The best sort of travel insurance is the sort you don't use

An article I wrote a few years ago, published elsewhere:

When your average citizen takes out travel insurance, it is most likely to protect against such tragedies as losing an iPhone overseas, dropping a wallet in the ocean or perhaps finding themselves in Vietnam and their luggage in downtown Boston. Having been in this game a while now, it is my opinion that if losing your iPhone is the worst thing that happens on your holiday you’ve had a pretty good time.

It may surprise you to know that a travel insurance policy is, by and large, a health insurance policy. Greater than 95% of the spend of travel insurance companies relates directly to health costs.

Each travel insurer has a series of service providers sitting behind them, one of which is an assistance company - sometimes it is the same organization, sometimes a service provider. Assistance companies have 24h call centers with coordinators, nurses and doctors available to assist distressed travellers around the clock.

In the event that John Q Citizen becomes unwell or is injured whilst they are away – by getting gored by a bull in Pamplona for instance – they or their relatives call the assistance company and a whole train of events unfolds, which might include directing patients towards local health care facilities to help with their medical problems.

The assistance company will maintain contact with the now patient and their family. In the event that the medical issue is of a serious nature, things tend to pan out in one of two ways that relate to the quality of health care available locally, the price of that care, the patient's location and the underlying urgency of the patient’s medical condition.

Let’s focus on the sicker end of the spectrum because clearly many issues are of a minor nature and never come anywhere near an air ambulance provider like West Coast Aeromedical .

If “definitive care” is available locally AND the quality of local medical care is high AND treatment of the matter is urgent assistance companies will usually head down the route of electing to keep the patient where they are for treatment in the theory that that is both (a) best for the patient and (b) cheaper than an international medical retrieval.

If “definitive care” is NOT available locally OR the quality of local medical care is questionable it is then the key decisions become urgency and mode of transport. ?There are, again, an array of transport options available but seeing as we are in the Air Ambulance business, again we might focus on that.

The people with the dollars talk to the people with clinicians and wings

The assistance company, having decided that medical evacuation is required and that this is most appropriately by air ambulance asks its panel of Air Ambulance providers for a quote. At this stage, the available information usually consists of the patient location and their ultimate destination and not much else.

Our co-ordinator submits a quote, and due to the price of aviation fuel the retrieval company with the aircraft that has to do the least amount of flying to get the job done is usually cheapest. Paperwork is exchanged and the job confirmed.

Clinical information is then available and at this stage the West Coast Aeromedical Medical Director is brought into the discussion – to liaise with treating clinicians at the hospital of origin as well as the destination unit. How many times is it quick and easy to have a chat with someone you’ve never met in the hospital? Well, it is fair to say that these conversations can be difficult – finding the right person in an overseas hospital at a sometimes odd times of day and surmounting the language barrier is not straightforward.

We are often going to locations where the quality of the medical and nursing staff are excellent but the broad array of diagnostic equipment that many of us consider routine are just not available. Similarly there are many locations where the patient will have a problem that is unable to be treated effectively with the resources available locally. It’s part of the game, and in many ways it’s why we are needed in the first place.?A lot of the legwork for the coordinator is about trying to construct a story that is useful for the retrieval team and help plan for every contingency.

What happens if you don't have travel insurance?

Well, not only are you or your family potentially up for the cost of treatment in your formerly idyllic holiday destination that can easily amount to tens or even hundreds of thousands of dollars, not only are you or your family up for the cost of getting you home which again can easily be above one hundred thousand dollars, here's the most important thing: You don't have the assistance company on your side, with all their experience of "what to do" when "that thing happens" in "country X".

Take out travel insurance people, it's about $100 per person for a week away and worth every dollar. All of the above costs are covered and you won't expose your family or your mates to the perils of raising large amounts of cash in short amounts of time. Hint: once you've left home it's too late.

My name is Paul Bailey, thanks for reading! I manage risk for a living. I'm the Medical Director of West Coast Aeromedical . I used to be the Medical Director of the largest ambulance service in the world. In another life I was a jellyfish hunter. These days I also provide aeromedical coordination services in two Australian jurisdictions. Like or comment on this post if you found it interesting, follow me on Twitter @waambedic, or drop me an InMail if you want to continue the conversation.