Urgent! Have DAN insurance; Generali demanding upfront payment b4 providing medical evacuation

[AdivingBel]

In my case, I'm kind of stuck with DAN Travel since they will insure you at age 70+; many policies will not.

Well, there is that. I honestly haven't checked that out with my current provider, but I'm not too far from that situation. I hope I'm still healthy and hale enough for it to be an issue. I'm actually envious.

 

[Julie T]

Nothing warned me away from DAN travel insurance. I just never associated DAN dive insurance with their travel insurance offering. It's pretty clear on their site that they are separate entities underwritten differently.

As far as their travel insurance offering, I've found much more cost effective plans with better policies regarding the amount of medical coverage, weather related (hurricane) cancelation, reasons & reimbursement for trip interruption and cancelation, etc. etc.., basically for many of the reasons I buy trip insurance. For all insurance the devil is in the policy details and it's your responsibility as a consumer to read and compare the details of the plans. I wish it wasn't so and that you could just go by the "name brand," but almost all policies are underwritten by different companies than those they are marketed under. It's the world we live in... All IMHO, YMMV.

I'm sorry you were caught up in your current situation, but most trip insurance plans that I know generally require for you to pay for expenses up front and then file for reimbursement after the fact. DAN dive insurance is a completely different beast when it comes to dive accidents and payment.

It sounds like you're more savvy than the average consumer when it comes to travel insurance. Most people would not have been that clued in about different underwriters, etc. Not everyone can be expert on everything. That doesn't signal a lack of "due diligence." Tim did read the DAN travel insurance policy before buying, but he was also relying on DAN's name. Clearly a big mistake. I also would have thought that DAN would care enough about their "brand" to not want their name tarnished by association with poor travel insurance, given that their dive insurance has such a great reputation. And I'm sure that DAN knows that the travel insurance is riding on the coattails of their dive insurance's reputation. If the travel insurance side of business keeps screwing up the way they did with Tim's family, it will drag down DAN's overall reputation. And the number of ways in which the DAN travel insurance has screwed up and fumbled this case are many and extensive - I've only touched on the biggest problems.

Re paying expenses upfront: not many people have the financial resources to pay out-of-pocket for a medical evacuation from a foreign country, and then await/hope for reimbursement (which may or may not be forthcoming after an indeterminate length of time from an insurance company financially invested in denying as many claims as possible), given that medical evacuations can cost anywhere from $25,000 to $100,000 or more, depending on location. Ergo, why we purchase of travel insurance policy to cover such contingencies.

 

[AdivingBel]

It sounds like you're more savvy than the average consumer when it comes to travel insurance...

I don't know about savvy, but I do have experience with dive travel. I'm very sorry for your situation, but I don't have much positive to add beyond my previous explanation. I hope others reading this thread can gain from your experience (which is one of the strengths of SB). If you have specific needs you are trying to insure against while traveling, you have to make sure they are spelled out in detail in the policy or you have written confirmation that your specific needs are covered. My basic understanding is these types of policies are written in an "inclusive" (not "exclusive") fashion, i.e. if it's not in the policy agreement there is no guarantee it's covered. As cold hearted as it sounds, it's not a matter of sullying a brand name, but statistics and financial risk. Again, good luck and best wishes.

 

[ChuckP]

Re paying expenses upfront: not many people have the financial resources to pay out-of-pocket for a medical evacuation from a foreign country, and then await/hope for reimbursement (which may or may not be forthcoming after an indeterminate length of time from an insurance company financially invested in denying as many claims as possible), given that medical evacuations can cost anywhere from $25,000 to $100,000 or more, depending on location. Ergo, why we purchase of travel insurance policy to cover such contingencies.

Someones money is someones money - you are worried about getting reimbursed for the cost, you are no different than the owner of the airplane - he's worried too and rightfully expecting paid upfront before services are performed. The same with the hospital, why should they fight to get paid?

ANY travel insurance policy I bought, I'd make sure it was accepted wherever I was traveling to or be prepared to pay upfront. In Mexico, they will leave you outside on the gurny untill the ambulance is paid and leave you in the hallway until the hospital is prepaid - sounds cruel but it's their house, their rules.

 

[Cert1967]

Unfortunately, dive insurance is not travel insurance, or vice versa.

This is off the track. A single insurance contract could combine and meet your needs for risk mitigation associated with both general travel and dive specific risks. Individual risk tolerance most often varies as a trade-off between that risk and the cost of offsetting it. The issue is what risks and in what amount, are covered.

Commonly referred to 'travel/dive' insurance contracts typically exclude risks - such as the DAN promoted Annual Travel policy, GENERALI US G540. Without the exclusion of specified events the 'Covered Expenses' section of the contract would apply.

General Exclusions, G540

... you or your Traveling Companion mountain climbing, bungee cord jumping, skydiving, parachuting, hang gliding, parasailing, caving, extreme skiing, heli-skiing, skiing outside marked trails, boxing, full contact martial arts, scuba diving below 131 feet (40 meters), or travel on any air-supported device, other than on a regularly scheduled airline or air charter company;
​

Covered Expenses, G450

1- Expenses incurred by you for Physician-ordered emergency medical evacuation, including medically appropriate transportation and necessary medical care en route, to the nearest suitable Hospital, when you are critically ill or injured and no suitable local care is available, subject to prior approval by us or our authorized agent;

2- Expenses incurred for non-emergency repatriation, including medically appropriate transportation and medical care en route, to a Hospital or to your place of residence in the United States of America, when deemed medically necessary by the attending physician, subject to prior approval by us or our authorized agent.
​

As a core issue you are entering into a unilateral, aleatory, contract with an insurance company. Consideration? The purchaser pays an amount to the insurance company, and the insurance company promises to indemnify, subject to numerous conditions, the insured for certain defined risks.

It is commonly accepted that few insured read their insurance contracts, even carefully business professionals, often relying on their agent's good faith and skill. Compounding this, 'Dive/Travel' policies are often bought online - without the benefit of an insurance agent and without being read, much less understood, by the purchaser.

For divers the core issue is their risk tolerance while diving and traveling. Understanding how insurance marketed as 'dive' and/or 'travel', combined with any other insurance they may have, offsets risk is the core element of protecting the diver's financial and physical well being.

Turning to the DAN marketed GENERALI US G540 there are interesting elements to it.

• General – <<>> This Policy is a Secondary Policy which has its benefits determined after those of the other policy,
• TRIP means: A period of round-trip travel at least 100 miles away from <<>> and the Trip does not exceed 31 days in length.
• Payment of Claims <<>> All other benefits are paid directly to you, unless otherwise directed.
• PRE-EXISTING CONDITION means a Sickness or Injury during the 180-day period immediately prior to your effective date <<>>

The prudent consumer is well advised to read all of their existing and proposed insurance contracts, carefully considering the conditions and risk that they are willing to accept.


******************

Attached CALIF G540_DOC.pdf was today sourced from DAN travel insurance, specifying CA residency

​

 

[Julie T]

Someones money is someones money - you are worried about getting reimbursed for the cost, you are no different than the owner of the airplane - he's worried too and rightfully expecting paid upfront before services are performed. The same with the hospital, why should they fight to get paid?

ANY travel insurance policy I bought, I'd make sure it was accepted wherever I was traveling to or be prepared to pay upfront. In Mexico, they will leave you outside on the gurny untill the ambulance is paid and leave you in the hallway until the hospital is prepaid - sounds cruel but it's their house, their rules.

No one is saying the bills shouldn't be paid. We're saying that DAN travel insurance needs to fulfill the terms of the policy and pay for services per the contract.

 

[Jcp2]

No one is saying the bills shouldn't be paid. We're saying that DAN travel insurance needs to fulfill the terms of the policy and pay for services per the contract.

I think that they will pay the benefits to you directly after you submit the claim of payment to them after paying the service provider. The catch is that you would have to be able to pay the service provider first. It’s a similar problem that many people who travel outside the reach of their health insurance network have that they are probably not aware of, even within the US. Ending up at an ER that is non par with your medical insurance plan will result in full charges being levied and your insurance company paying only a fraction of the bill. The only reason why you get treated first before a wallet biopsy here is because of the federal EMTALA act passed in 1986, which obligates any hospital recipient of federal health care dollars to examine and treat any patient presenting in an emergency center regardless of ability to pay. Prior to this, what you describe happened in Mexico happened here routinely as well.

 

[tursiops]

This is off the track. A single insurance contract could combine and meet your needs for risk mitigation associated with both general travel and dive specific risks. Individual risk tolerance most often varies as a trade-off between that risk and the cost of offsetting it. The issue is what risks and in what amount, are covered.

Commonly referred to 'travel/dive' insurance contracts typically exclude risks - such as the DAN promoted Annual Travel policy, GENERALI US G540. Without the exclusion of specified events the 'Covered Expenses' section of the contract would apply.

General Exclusions, G540

... you or your Traveling Companion mountain climbing, bungee cord jumping, skydiving, parachuting, hang gliding, parasailing, caving, extreme skiing, heli-skiing, skiing outside marked trails, boxing, full contact martial arts, scuba diving below 131 feet (40 meters), or travel on any air-supported device, other than on a regularly scheduled airline or air charter company;
​

Covered Expenses, G450

1- Expenses incurred by you for Physician-ordered emergency medical evacuation, including medically appropriate transportation and necessary medical care en route, to the nearest suitable Hospital, when you are critically ill or injured and no suitable local care is available, subject to prior approval by us or our authorized agent;

2- Expenses incurred for non-emergency repatriation, including medically appropriate transportation and medical care en route, to a Hospital or to your place of residence in the United States of America, when deemed medically necessary by the attending physician, subject to prior approval by us or our authorized agent.
​

As a core issue you are entering into a unilateral, aleatory, contract with an insurance company. Consideration? The purchaser pays an amount to the insurance company, and the insurance company promises to indemnify, subject to numerous conditions, the insured for certain defined risks.

It is commonly accepted that few insured read their insurance contracts, even carefully business professionals, often relying on their agent's good faith and skill. Compounding this, 'Dive/Travel' policies are often bought online - without the benefit of an insurance agent and without being read, much less understood, by the purchaser.

For divers the core issue is their risk tolerance while diving and traveling. Understanding how insurance marketed as 'dive' and/or 'travel', combined with any other insurance they may have, offsets risk is the core element of protecting the diver's financial and physical well being.

Turning to the DAN marketed GENERALI US G540 there are interesting elements to it.

• General – <<>> This Policy is a Secondary Policy which has its benefits determined after those of the other policy,
• TRIP means: A period of round-trip travel at least 100 miles away from <<>> and the Trip does not exceed 31 days in length.
• Payment of Claims <<>> All other benefits are paid directly to you, unless otherwise directed.
• PRE-EXISTING CONDITION means a Sickness or Injury during the 180-day period immediately prior to your effective date <<>>

The prudent consumer is well advised to read all of their existing and proposed insurance contracts, carefully considering the conditions and risk that they are willing to accept.


******************

Attached CALIF G540_DOC.pdf was today sourced from DAN travel insurance, specifying CA residency

Since you quoted me and responded with your essay, I feel obliged to respond, although less at length.

To disagree, the point is EXACTLY dive accident versus travel insurance.
It is silly to dive without dive accident insurance; one trip to a chamber costs more than a lifetime of buying the insurance. And DAN is the gold standard, especially if you live in the US and especially if you dive in the US and out of the US. I do not believe that is in dispute.

Many refuse to purchase travel insurance, saying they will "self insure." Well, fine, if the coverage is for trip interruptions and lost luggage, etc. But this thread is about a non-diving medical event, not covered by dive accident insurance, and only uncertainly covered by one's travel insurance.
If your message is, RTFP, I agree. Ask questions, check out specifics you are concerned about. Assume nothing. Good advice.

But your post seems to be about something you call travel/dive insurance, although I can't tell if you mean a combined policy or are using "/" to mean "or," in which case I wish you had used "or." There are indeed some combined dive accident and travel policies, none I known of with the reputation DAN has for covering dive accidents, and the most well-know of which does NOT cover accidents in the US, only out of the US. How nice.

The thread is really about the problem of DAN's name on a Generali policy. and whether the services provided matched the services sold; they certainly did not match the services expected, but, as you say, RTFP. I suspect a problem here is that DAN and Generali are quite new partners; they will take some time to sort out their relationship. I'll put a lot of faith in DAN not wanting to sully its good name, so I hope they become aware of this thread and I'm sure they will recognize the negative impact it has on the DAN name.

 

[Cert1967]

IMO, The biggest takeaway to me (that I did not see mentioned) is never under any circumstances, ever skip a decompression obligation from any computer.

I always wear two computers and I intended for one to be a backup to the other. They are different computers running slightly different algorithms. Depending on the repetitive dives profiles sometimes one is more conservative that the other and in other cases it is the opposite. I always follow both of them. I never violate the deco obligation of either one.

At first it was a bit annoying to have two different computer with different algorithms (the new one is a Shearwater Perdix and the old one a Zeagle N2ition), but now I actually like that they are different. I feel it is more conservative if I meet the NDL and/or Deco obligation of both of them.

It is not uncommon that one of them will go into deco (Even when I am using Nitrox with the rest of the group). I don’t want to cut my dive short so I just meet all the deco obligations and then I do the safety stop.

Some divers seem to have an objection to staying in the water (at 20ft to 10ft, 6m to 3m) any longer than the minimum required and that is a problem. If you want to avoid DCS do very long decompression/ safety stops. Remember, all dives are decompression dives. It doesn’t matter if you have a deco stop obligation or not, you still have to out-gas (decompress). Even if you are under the NDL, you still have to decompress (out-gas).

It is safer (and under some models also faster) to out-gas in 10 ft to 15 ft of water depth, that on the surface.

Note: this is my opinion, but it is based on several conversations that I have had with at least three hyperbaric medicine researchers from DAN. They all agree that the emphasis by many divers to do the shortest stops possible (as required) is probably not the best approach.

There is a fear of deco stops in some diving communities and the industry that is totally counterproductive. All dives should include deco stops, but some divers are only comfortable calling them safety stops. In the real world they are the same... it is just a continuum.

YMMV

And yes, get Nitrox.

I will get of my soap box now.

Since you quoted me and responded with your essay, I feel obliged to respond, although les at length.

To disagree, the point is EXACTLY dive accident versus travel insurance.
It is silly to dive without dive accident insurance; one trip to a chamber costs more than a lifetime of buying the insurance. And DAN is the gold standard, especially if you live in the US and especially if you dive in the US and out of the US. I do not believe that is in dispute.

Many refuse to purchase travel insurance, saying they will "self insure." Well, fine, if the coverage is for trip interruptions and lost luggage, etc. But this thread is about a non-diving medical event, not covered by dive accident insurance, and only uncertainly covered by one's travel insurance.
If your message is, RTFP, I agree. Ask questions, check out specifics you are concerned about. Assume nothing. Good advice.

But your post seems to be about something you call travel/dive insurance, although I can't tell if you mean a combined policy or are using "/" to mean "or," in which case I wish you had used "or." There are indeed some combined dive accident and travel policies, none I known of with the reputation DAN has for covering dive accidents, and the most well-know of which does NOT cover accidents in the US, only out of the US. How nice.

The thread is really about the problem of DAN's name on a Generali policy. and whether the services provided matched the services sold; they certainly did not match the services expected, but, as you say. RTFP. I suspect a problem here is that DAN and Generali are quite new partners; they will take some time to sort out their relationship. I'll put a lot of faith in DAN not wanting to sully its good name, so I hope they become aware of this thread and I'm sure they will recognize the negative impact it has on the DAN name.

Travel Insurance? Dive Insurance?

Just words.

What counts is the content of the insurance contract.

One policy (contract) could cover all risks associated with dive travel and is available.

Many general health and accident plans cover international medical treatment, including evacuation. My wife's does - the key phrase is "medically necessary". Up front payment, while not contractually mandated, maybe, probably not.

DAN "Diver Insurance"? Its not DAN, it an insurance company contract. For all the divers that have redundant safety mechanisms in place, it would be prudent to have a 'backup' in the case emergent medical and evacuation are needed and the provider(s) want cash up front.

As for Generali and DAN? Its simple, G will pay what the contract mandates and no more. I believe G uses a third-party service administrator, adding another level of complexity.

DAN full well knows the negative publicity they may receive due to their relationship with their insurance marketing partners.

 

[tursiops]

Travel Insurance? Dive Insurance?

Just words.

What counts is the content of the insurance contract.

One policy (contract) could cover all risks associated with dive travel and is available.

Many general health and accident plans cover international medical treatment, including evacuation. My wife's does - the key phrase is "medically necessary". Up front payment, while not contractually mandated, maybe, probably not.

DAN "Diver Insurance"? Its not DAN, it an insurance company contract. For all the divers that have redundant safety mechanisms in place, it would be prudent to have a 'backup' in the case emergent medical and evacuation are needed and the provider(s) want cash up front.

As for Generali and DAN? Its simple, G will pay what the contract mandates and no more. I believe G uses a third-party service administrator, adding another level of complexity.

DAN full well knows the negative publicity they may receive due to their relationship with their insurance marketing partners.

LOL
Your post? Just words.

"One policy (contract) could cover all risks associated with dive travel and is available."
Right. Travel is one thing, and dive accidents are another.
If you actually know of a policy that is so good, what is it?