During a recent holiday in Australia, my daughter encountered a Redback Spider and was bitten, leading to a visit to the emergency department where she needed various pain relief medications and creams. Can we claim the medical expenses back from our insurer?
A hospital visit is scary at the best of times, but a holiday hospital visit brings on a new layer of stress. With not knowing the hospital system, how much treatment costs and depending on your circumstances even the language. Luckily this instance was in another English speaking country, but the stress is still very real. It’s natural to have questions about your travel insurance when you suffer a medical emergency on holiday. Situations like these, it’s crucial to understand your travel insurance policy and what it covers, which is why it’s important to read your policy before you travel no matter who you purchase it from. Many travel insurance providers offer medical cover abroad which is likely to include medical emergencies such as hospital visits.
If you find yourself in this situation then you should ready your policy carefully to see exactly what is covered and under what circumstance. The policy holder that initially brought this question to us would be looking for sections detailing how the policy treats insect bites and injuries for example. Additionally, reach out to your insurance provider as soon as possible. They can provide guidance on the claims process and inform you of any information required to support your claim. Make sure to keep any letters and receipts you received from the emergency room visit and any medications you purchased, as these documents can support your case and speed up the reimbursement process. Remember, the terms and conditions of travel insurance policies can vary, so it’s essential to familiarise yourself with the specifics of your cover while traveling.
As great as all of this advice is though we understand that it can be a bit overwhelming. Especially when you’re in crisis mode. We can’t speak for all providers, or every individual case. But we do know about the travel insurance policies we offer so we want to outline how our policies work for you as simply as we can without you needing to read an re-read a policy document to make sense of it. That way you can purchase your policy with peace of mind and understand what you’re getting from the start. If you’d like to read our full documentation for yourself just click this link and you’ll be brought to the PDF.
How Much Of Your Hospital Stay Is Covered?
Our travel insurance comes under two levels of cover. Gold and Platinum. Depending on which you opt for will depend on your maximum level of cover. For our Gold policy holders you can receive medical cover of up to €5 milliion, but will need to pay an initial excess of €95 per names person on the policy. The Platinum level removes this excess as well as raising the maximum cover to €10 milliion. This includes €450 dental care, €2000 burial assistance in the worst case scenario and a hospital benefit of €20 a day, up to €150 for Gold policy holders and €25 a day up to €200 for Platinum. So in the event of an emergency you can rest assured that you’ll be financially covered as long as your claim is not based on some of the policy exclusions. We know that sounds scary, but don’t worry we’ll talk you through that too.
What’s Covered?
Finding out what’s covered in your travel insurance is one of the most important aspects of finding the right policy for you. And while the list of exclusions can seem a bit much (we’ll go through the important parts) a good rule of thumb for our policies is, if your claim could be easily preventable or was a foreseeable result of your actions then it is likely not covered. But if the claim was beyond your control then you have a right to claim.
For an example, if you end up in hospital because you were in a road accident that wasn’t your fault then you will likely be able to make a claim, however if you were drink driving you will be forfeiting your right to a claim. This rule of thumb is especially important for travel insurance vs. private health insurance as we tend to engage in higher risk behaviours on holiday. Which is why it is also important to understand the specific exclusions in your policy. We’ve outlined some of the key exclusions for you (with examples), but we suggest making yourself familiar with all exclusions as soon as possible.
Exclusions:
1.) Pre-existing medical conditions (unless they are declared and you have been informed of their cover) – If you have asthma and suffer a severe attack while abroad you may not be covered. Which is why it’s important to inform us of existing conditions so we can try to include them in your policy. This includes the costs of medications which you know you will need to continue while abroad such as an inhaler.
2.)Medical treatment that in a professional medical opinion could be reasonably deferred until a policy holder returns to Ireland & any continued treatment upon return to Ireland – A minor medical issue (like a mild allergic reaction) which does not require immediate treatment in the eyes of a medical professional will not be covered. Nor would follow up appointments when you return to Ireland, if you broke your arm and the initial hospital visit was covered but you required another x-ray when you returned to Ireland, the second visit would not be covered.
3.)Costs incurred through illness for which you should have obtained inoculations before travelling – Many destinations require inoculations for specific illnesses. If you contract Dengue Fever while travelling in South America due to a failure to receive an inoculation against it for example. Costs related to treating the illness will not be covered. It’s extremely important to be aware of the required inoculations when you travel to protect your health.
4.) Hazardous activities such as injuries sustained playing sport. Don’t worry, this sounds more restrictive than it is. There is a full list of hazardous activities that are covered by default in our policy wording which ca be accessed here on page 11. Really what this means is our policy recognizes there is a difference in risk on some activities. – If you decide on your trip abroad to take part in an amateur boxing tournament and get injured you are not covered for that (see our rule of thumb on easily foreseeable and preventable claims) however if you fall off your bike while on a cycling tour you likely would be.
