DCS and no DAN - WHAT NEXT?

[avm1310]

No way to answer your question without knowing where your hypothetical DCS hit occurred.

In many third world counties, where a lot of diving happens, the answer would likely be "sucks for you." If you can't pay, or even prove you can pay, for your medical care, you don't get any. That's a key reason for DAN insurance, even if your first world medical plan would cover you. With DAN, the chamber folks know they'll get paid. With your plan that they have never heard of and which exists in a country far away from them, they'll want cash up front.

As far as being unconscious, there's a reason why the dive op and/or your dive buddies should know that you have DAN coverage and how to get your DAN info.

I can tell you from my experience that some so called third-world countries and/or remote locations can be more prepared than one would think. It's not a guarantee that this will happen everywhere, but I will tell you I was bent almost 15 years ago in Cozumel. I received excellent healthcare service. Plus, I didn't have to pay anything bc I had my health insurance plan pick up the tab. Incidentally, I also had DAN insurance, which in this case paid nothing, since it is designed as a back up/secondary insurance. I should say that I was fortunate that the event occurred in a place where a Texas based worldwide network was operating. It's called SSS network. I think they have like a dozen chambers throughout the world. Mostly third world and remote locations, but giving first world care- and also doing all the insurance processing for free out their US office.​

 

[Mustard Dave]

I can tell you from my experience that some so called third-world countries and/or remote locations can be more prepared than one would think. It's not a guarantee that this will happen everywhere, but I will tell you I was bent almost 15 years ago in Cozumel. I received excellent healthcare service. Plus, I didn't have to pay anything bc I had my health insurance plan pick up the tab. Incidentally, I also had DAN insurance, which in this case paid nothing, since it is designed as a back up/secondary insurance. I should say that I was fortunate that the event occurred in a place where a Texas based worldwide network was operating. It's called SSS network. I think they have like a dozen chambers throughout the world. Mostly third world and remote locations, but giving first world care- and also doing all the insurance processing for free out their US office.
​

What is 'backup/secondary insurance' and why would you have it? In the event of a claim where the risk is the subject of two or more policies, the one you claim off would seek a contribution off the others.

 

[DandyDon]

What is 'backup/secondary insurance' and why would you have it? In the event of a claim where the risk is the subject of two or more policies, the one you claim off would seek a contribution off the others.

UK medical and DAN Europe are different from what we have in the US. Here...
1: Primary insurance like a person's medical insurance from work or private purchase will pay all that is required under the terms of that policy; then
2: Secondary insurance like DAN America Dive Insurance will pay all that is required under the terms of that policy - up to the balance of the total loss. It's really just a matter of how they split the costs.
But for divers who do not have primary insurance, or whose primary insurance does not cover scuba or losses outside of the US, then DAN America assumes primary payment responsibility.

Canadians have entirely different medical coverage that varies between provinces I believe. Of the few I've read discussing DAN coverages, most have said that their medical coverage pays for diving accidents in Canada or for treatment in Canada, but not outside of their country - so they will buy DAN America dive insurance to cover them on trips, or diving near our border when they might be treated in the US. Some provinces may cover citizens outside of the country, but I don't know.

We also have Dive Assure dive insurance, which claims to be primary coverage - so that a diver's primary medical insurance and Dive Assure should split costs evenly. However, those claims are just a marketing gimmick, and in reading the exclusions of their coverage - there is a clause that nullifies that claims and makes that coverage secondary. It seems like fine coverage otherwise, but that claim is a lie, albeit a legal one.

Mexican citizens cannot purchase from DAN America as it really is for US & Canada only. DAN Mexico is very different, but then Mexicans have different medical insurance through their work. I think that Central and South America have their own DAN as well, but know nothing about theirs.

 

[Kevrumbo]

What is 'backup/secondary insurance' and why would you have it? In the event of a claim where the risk is the subject of two or more policies, the one you claim off would seek a contribution off the others.

The backup/secondary insurance of DAN can be used for service reimbursement in the case of Hyperbaric Oxygen Therapy treatment for DCS provided by a foreign outside-of-US health care provider (primary US Health Insurance Carriers tend to be wary & reluctant of processing claims outside of the US Health Care System).

Invoice for my HBOT in Truk Oct 2008 was $3k for the Table 6 treatment, and a $500 Physician's fee (for only a telephone consult from the Chamber Tech in Truk to the Hyperbaric Specialist Doctor in Melbourne Australia!).

It took a year of back 'n forth email/snail mail correspondence between DAN & their Insurance Underwriters, Hyperbaric Health Australia and myself, before DAN finally cut me a check, which I then promplty wired the funds over to Hyperbaric Health Australia.

However, the additional work-up on the way back in Honolulu for PE/DVT and another Table 6 HBOT at Kuakini Medical Center was covered immediately by my primary health insurance through my regular job, since this treatment was performed in the US by a recognized health care provider. . .

btw, here in SoCal off-shore Los Angeles, if you have a diving accident and are indigent with no health insurance whatsoever --by virtue of being part of the Los Angeles County Dept. of Health Services, you will still receive prompt treatment by LA County Lifeguards/EMS & Chamber personnel at the Catalina Hyperbaric Chamber. (You don't even need necessarily to have DAN"s advance permission to receive treatment at this facility either. . .)

 

[tracydr]

I thought I might have DCS here locally. I never really thought I would need DAN locally, in fact, I thought it would actually be a problem, since I've had problems with two insurances in the past. Well, my insurance wanted to take my problem to a medical management group meeting or some such nonsense, which would take 4-5 days. In the meantime, I was sitting in the ER,with the dive doctor telling them it was an emergency decompression illness! It took until the next morning, nearly 24 hours,until I got a level 6 chamber ride, which, by that time, didn't really help my symptoms anyway. Might have been somewhat useful to have been on oxygen while I was waiting which I was not. Oh, BTW, I was given my blood pressure meds, despite a blood pressure of 80/60, which rapidly became 40/ nothing!
Hospitals are just so much fun! And I'm a doctor and do a pretty good job of defending myself. I hate to think of non-medical people and the treatment they get!
I will have DAN before any dive I ever do again. Btw, I haven't dived since my hospitalization. I'm still recovering.

---------- Post added November 1st, 2013 at 08:51 PM ----------

The backup/secondary insurance of DAN can be used for service reimbursement in the case of Hyperbaric Oxygen Therapy treatment for DCS provided by a foreign outside-of-US health care provider (primary US Health Insurance Carriers tend to be wary & reluctant of processing claims outside of the US Health Care System).

Invoice for my HBOT in Truk Oct 2008 was $3k for the Table 6 treatment, and a $500 Physician's fee (for only a telephone consult from the Chamber Tech in Truk to the Hyperbaric Specialist Doctor in Melbourne Australia!).

It took a year of back 'n forth email/snail mail correspondence between DAN & their Insurance Underwriters, Hyperbaric Health Australia and myself, before DAN finally cut me a check, which I then promplty wired the funds over to Hyperbaric Health Australia.

However, the additional work-up on the way back in Honolulu for PE/DVT and another Table 6 HBOT at Kuakini Medical Center was covered immediately by my primary health insurance through my regular job, since this treatment was performed in the US by a recognized health care provider. . .

btw, here in SoCal off-shore Los Angeles, if you have a diving accident and are indigent with no health insurance whatsoever --by virtue of being part of the Los Angeles County Dept. of Health Services, you will still receive prompt treatment by LA County Lifeguards/EMS & Chamber personnel at the Catalina Hyperbaric Chamber. (You don't even need necessarily to have DAN"s advance permission to receive treatment at this facility either. . .)

Should have gotten treated on Catalina. Instead,I denied my knee pain, limped home to AZ, got the MRI and finally realized,crap,was I bent?

 

[Kevrumbo]

. . .Should have gotten treated on Catalina. Instead,I denied my knee pain, limped home to AZ, got the MRI and finally realized,crap,was I bent?

The best place for a diver to be if unfortunately s/he suffered a diving accident and needed treatment R/O DCS/AGE is right here in SoCal:

SoCal Hyperbaric Chamber For DCS/AGE: Always Go With LA County/USC Catalina. . .

USC Catalina Chamber vs Most Mainland Chambers

Mainland Chamber
Most seen are Clinical Patients
Inland Hospital/Clinic
Most Cases Delayed
ER Stabilization before sent to Chamber
Retreatments
Paid Staff Physician onsite
Funded by Clinical Patient Treatments

Catalina Chamber
Treat Divers only 24/7
Location is Where the Divers are
Fresh/Urgent Cases
Extension of LA County Medical Center ER
Few Retreatments
Volunteer Crew
Fly on-call Physician in
Funded by LA County Grants & Donations

Development of DCS Symptoms:
66% Within 30 Minutes
74% Within 2 Hours
95% Within 24 Hours
50% of divers Do Not Seek Treatment for >12 Hours after symptoms Develop (Serious Mistake!!!)

DCS Physiological Susceptibility Factors:
("An Alteration of Blood Flow")
Dehydration
Illness & Injury
Drugs & Alcohol
Cold Stress
Heavy Exertion
Obesity
Age
Anxiety
Patent Foramen Ovale
(above info from the USC Catalina Hyperbaric Chamber Mainland Based Volunteer Crew Program, class taken back on Oct 6-8 2006)

In my experience and in light of recent events here in off-shore LA County:

Simple straightforward triage as a First Responder (i.e. Boat Captain, Dive Master, Rescue Diver etc on the scene), based on initial reported symptoms and worst case scenario of a just surfaced conscious diver onboard in post-dive distress . . .Rule Out DCS and/or AGE.

Radio-in, rendezvous & evacuate patient by Baywatch Paramedic Boat or US Coast Guard Helicopter to Big Fisherman Cove West End Catalina while underway at sea. Evaluate and begin Oxygen Therapy at Catalina Hyperbaric Chamber as necessary with attending Emergency/Hyperbaric Physician on-call & enroute, and then post-treatment assessment & stabilize for transport. Helicopter patient back to mainland LA/USC County General Hospital for further diagnostic work-up/treatment as needed for secondary conditions or comorbid pathologies.

IMO, this is the preferred beginning of the standard chain of care for all dive accidents with suspected DCS/AGE --whether victim is conscious or unconscious; alert & oriented or in full cardiorespiratory arrest: the initial response and call for immediate aid should always be the same.

THIS ALSO IS STANDARD OPERATING PROCEDURE FOR ALL COMMERCIAL SPORTDIVE BOATS HERE IN OFFSHORE LOS ANGELES COUNTY FOR A DIVING ACCIDENT --TRANSPORT IMMEDIATELY TO THE CATALINA HYPERBARIC CHAMBER VIA BAYWATCH BOAT OR US COAST GUARD HELICOPTER ("WHEN IN DOUBT, CHOPPER 'EM OUT") . . . THIS IS THE BEST MOST PRUDENT COURSE OF ACTION TO TAKE AS EITHER A FIRST RESPONDER OR VICTIM!!!


USC Catalina Hyperbaric Chamber​

 

[crosshairs]

For my hypothetical I am somewhere that requires an expensive med evac. I am unconscious and the dive op knows I am not a DAN member. What does he do?

They fill up your weight belt grab whatever gear they want and push you over board....dead body's are bad for business

 

[scubawikileaks]

There is truth in most of the replies to your question. There is a bit of misunderstanding in your basic question so I will start there and try to give you a realistic picture of what really happens in a DCS or AGE incident. I will put it on the blog as it will be kind of lengthy. I will describe what happened to me in two cases - One event began in the Bahamas and wound up in Miami. The second event happened and was resolved in Belize. I cannot speak to the DAN Entities responsible for Europe and the Far East.
Please go to www.scubawikileaks.com for this post.

---------- Post added November 2nd, 2013 at 02:42 PM ----------

Divers in Europe are doing business with DAN Europe. This is not DAN Americas. If it is like PADI, DAN has sold someone a franchise/license to do business under DAN's name and have agreed to certain standards of business and conduct of the business. After that they run their business as they see best.

 

[EastEndDiver]

scubawikileaks so far all of your posts have been made to slam DAN.Do you have any useful information that may help fellow divers or are you just here to slam DAN?
It seems you have an agenda and tunnel vision and so far have added nothing to "our" community (Scubaboard).

If you think your destructive and so far unsubstantiated criticism of DAN is helpful I beg to differ with you it just shows you are pushing an agenda with no facts and just conjecture to back it up.In fact it has worked against you in my eyes I would never buy anything you are selling because of your tunnel vision and lack of facts.

 

[avm1310]

The backup/secondary insurance of DAN can be used for service reimbursement in the case of Hyperbaric Oxygen Therapy treatment for DCS provided by a foreign outside-of-US health care provider (primary US Health Insurance Carriers tend to be wary & reluctant of processing claims outside of the US Health Care System).

After my accident I wondered why was the chamber taking all my major medical health plan info when I had DAN.
They told me that DAN's plan is called something like "excess" so it is a payor of last resort after any and all other insurance got used up. They also told me their chamber had a claims office in Texas free to the patients which would do all the filing and waiting. They did and I got charged $0.00.


I must say I was surprised, because I thought DAN was taking this charge up-front. That's the way they advertise like "we pay", not like "your existing insurance will pay, and if they don't, then we will". What if my health plan is one self-funded through a company plan? The future premiums would go up by taking that hit of an invoice. So, just saying, when dealing with any insurance, read the fine print.