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Medical Tourism and the Travel Insurance predicament

person walking into airport with suitcase

The appetite of patients to seek treatment overseas shows no signs of slowing down, and yet most insurers have not caught up with this trend. In 2020, a holiday maker can find travel insurance to travel to another country to spend a week, strapping two pieces of wood to their feet and then throw themselves down a steep mountain with varying results, many of which often result in the tourist being hospitalised or even being medically repatriated to their home country.

This somewhat bizarre situation does not only apply to skiing, to also applies to other so-called dangerous sports such as equestrianism or even rugby. You will be able to secure insurance to participate in all sorts of sports that could lead to hospitalisation, but your travel insurance policy will usually have a blanket exclusion that prohibits you travelling for the specific purpose of seeking medical treatment. The policies will usually contain an exclusion statement that states…. “The insurance will not cover you when you are travelling with the intention of obtaining medical treatment or consultation abroad.”

You may think that it is particularly odd that you can easily secure travel insurance to go skiing for a week, but your travel insurance will not cover you if you are going to get veneers put on your teeth? We could continue on our jovial assessment of this situation, but there is a very serious point here. Insurers create policies based on risk. Moreover, contrary to public opinion, insurers don’t like to lose. When they lose, they pay out, when they pay out, the numbers can be staggering. It is akin to a Las Vegas casino owner assessing a new game that is about to be introduced into their casino. If there is a real risk that the house can lose their shirt possibly on every night that the casino is open, they simply will not introduce the game. Medical tourism is currently being construed as that type of casino risk. This exclusion approach is an extremely blunt instrument, but when you dig a little deeper, you can start to comprehend the reticence of the industry to provide blanket coverage for patients travelling abroad.

Consider our imaginary patient, Mrs Sangupta, travelling to London from Delhi for an abdominal surgery. It should be a relatively straight-forward operation at a private hospital in London which charges £400.00 per night. Mrs Sangupta has paid for the surgery and in that charge, she is expected to stay in the hospital for only two nights. Unfortunately for Mrs Sangupta, there is a complication! Mrs Sangupta is in theatre for longer than expected, and due to the complication, Mrs Sangupta is required to spend 10 nights at the central London hospital at a cost of £4,000.00 Already, this straight-forward operation is costing £3,200.00 more than expected.

To make matters worse, Mrs Sangupta’s surgeon has said that she is unable to fly home on a normal flight and will be required to use a medical repatriation flight (the equivalent of an air ambulance) where she will be accompanied by medical staff and transferred to a hospital in Delhi when she arrives home. The cost of this service could in the region of £40,000.00 depending on the aircraft, distance flown, number of medical personnel on the flight, airport landing fees and distance ground ambulances have to travel. Our example above is possibly extreme, but unfortunately, it is not uncommon. With Mrs Sangupta’s insurance costs exceeding £43,200.00 on an annual travel insurance policy that may have cost as little as £60.00 you can understand why the blanket exclusions are put in place. The insurance companies, like the casino owner, will lose their shirts, therefore we do have some sympathy with them.

Insurance is available form specialist providers and as you have already guessed before I even finish typing this sentence……it is understandably very expensive. This means that most patients are travelling overseas to have medical procedures, and they are in effect self-insuring. This means, that should anything go wrong, like Mrs Sangupta, you would be liable for the £43,400.00 costs of repatriation. As my old Latin teacher used to shout “Caveat Emptor”…. Let the buyer beware!! Making the correct choices of where you are being treated, and by whom will significantly reduce the risk of having to be medically repatriated, but as any good surgeon will advise, undergoing surgery of any sort is not without risk.

Patients from the United Kingdom should also be aware that many NHS hospitals will charge to surgically remediate any mistakes made by an overseas surgeon if it was an elective surgery which you could say adds insult to injury.

In an industry with an annual value of £87 Billion solutions will be available and will increase in time, but until they do, choose wisely. The lowest cost location for your operation, will not always be the wisest decisions. You should compare, contrast and investigate fully before you make what could be an incredibly expensive decision.