The call came at 9:00 PM. A friend needed to be evacuated from a Caribbean clinic for life-saving treatment. When she arrived the next day, she was within hours of death. The complications—and cost—were horrendous; the alternative: unthinkable.

Even if you can afford to lose the price of a non-refundable plane ticket and cancel hotel reservations, the true cost of having to abort a trip midstream, becoming sick in a foreign country or escaping an impending hurricane can be far costlier than you might imagine

I know. After never making a travel claim, we had two—for different reasons—on a recent trip to Japan. An infection required IV treatments and a typhoon caused us to cancel a prepaid visit to Nikko. Our insurance reimbursement was not only higher than the premium paid, but the assurance that we were covered was worth much more. .

Typoon alert

Typhoon alert

If you understand insurance lingo, you can avoid spending more than necessary. Many buy full coverage for a trip when they book it even though they’ve only made a deposit. That’s because most policies will not cover “pre-existing conditions” unless you purchase the policy within a 14-to-30-day window after first payment. Travelers assume—incorrectly—that their high blood-pressure, diabetes, or asthma must be covered from day one. Yet, these are only considered pre-existing if there was a new treatment or medication change in the 60-to-180 day “look-back period.” If a policy has a 60-day look-back and someone takes blood-pressure meds, a stroke that might have been precipitated by that issue would be covered as long as there were no changes in treatment two months prior to the deposit. If, say, you adjusted your insulin dosage two weeks before you signed up for the trip and later had a diabetic-related illness while traveling, you would be entitled to reimbursement because you had purchased the policy in a timely way. If you booked a safari tomorrow and had been medically stable for the past three months, you wouldn’t have to worry about a look-back period. But, if you had a new diagnosis before the trip and had not yet bought insurance, anything related to that finding would not be covered.

The best way to save money is to not insure the whole trip the day you make the first payment. It’s only necessary to insure the portion of a trip that is non-refundable. And just as you can make payments on trips, you can add more insurance to cover what is at risk.

An illness during traveling may require immediate payment to a foreign health provider and sometimes a rapid return home. There are two types over medical coverage on travel policies: primary and secondary. With secondary, you must first submit your claim to your health insurance provider and wait to see what they pay before asking the travel insurer to cover the balance due. Tin Leg, the company I used for the Japan trip, offered primary coverage so it was a one-step process to be reimbursed for my medical expenses.

Evacuation can be expensive.

Evacuation can be expensive.

After watching a passenger evacuated from a cruise ship by helicopter, I wondered what it cost. Steven Benna, spokesperson for Squaremouth, a travel insurance comparison site, said that they recently paid $80,000 to rescue someone from the Galapagos, where we had been the year before.

Trip interruption is far more likely than a rescue at sea. Having to cut a trip short because you, a traveling companion, or a close relation at home has an accident or illness, may require paying high last-minute fares. Most policies offer 100% coverage when a trip is cut short, but since the costs escalate in emergencies, consider one that gives 150-to-200% of your original cost. When our trip was interrupted by the typhoon, we were reimbursed for prepaid hotel, meals, and excursions.

Watch for exclusions. Planning on scuba diving, bungee-jumping, driving a Ferrari, hang-gliding, or skydiving? Check carefully because while skiing may be covered, heli-skiing may not. Snorkeling might be fine, but the policy might not include care in a hyperbaric chamber. What if you need to be rescued from a mountain in Nepal, an African safari, an Indonesian lava flow, or political coup? Unless you have extraction insurance you may be on your own. Don’t want to have surgery where you don’t speak the language? Some companies will send you to your hospital of choice. Most policies cover repatriation—a polite way of including returning your remains if you die on your trip.



Many dread filing the claim. For us, the process with Tin Leg began with a short telephone interview and was followed by a form they filled out sent via email for corrections an electronic signature. They also accepted our receipts by email and paid promptly, so it was painless. Some agents will handle the paperwork for clients who book insurance through them. When one of our travel companions, Marguerite, required surgery shortly after final payment for a cruise, Ann Morin, owner of Your Dream Vacation, submitted the claim while Marguerite recuperated.

Trip emergencies are not rare. We’ve watched many an ambulance transport someone from a cruise port. Our tablemate last year was sent ashore to have an expensive MRI in South Korea. And at risk of sounding like Typhoid Mary, I returned from a trip to Alaska with a flu severe enough to require hospitalization. A few days earlier, I would have been critically ill far from my Florida home—but at least I would have had really good travel insurance.

When You Go:

First, check the coverage offered by your credit cards, which may offer some benefits, although none are as comprehensive as trip-specific policy.

Comparison Sites:

Specialty Plans:


Medical evacuation to hospital of your choice:

Extreme sports coverage: (Includes shark cage diving, dog sledding, ziplining, camel riding, and more adrenaline pumpers.)

Evacuation/extraction from natural disasters, war, and other extreme situations:

About the Author:

Gay Courter is a bestselling novelist (The Midwife, Code Ezra, Flowers in the Blood) and documentary filmmaker.  She travels for both work and pleasure since her first around-the-world trip at age six.