Statistics: Will I have a medical emergency overseas?

By Wayne Wirtanen
This item appears on page 58 of the August 2011 issue.

Will I have a medical emergency overseas? The short answer is ‘Probably not.’

Medical emergencies are rare, but insurance protection for what can become very expensive treatment and emergency medical evacuation is relatively inexpensive.

Statistics that I’ve generated over the years and have received from insurance companies indicate that only on approximately one trip per 1,000 trips will an overseas traveler have any kind of medical emergency that requires an outpatient visit to a hospital or other medical clinic, etc., that is, a medical problem that needs more than first-aid type of treatment.

Overseas medical emergency statistics

Providing more detail, recently Barry Gagnon of Old Republic Insurance Group supplied me with the following statistics from their claims department.

• Frequency of travelers requiring outpatient treatment — one per 1,000 trips.

• Frequency of travelers being admitted to hospitals as inpatients (differentiated from those needing only first aid) — one per 2,000 trips.

• Frequency of travelers requiring medical evacuation — one per 4,000 trips.

So if you took three overseas trips per year, statistically, you would need emergency medical evacuation once every 1,333 years. However, each year it is needed by many overseas travelers, and you know how statistics work; it could be your turn on your next trip.

A statistical example

ITN subscriber Betty James of Fort Myers, Florida, was one of those statistics. For $154, she had purchased a “zero trip cost” (post-departure coverage only) policy from Travelex for her 2009 cruise along South America. While on board the Norwegian Sun, she fell and broke her hip.

After a phone call to the emergency number provided in her policy, Travelex took charge of her care, arranging multiple ambulance trips and her medical/surgical services, including a Learjet emergency medical evacuation flight to a hospital in Chile accompanied by two medical personnel.

Travelex monitored her progress while she was in the hospital and, ultimately, flew her and her travel companion home to Florida, where a limo waited to take her directly from the airport to her front door. The cost to her primary-payer insurance company ended up totaling some $80,000.

But Betty’s policy guaranteed that she never got a bill!


In addition to not supplying trip-cancellation/interruption protection, a disadvantage of the “Betty James Travel Insurance Strategy” is that this type of policy will not allow the preexisting-condition clause for medical coverage to be waived. (Most full-feature travel insurance policies will waive the clause as long as the policy is purchased within a specified number of days after the first trip deposit is made. This period can vary significantly; be aware of this detail when purchasing a full-feature policy.)

Generally, if your health has been stable, with no change in your treatments and/or medications, this clause shouldn’t be much cause for concern.

In the case of a claim, the insurer will require a “look back” to determine whether or not your health conditions met their criteria for stability. This look-back period may vary from 60 days to 180 days from the effective date of the policy, depending on the insurer and the policy selected. The effective date for a “zero trip cost” (“Betty James Strategy”) policy is the date of departure.

The shorter the look-back period, the better it is for the policy purchaser — less exposure to claim refusal plus less paperwork required to document health stability.

Travel Guard International (Stevens Point, WI; 800/826-4919) and Travelex Insurance Services (Omaha, NE; 800/228-9792) both have “primary payer” policies with 60-day “look backs.” These are the shortest look-back periods available. You’ll find that most other policies have look-back periods of up to 180 days.

A good thing — the preexisting-condition clause does not apply in the case of an accident or any emergency medical evacuation.

Emergency medical evacuation costs often can be much greater than costs resulting from accidents. In the case of the Betty James incident, her medical costs came to about $35,000, but the total cost of her emergency medical evacuation was about $45,000.

Overall, the “Betty James Travel Insurance Strategy” provides great coverage. For details, see the September 2010 issue, page 54, or send me $2 for a reprint.

Types of overseas medical emergencies

Here are a few more statistics.

• Falls and their resulting bone fractures constitute 42% of medical emergencies, and these most commonly tend to generate the most serious problems. (Hold tight to those railings!)

• Heart attacks and strokes constitute about 22% of overseas medical emergencies.

• The balance of some 36% of medical emergencies comprises a variety of minor problems, such as cuts, bruises, gastrointestinal disorders and other issues.

What does all of this mean?

Simply, the above statistics indicate that even though the likelihood of your having a medical emergency while overseas is low, it makes sense, while planning an overseas trip, to “be prepared,” as the Boy Scouts always advise.

In addition to buying medical coverage and emergency medical evacuation coverage, my recommendation has always been to take more cash than you expect to need and to have a couple of credit cards with high available balances. There are few emergencies that this strategy couldn’t handle.

Protection for overseas medical emergencies

As far as I am aware, every full-feature travel insurance policy provides trip-cancellation/interruption coverage plus an adequate degree of medical and emergency-evacuation protection.

Trip-cancellation/interruption coverage is the most expensive portion of any full-feature travel insurance policy. In a previous article, I made recommendations as to when it would be prudent to buy this type of coverage and when it would be rational to consider forgoing this relatively expensive coverage. (See the June 2010 issue, page 53, or send me $2 for a reprint.)

I have seen statistics suggesting that only about three percent of overseas travelers have presented claims for trip cancellation or interruption.

Travel insurance broker Dan Drennen (Omaha, NE; 402/343-3621, recently quoted me a “zero trip cost” post-departure policy that provides $75,000 of medical coverage and up to $2,000,000 for medical evacuation (from a “primary payer” insurance company) for a 75-year-old traveler on a 30-day overseas trip… all for only $73!

Buying travel insurance from a broker provides access to a whole variety of insurance policies. Additionally, in the unlikely event of having a problem with a claim, you’ll have someone knowledgeable on your side when dealing with the insurance company.

Happy trails!