A DAN question

[Guba]

Here are the facts of a situation as I know them. I'm not arguing for or against any "side", individual or organization. I just want to see some other divers' perspectives on this situation.

A dive instructor is conducting some private open water checkout dives. The group gets to the lake and makes preparations. It's the instructor's habit to get into the water and don the last of his gear there, and he does so. However, someone in the group (I don't know who) left something at the vehicles, and the instructor goes back for it. On his return, he rounds a boulder about 4 feet from the water's edge and is bitten by a rattlesnake (some of you may remember a previous post about this). He is transported to a hospital, then transferred to another where he receives 13 units of antivenin, at a cost of about $8000 per unit. He makes a full recovery over time.
Now then, he contacts DAN. The instructor has been a professional member for over ten years and has referred scores or possibly hundreds of divers to DAN (often because he sponsors out of country trips and always recommends divers have additional coverage and protection). The DAN rep reports that DAN will not cover any part of the 'accident' (I don't trust that term, for I'm absolutely sure the snake MEANT to hurt the guy), since "the dive hadn't actually begun. A 'dive' is defined as the time from point of entry to the exit of the water."

So the questions...What are your thoughts on this matter? Is the instructor entitled to be upset with DAN's policy and decision? Should DAN be involved at all? Is the organization justified in their position in this case?

Of course, I'm not fishing for legal interpretations. I'm just curious about how others think and feel about this situation.

 

[sberanek]

I'm at work at the moment so I can't verify... I think in the latest DAN magazine they had an article about evacuating a non-diver and his treatment. I'm not sure if they covered his treatment, but the did evacuate him.

--Shannon

 

[boulderjohn]

My initial reaction--without even pretending to be an attorney or anything like that--would be that this was not a diving incident. I myself had a medical problem while on a dive trip, and it was not really dive related. I hoped that DAN would help me out a bit, but I was not surprised or upset when they did not.

Does this person not have regular health insurance? My regular insurance would have covered this without a problem.

 

[Steve50]

My initial reaction--without even pretending to be an attorney or anything like that--would be that this was not a diving incident. I myself had a medical problem while on a dive trip, and it was not really dive related. I hoped that DAN would help me out a bit, but I was not surprised or upset when they did not.

Does this person not have regular health insurance? My regular insurance would have covered this without a problem.

Ditto on the health insurance.

 

[billeelou]

no- unfortunately,
Dan would not cover a gunshot wound on the boat after a dive: if their definition is from point a to point b, but would cover if he was shot leaving the water or if they shot him while entering....

kinda like Mexico insurance, when in Mexico it covers but once you are on the bridge......

now if the rattler was swimming???????

 

[Leejnd]

One thing that jumped out at me as I read your description was this part:

The instructor has been a professional member for over ten years and has referred scores or possibly hundreds of divers to DAN (often because he sponsors out of country trips and always recommends divers have additional coverage and protection).

This sounds as if either you or he was expecting DAN to factor his length of DAN membership and number of divers he's referred to them into their decision on whether or not to cover him. Otherwise, there would be no point in bringing this up. In reality, they CAN'T factor this in (nor should they). The length of membership or number of previous referrals should have no bearing on whether or not a particular incident is covered. Think of the guy who just joined DAN who gets bit by the same rattlesnack -- does he deserve coverage any less than this guy?

With that said, I think it's a grey area, and there are different ways of looking at it. Let me say up front that I have no idea what DAN's policies on coverage are, so I'm just throwing out thoughts here.

On the one hand, DAN would certainly cover an injury caused by a creature in the water, right? And this guy was on his way down to dive, four feet away from the edge of the water in his dive gear -- should the water's edge really be the delineating factor of whether or not an injury is covered? The walk past that boulder could be construed as part of the dive process -- he had his dive gear on and was about to enter the water, right? What about another type of injury -- if a diver tripped and fell on his way down to the water due to all the heavy equipment on his back, wouldn't it be covered? That's a dive-related accident, as it was the dive equipment that presumably caused him to fall.

On the other hand, anyone can get bit by a rattlesnack at any time, if they are in an area where there are rattlesnakes. The fact that he was diving had no bearing on his getting bit -- he was just in the wrong place at the wrong time. It wasn't caused by *the dive* so to speak, the way a sea creature injury would be. In other words, the only way one could GET bit by a shark is by being in the water for a dive, whereas rattlesnake bites have nothing whatsoever to do with diving.

So it seems to me it could go either way. I do find it a bit disappointing that DAN wasn't willing to be bit broader with their coverage in this case.

 

[Bobyjimmie]

I am a new DAN member and there are different steps to their coverage now, they will evac members for non-dive accidents like someone said above and facilitate their treatment only if you are that level of member but I also think if you have personal health insurance on such a situation they take over. At least thats how I read the brochure.

 

[RJP]

He went back to get something from the parking lot, right? Suppose he was hit by a car on his way back down to the water? I'm guessing no one would expect DAN to cover that, so why would they cover being bit by a snake on the way to the water? Just because he was heading to the water?

What about a car accident on the drive to the lake? Suppose he fell out of bed upon waking to go diving? How about a hernia loading his tanks into the car the night before?

DAN is dive insurance and, while however unfortunate, this was not a diving accident.

 

[Leejnd]

He went back to get something from the parking lot, right? Suppose he was hit by a car on his way back down to the water? I'm guessing no one would expect DAN to cover that, so why would they cover being bit by a snake on the way to the water? Just because he was heading to the water?

What about a car accident on the drive to the lake? Suppose he fell out of bed upon waking to go diving? How about a hernia loading his tanks into the car the night before?

DAN is dive insurance and, while however unfortunate, this was not a diving accident.

That is definitely one way to interpret it - that's pretty much what I was saying in my "on the other hand" paragraph. At some point there has to be a cut-off to when an injury is considered dive-related and when it's not. It sounds like DAN's cut-off is entering the water, in which case this would not be covered.

However, that eliminates injuries like the one I theorized - the diver who falls down and injures himself on the walk down the sand to the surf, due to the heavy gear on his back. It seems to me that WOULD be considered a dive-related accident -- one could argue that it WAS part of the dive, as it was part of the "entry". I mean, if a diver was on a boat and, while geared up and ready to do his giant stride, a big wave rocked the boat knocking him backwards and he injured himself on the deck, wouldn't that be covered? He's not IN the water yet, right?

 

[rawls]

I believe that DAN does not cover the actual medical treatment of someone who is injured. It takes care of the cost of evacuation to a medical facility and not just any facility. If you are injured where I dive...and say the diver has some type of DCI...DCS or AGE...or any other injury that requires evac, they will pay for the evacution, which in our case will most likely be a dive boat 30-40 miles off shore. This evacuation, without DAN insurance could cost anywhere from $15,000 to $30,000. DAN will pay for that. And it won't have you stopped of at just any hospital. They will pay to get the diver air lifted to Duke University if it is a DCI...or a class A trauma center for a physical injury worthy of such treatment. But...As far as I understand, they don't specifically pay for the actual medical treatment...As some others have posted, this should be covered by personal insurance...