to look for the terms, limits, restrictions and exclusions of a policy—what conditions, circumstances, activities, behaviours, hazards and countries that can restrict coverage or nullify a claim. Typically insurance is more about its exceptions than its rules—what it doesn’t cover than what it does. Adventurers for example, should note that hand-gliding comes at a cost, if it’s covered at all. More generally, some policies not only have a maximum but also a minimum time for a hospital stay. And one big nullifier can be whether alcohol was consumed prior to an injury, even though you deem it had little to do with anything that happened.

A good guide and travel company will tell you what you can and can’t do on a trip with regards to insurance. (If they don’t, ask.) Or, they’ll get permission from an insurer if the opportunity to bungee jump unexpectedly arises. That’s advice any independent traveller should heed: get permission, in writing via email if possible, before you get in the shark cage—chances are that one isn’t covered!

In Canada travel health policies operate in conjunction with provincial and territorial health schemes, which in most cases require you to be a resident for eligibility. You can leave for up to a year and still be covered¬, but even a day more could void your insurance. Be warned—you should get insurance long before taking off. It’s harder to buy it, if at all possible, once on the road.

Good insurers always have a 24/7 hotline, are contactable from most places on the planet, and will call your family if a problem arises. One of the best things they often offer is “third party assistance”—a company or contacts who work with people on the ground where you’re injured or sick who help make the necessary medical or transportation arrangements. You just can’t put a price on that kind of reassurance.

Things to Keep in Mind When Buying

• Shop around/compare policies: what’s covered or exempted; can you, or how can you, extend policy if trip is extended?
• Pre-existing conditions: if you have a diagnosed health condition like heart disease some insurers won’t cover it; others have restrictions, which may include not covering costs relating to the condition.
• Amount you are insured for: medical care is expensive everywhere, don’t go cheap.
• What’s the deductible? Is there a co-payment clause?: some polices require you to pay a percentage of the total cost of care, which can reach into thousands of dollars.
• Travel activity: where you’re going, what you’ll be doing, length of time.
• Credit cards & employers often provide travel health insurance: but never assume this and always call before trip to find out what a policy covers.
• Can policy be combined with trip interruption/cancellation, lost/stolen goods insurance?

Things to Ensure You’re Insured For

• Emergency medical care, in-patient hospital care, out-patient care at doctor’s office, ground & air ambulance service, necessary medications, other treatments deemed necessary by certified health care professional.
• Evacuation & repatriation services: evacuation from any location, transportation home with appropriate medical backup.
• Flight or travel accident insurance: covers death/disability due to airplane or other licensed carrier (i.e., train) accident.

Things To Pay Special Attention To

• How your insurer defines “pre-existing condition” & “medical necessity”: definitions are not uniform across industry.
• Full Disclosure clauses on age, health status, travel itinerary: to be fair, as adventure travel becomes more common, insurers have become more flexible.
• Don’t Delay Calling clause: does insurer need to be contacted ASAP prior to seeking medical care?; delaying calling, or getting treatment before talking to insurer, can lead to conflicts where claims may be refused.
• Non-emergency health care: often not included, this may include follow-up care for an injury.
• Getting detailed receipts from hospitals, doctors abroad; putting in claims immediately.
• Getting letter from doctor or medical facility stating all treatments were necessary.
• Bringing provincial/territorial health card, copy of policy, contact number of insurer.

Good Adventure Travel Health Insurance in Canada

• Travel Insurance Cooperative (TIC), RBC Insurance, Trip Mate. Also, ask any insurance company if they have special provisions for adventure travel.

Q&A: Don Forster, Adventures Incorporated, GoAway Travel, On the Merits of Insurance

OP: You’ve worked in adventure travel for many years. Is there a particular story where travel health insurance was a Godsend?

DF: (Years ago on a trip in Zaire) the roads were so muddy the trucks had chains on the tires with four-inch spikes. [At one point the trucks got stuck in the mud.] They put rocks under the tires for traction, told everybody to stand back, but just as they [did] one of the passengers saw a rock slip and moved toward the wheel. The woman got sucked under the back wheel. It ripped open the inside of her thigh badly…Because the driver had a GPS—this was in the middle of a rainforest—he could give their exact location, while the other walked to town. They were able to contact the UN base there, who flew a helicopter in. [She was then flown] back to the U.K. All covered by her travel health insurance. The UN’s involvement was a mercy mission. But there was a cost to getting the helicopter off the ground, and the insurance company covered all of that, plus her boyfriend flying back with her.”

OP: How typical is that kind of care?

DF: “If you get the right kind of insurance that type of service is there.”

OP: Credit cards often have health insurance for when you leave the country. What do you think of these plans?

DF: “Credit cards might say medical, but it’s not going to be for the amount we need, like in the horrible situations I mentioned. This is why most [insurance] sales reps say don’t rely on credit card insurance because there are too many hidden fine points. Go for the experts—you’ll pay a bit more but you know you’re covered. Having said that, travellers can use their credit card or employer’s plan to give them even more coverage…It’s not a common occurrence [on trips] people getting sucked under wheels of trucks. But it can happen is the point!”

OP: What about that fine print?

DF: “Travellers should make sure the dollar amount for health care is as much as a [travel] company requires—to get a jet in somewhere might cost $200,000, and if you’ve only got $100,000 in insurance, you’re up for the other hundred grand. Most companies ask for $1 million USD in coverage. That’s average. You might have enough to cover if you’re in a hospital in Harare, but if you want to get home and don’t have repatriation insurance, you won’t be allowed to do it. Or if you do it, it’ll cost you.”

OP: Many insurers won’t cover certain adventure activities. What do you think of this?

DF: “The industry is becoming tougher. We were in Mexico and across from the ruins there is a guy who runs microgliding. When I first started it would be in our trip notes. Due to insurance issues it’s been pulled. But you can’t avoid seeing the mircogliders overhead…so we would stand with our driver as a witness and say, ‘the company does not endorse this.’”

OP: So if travellers want to go off-script they need extra insurance?

DF: “It depends on what the activity is, [like] skydiving is off-script and viewed by [insurers] as higher risk. But insurance companies can be quite good, if you just let them know.”

OP: Can travellers count on insurance companies to come through for them when something happens?

DF: “When it comes to health issues, generally speaking if [your case] stands on its own merits, and if you’re with a good insurance company, a reputable one, you’ll be safe and secure.”

Note: The information in this article is intended as a guideline only. For more info on insurance call your provincial or territorial government’s financial services office or branch. Always take time to fully investigate and compare policies between companies before buying. And always get individualized medical advice from a doctor or travel health clinic before travelling.

This entry was posted on Saturday, October 13th, 2007 at 5:00 pm and is filed under Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a comment, or trackback from your own site. Add to del.icio.us.