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

[Julie T]

Final update: 1:50 pm PST 4-27-21. Xander has finally been picked up by a Medevac flight arranged and paid for by Generali, and is en route home from Cabo San Lucas to Denver, CO. It took a crazy number of phone calls and emails by the family over the course of days, during which there was very stressful uncertainty, to find the right people at DAN and Generali to make this happen, but ultimately Generali did make good on the emergency medical assistance commitment in their travel insurance policy. There must be a problem with DAN/Generali's personnel, or with their training, that this situation became so confusing and fraught. I hope the companies will work on this. (Note: I wanted to add this update to the top of my original post, but the "edit" option has disappeared for that post - am guessing that happens after a certain number of days/hours pass?)

For the sake of comparison, I looked at the online terms and conditions for both DAN's dive insurance and their travel insurance (although the governing terms and conditions will be those provided with the final purchased policy). The wording for both types of insurance is somewhat ambiguous in regards to when DAN might provide payment upfront, and when it will reimburse the client for expenses incurred.

For Xander's case, DAN and Generali eventually did agree that they would cover the cost for the medically necessary evacuation upfront, rather than requiring that Tim first pay himself and later request reimbursement. Given that DAN pre-approval is required for medical evacuation under their policy, and that the cost of an urgent medevac flight between two countries would exceed most people's credit card limits (and there wouldn't be time to refi a house to get the money), it makes sense that DAN would pay for the flight upfront, rather than requiring that the customer pay and later request reimbursement. A medical evacuation is a different situation, both in type and in orders of magnitude of cost, than having, say, a flight delay that necessitates extra nights at a hotel and a few more restaurant meals, for which one later requests reimbursement from the insurance company.

Thanks everyone for your input and insights,
Julie

DAN dive insurance terms and conditions:
https://www.diveassure.com/wp-conte...g-Accident-Policy-Gold-and-Platinum-INTL1.pdf

DAN travel insurance terms and conditions:
https://mk0diveassurecoatkqm.kinstacdn.com/wp-content/uploads/2019/12/DiveTravel-DOC-USA.pdf

 

[Kohanbash]

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;

So if you have the basic dive insurance coverage (and travel insurance as a dan member), will they evacuate you if needed for an injury below 131ft?

 

[Julie T]

So if you have the basic dive insurance coverage (and travel insurance as a dan member), will they evacuate you if needed for an injury below 131ft?

Good question!

 

[Centrals]

In Asia Pacific(not including Australia) DAN offer 3 diving insurance plans: Master(50m max), Preferred and Preferred +(both of them offer unlimited depth but need to prove certification as well as equipment and gas mixes used).


DAN DAN World : Insurance Comparison

 

[tursiops]

So if you have the basic dive insurance coverage (and travel insurance as a dan member), will they evacuate you if needed for an injury below 131ft?

DAN's dive accident insurance varies by your location, in fact it varies by the U.S. state you live in. In Virginia, depth is irrelevant, even for the lowest cost accident policy.

 

[Centrals]

Read the small print.
I use DAN(Preferred Plan+) diving insurance and also separate travel insurance by another under-writer.
Pay what you can afford it. There is NO such thing as over insured in my book.

 

[gopbroek]

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

​

I very surprised that in the 'General Exclusions" section paragraph 's. Pandemic and/or Epidemic;' is not highlighted in addition to a pre-existing condition. I am very surprised that Dan payed anything.

 

[Centrals]

I very surprised that in the 'General Exclusions" section paragraph 's. Pandemic and/or Epidemic;' is not highlighted in addition to a pre-existing condition. I am very surprised that Dan payed anything.

If I ever travel again over next few months I will read the small print on Pandemic/Epidemic in any insurance policy. No wish to be caught off-guarded.

Covid Insurance for Foreigners | 100,000 USD Cover | Certificate in 5min

Business sense.

https://www.bluecross.com.hk/en/ePromotion/COVID19Protection/Latest

 

[bobfmdc]

Well to a customer, DAN is DAN. I've run into several divers with "I've heard..." stories, but as I said there are not many positive -- or negative -- accounts on-line. That seems pretty odd given the ubiquity of DAN



Right...and the "reimbursement later" is usually where it goes sideways, at least in my experience. The primary goal of the secondary insurance is to not pay any claims.

I would love to be able to trust DAN but I do not see anyone chiming in here with a direct, personal experience.

In answer to your question, I have had experience with DAN on travel insurance, and recently, but not on emergency care like Julie T. ( I hesitate to write this here because my case was after-the-fact reimbursement, not a serious on going health issue.) The DAN people may know their dive insurance policies and procedures, but, in general, the DAN people who deal with travel insurance don't even know what they are selling, much less who to call to resolve issues. The DAN people cannot explain their policies' coverage and refuse to make any interpretations whatsoever--they just refer you to the underwriter, currently Generali. For some of them (not all) the more you ask, the more antagonism you get. Even the phone numbers and email addresses on the DAN website were wrong recently until I corrected them. Not sure they got them all fixed.

That said, I did have a good experience with Generali for claims on family trip interruption due to cancelled American Airlines flights in July (2021). The key to getting satisfaction in a case like this is documentation--documentation--documentation. The major component is that, if you have gotten hosed by a low performing airline like American for something related to flight cancellations or delays, you have to get a statement from the airline's customer relations people that documents the cause. Then you have to see if it is covered by your policy. For example, if your trip was interrupted by a flight cancellation or significant delay, the DAN/Generali travel policy covers maintenance and weather but not crew availability. In my case, I got all my stuff together after several conversations with their information people and my claim went right through.

Along the way, I had good help from the people at the info lines--if you can reach them. They know the policies like DAN should. DAN is your agent on these policies--they should be able to explain them. Would you buy home insurance from someone who just said, "WTF I don't know. Call the underwriter; I just sell the stuff."

As for contacting Generali, the only time you can get through without waiting hours is in the early morning or late at night (I got this from an information representative whom I finally reached at 10pm EST). Their address of record is in San Diego, but the person who answers the phone may be anywhere.

Finally, the first thing you read in the DAN/Generali policy is about emergency service. I am not that familiar with the section, but I looks like the overriding first instruction says to call the 24-Hour Emergency Hotline. It says:

"If you need emergency help for an available service, you can call toll-free 24 hours a day to (877) 243-4135 from within the United States, or call collect to (240) 330-1529 from around the world."

I am sure Julie T must have called these numbers among others, but it is a good place to start if you get nothing out of DAN--which is likely.

 

[bobfmdc]

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

Same here, and the Generali policies for us are back to where they were price-wise a few years ago before they increased about 250% under the previous underwriter.