What are medical expenses and repatriation?
This is the section of your travel insurance policy that covers medical costs for illness or injury while you’re on holiday. It will also usually cover the cost of getting you back to the UK. In your policy this is called repatriation.
Types of complaints we see
We hear from consumers who contact us to complain because:
- the insurer took too long to confirm cover
- the standard of medical care wasn’t good enough
- they should have been repatriated sooner – or in a different way
- they shouldn't have been repatriated
- the insurer said the situation wasn’t a medical emergency – and treatment wasn’t necessary
- the claim isn't covered because it's linked to a pre-existing medical condition.
You can find more information about pre-existing medical conditions on our website.
How to complain
Talk to your insurer first. They need to have the chance to put things right. They have to give you their final response within eight weeks for most types of complaint.
If you’re unhappy with their response, or if they don’t respond, let us know. We’ll check your complaint is something we can deal with, and if it is, we’ll investigate to understand what happened and what went wrong.
Find out more about how to complain.
What we look at
To help us consider a complaint fairly, we’ll ask you to provide some information. We’ll make our decision about what happened using evidence provided by you, the financial business and any relevant third parties. We look at the events surrounding the claim as well the wording of your policy to help us. The following gives an idea of our approach:
Most travel insurance policies ask you to contact your insurer before you get medical help.
Some policies say you don’t need to do this for minor ailments or where expenses are likely to be less than a specified amount, for example £250.
Insurers usually ask you to contact them so that they can ask their agent based in the country you want to be treated in to:
- agree the medical expenses
- decide you or the injured or ill person is fit enough to travel (‘fit to fly’ or ‘ftf’)
- decide whether you or the injured or ill person should be repatriated (returned home) or evacuated to the nearest suitable place for treatment
We don’t think your claim should automatically fail just because you didn’t contact them first. We’d look at:
- what your reasons were for not contacting them
- whether your medical expenses were necessary and reasonable – a lot of complaints involve treatment at private hospitals, but most travel policies exclude these costs and cover treatment in public hospitals only
- what they would have done if you’d contacted them first
You won’t be able to return to the UK until you have a fit to fly (ftf) certificate from the treating doctor. We often see complaints where the treating doctor and the insurer disagree about:
- when you can be safely repatriated
- the transport which is suitable for repatriation
We’d expect your insurer to take account of the recommendations and advice of the treating doctor. It’s our view that your insurer’s medical team have the necessary expertise and experience to assess your repatriation needs.
Your insurer will make a decision on what’s medically appropriate. It’s not necessarily unfair for your insurer to insist on the cheapest option, even if it does take a little longer – as long as it doesn’t have a significant impact on you.
Most travel insurance policies only cover the cost of private treatment in very limited circumstances. If your claim for medical expenses has been turned down because private treatment isn’t covered, we’ll look at whether:
- you were told that private treatment wasn’t covered when you contacted your insurance company
- you chose to go ahead knowing private treatment might not be covered
- you were offered any help to move to a public hospital
- we think your actions were reasonable in the circumstances
We might think it was reasonable for you to use a private hospital if:
- you needed emergency treatment that couldn’t wait
- you were taken to a private hospital without being able to check first to see if this would be covered under your policy
- your treatment wasn’t available in any public hospital within a reasonable distance from you
- the standard of care at a public hospital was so unacceptable that it wouldn’t have been reasonable to expect you to remain there for treatment
The standard of medical care varies from country to country. Although we’d expect your insurance company to look into any concerns you raise, there’s often little they can do about these concerns.
If your claim was delayed, we’ll look at:
- how long the delays were
- what caused the delays
- whether your insurance company could have reasonably done more to prevent or reduce the delay
- whether you got regular updates from your insurance company
- how you were affected by the delay
Putting things right
If we think you have made a mistake or treated a consumer unfairly, we'll ask you to put things right. Our general approach is that the customer should be put back in the position they would have been in if the problem hadn't happened.
The exact details of how we'll ask you to put things right will depend on the complaint, and how the customer lost out. In some cases, we may also ask you to compensate the customer for any distress or inconvenience they've experienced as a result of the problem.
My insurer says it's too risky to fly me home
Consumer complains about insurer's handling of claim after bad experience on flight
Travel Insurance Distress and inconvenience Up to £5,000
Information for financial businesses
If you’re a business looking for information to help you resolve complaints or want to find out more technical information, you can find more detail about complaints about medical expenses and repatriation in the business section of our website.