LIMITATIONS OF STANDARD MEDICAL COVERAGE & ALTERNATIVES; AEROMEDICAL EVACUATION

Generally, travel assistance insurance provides travelers with numerous services such as those listed below *:

-         emergency medical treatment ( of course!) with guaranteed payment for medical care

-         evacuation and repatriation

-         assistance in locating the nearest medical facility

-         legal assistance referrals

-         bail bond and financial assistance

-         trip interruption insurance

-         prescription replacement

-         multi-lingual assistance

-         assistance for lost documents, luggage

These policies are designed for mainstream travelers, not necessarily for those individuals who participate in “extreme” or adventurous activities, of which more and more people take part in.  By their very nature, when injuries arise from these sports, they are often serious and thus very expensive for an insurance company to cover.  According to an article written in National Geographic Traveller, October 2001,  the number of activities that companies exclude from coverage has greatly increased in recent years, but does vary widely from one company to another.  Activities such as bungee jumping, hang-gliding, mountain and ice climbing ( with ropes), heli-skiing and hot air ballooning.  Some companies have special policies for travelers who participate in activities excluded by their regular policies.  Besides these general exclusions, some companies have lower benefit caps for certain sports such as scuba diving.  Many policies use vague language that requires travelers to avoid “extreme risks” which leaves insurers the opportunity to avoid claims. 

For a Canadian perspective, I decided to enquire at the BCAA where I currently have their Travelgold insurance coverage.  ( Fortunately my husband keeps everything and had the policy manual on hand – a lot of fine print! ) After perusing the manual of “legal speak” and not finding any explicit exclusion of high risk activities, I fired off a direct question to the office – “ are there exclusions for higher risk activities such as bungee jumping?” 

The reply was “ unless you are participating in professional sports  ie receiving financial compensation , then all activities are covered except as excluded due to specific exclusions, such as if the injury was attributed to consumption or abuse of alcohol”. 

It seems that the Travelgold plan would cover me in the event of an injury from bungee jumping, then, as long as I wasn’t drunk!  Truth be told, we purchased our policy over the phone without having read the policy and were unaware of the specifics of coverage until recently.  Many travelers likely do the same. 

It would be easy for me to say “ well, then, we have to remind our patients to buy the right coverage for travel insurance and to read their policies carefully”, but you already know that, and wonder how you can possibly say all that you should say within a 15 minute pre-travel assessment!  Perhaps the best way to inform patients of this is thru posters or videos that they can watch while in the waiting room. 

With regards to aeromedical evacuation, most insurance policies ( including the BCAA Travelgold ) state that the company will evacuate a patient to the nearest medical facility equipped to provide the required treatment.  For example, a traveler seriously ill in Nepal, and in need of sophisticated treatment, may be transferred to Bangkok or Singapore, but not home – at the discretion of the company. 

References:

“Travel Assistance Insurance Exclusions”, National Geographic Traveller, 2001 October.

“Travelling Healthy”, Volume 15, No. 1, January/February 2002.

Travelgold, BCAA Travel Insurance Owner’s Manual and Policy, 2002/2003.

Dr. Helen Eng

e-mail: vicmak97@telus.net

fax:      604 – 946 - 0013