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ORIGINAL ARTICLES
Travel Insurance lainis Made by Travelers from ustralia
Pclcr.-\. Lco^i
Backcjfound: Little
is
known about travel insurance claims made by travelers returning honi abroad. This study was
designed
to
investigate travel insurance claims made by travelers from Australia, particularly examining demographic
tactors, type of travel insurance coverage, nature and duration of travel , when treatmem was sought during travel or
when the problem arose, use of emergency assistance, nature of claim, and claim outcome, including cost.
Methods:
A
random sample
of
approximately one
ii i
five claims reported during the period 1996
to
1998
to
a niajor
Australian travel insurance company were examified.
Results: A total of 855 dainis were examined, of which 42.6% (356/836) were made hy male travelers and
5 7 . 1%
(477/836)
were made
by
female travelers. The majority
of
claimants were
in
the 55 years and over age groups (445/836, 53.2%).
Medical and dental conditions accounted for 66.6% of claims (569/854), with the remainder associated with loss, theft,
and damage (285/854, 33.4%). The most common medtcai condilions were respiratory (110/539, 20.4%), Ftiusculoskele-
tal (90/539, 16.7%), gastrointestinal (75/539, 13.9%), ear, nose, and throat (67/539, 12.4%), anti dental condi tions (39/539,
7.2%.). Onlv one case
of
venous thrombosis was reported, secondary
to
a lower limb mfectiofi. Use
of
the travel insur-
ance company's emergencv telephone service was reported
in 1 7 . 1% of
claims (146/853). Almost two thirds (559/853,
65.5%) of claims were fully accepted. Those who claimed medical treatment, assault, and theft were significantly more
likely to have their claims accepted compared to those claiming dental condit ions, cancellation, curtailment, loss and
damage iy 127.78, df = 40, p < .00001). The majority of medical and dental condil ions did not require further medical
investigations (427/569, 75.0%). The mean cost of claim refunds was Australian dollars (AUD)991.31 (standard deviation
ISO]
•
AUD5400-76) for males and AUD508.90 (SD
'
AUD1446.10) for females. Claims for assault, cancellation, and cur-
tailment were significantly more expensive than other types
of
claims IKruskal-Wall is one way anaiysis
of
variance
[ANOVA ; x' = 106.87, df -= 8, p < .00001). Claims for treatment of gastrointestinal, ceiebrovascular, cardiovascular, mus-
culoskelttial condit ions, and pyrexiasof unknown origin were significantly more expensive than other medical and denial
claims (Kruskal Wallis one way ANOVA;
y
= 61.68, df -t 15. p< .00001).
Conclusions: This explorative study highlights the importance of travelers taking out appropriate travel insurance. Claims
for medical and dental conditions represent the majority of travel insurance claims made by Australian travelers return-
ing from abroad, although travel insurance also covers against such contingencies as loss, theft, and cancellation. The
most common medical conditions claimed were respiratory, musculoskeletal, and gastrointestinal disorders. Travelers
should be advised to take out appropriate travel insurance before departure overseas and to take care with preexisting
medical and dental conditions, whicti may not be able to be claimed against travel insurance.
( .onservaiu'eK. it is esiim.iteJ thai ber ween .Ml .-jul ol se\'ei"e in) ti "v is ( I I O U L ; 1 I I to be i^reater lo r people when
-111"-
o l tr. twiei s become i l l or uijnr ed whi Kl ti.i\elinL;. tiMwI in-ab road. Hee.iuse of il ic eiists ofinedie.i l .UK\ Jei i-
Kel aii ve esnniJted ni on tb K nie idenee rares o\ winoiis i.il ire.innen; abro.id. vUnrh n ia \ no i
SH-
eoveiwl h\ ' p r i -
healih prol>lenis h.iw been to mp dc d elsew lie iv. I he lisL wnc he.iltli lnsuiMiice or na ti oi Ml iieall h ser\ K es tron i l he
home (OunUA, .md lhe I I I L ^ I I eosts assoi t. it ed w i t h
.leni niedieal e^aeiiatioi i. ali f.ix elers should be .uKased o f
Pefe, A Leg g. tMF PHM FAC rM -Associa te Professor, , i, ^. ,, , .,i ^^,, , oiu pivb eus.w. navel nistuMUee. l or t n -
School of Put)lic Health and Tropical Medicine, James Cook , , , , . , , , , ,
,, - . _ •,, rx , . A ,• ^ , . , n.iteh. Aiistr.ili.i h.is neuoii.ited le uiiroc al health (.are
University. lownsvill e, QueRnsland, Australia; Francva W. • •
(.-if,
P/70; Research Assistant. School
of
Public Health .iKr eements
w u b
se vr.il eou ni rt es.
b tn
this . ^enciall v
and Tropic;il Medicine, James Cook University, Townsville. covers oi iK ' ei ii er^enev med
K M
uv.ument m A hospu.il,' '
Queensland. Australia. I i\i\'el ltisut.im e nori nali \ uiidei-\\ lales tr awl , ined-
. . icaL .ii id dent.i l expenses uu l ined b\ tr.i\vler\ .ibroad .itikl
The authors )iad no linancial or other conflicts of interest to
disclose. .ir iMii- es aeromedieal ex.i. u. i i ioi i ot ira\elei-s tii uler eon •
dit ioti s speeitied hv th e tr. iwl inMu.i iue polu \ I r,i\'ei
nepr^nl
H:que^ts:
Assocune Prafossor Peter A.
Leggal. , . , , , | , , , , , i , i,^.
.^Ivised
l o
re.ui their polteies
,
.n-e ully
to
School of Public Health and Tropical Medicine, James Cook i i i i i , i i i' i
see \\ lial is eowrcd, Ihe le\el ol the eveesses, and to I'heek
University, Townsville, Queensand. 4811 Australia.
lor an\- exiausions. In jiartn
nl.ii-.
those trawlers whi i
J Travel Med 2002;
9:59-65.
h.iw known iireexiMinL eo iduioits. who .ire wo rk ui -
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6 0
Journal of Travel Medicine. Volume 9, Number 2
oversets, or
W I H I
nrc goini; to uiulL-rtiiki.' ;iny form ol'li;)/-
ardtuis rcfi c;ttioii.i[ or ofciipacii)tK>l pursuit iu)y iK-cd to
ohni ii ,1 spcci.il tniVL'l iiisur,im"f policy, wli ich iii.iy ,ittr,K:t
.1
liit;liL'r prt'iniiiin,
Mc(.iic;)l niui tlcmn cart' also docs not tfi ic] to bo .is
aci'cssibic in the public licatth systems oltiiatiy dc\^ck)pinL;
cotmtrics: luwcvcr. private clinics lii.iy be fotuiti. There
iD.iy he liowever. lani uai c barriei's that need to he over-
(.oinc. Impossible, befoiv
travel,
it may he helpfiil to pro-
vide tnivelcrs with a recojuiiieiKiatioii (nrsuuahlc isiedical
tre;unK'nt services at tliei r destinacions, particitl.trly if
they are prone to mctiical problems. Ideally, this reconi-
ineiKlation should be tfiveti by tlieir travel health jJviser,
together with a letter otitliiiiiig their medical history. Otue
tniwliiig, rt'coiiiiiieii(.iations concertiiiig -iuitable doc-
tors available fi>r ct^nstiltatioii when overseas iii,iy be
obtained troni foreii n missions, hotels, private hospitals,
and travel clinics. In aildit ion. trawl instirance ami other
ajiencies often provide a service to assist traveleis in
[lndmg medical care when overseas and may be ,ibie to
assist with providing inforniiition on the medical history
t>f rhe traveler in an emergency. An article ilisctissint; com-
mon questions on travel insurance and liealtli has been
published elsewhere.''
Travel insurance is the most important safety net for
travelers in the event of misadventure, and should he rein-
forced by travel health advisers. Aitliotigh only 4% of gen-
eral practitioners (t il 's) in ,i iate l'>H(k study in the
Unitet Kini;doni wotiki advise a ti,iveler goiiiij; to Turkey
about travel uisunuice.' more recent stuiiies have slu>wn
abotit W)% of (;i»s in New Zenlaud" ant 39% of travel
clinics worldwide'' tistially ad\^ise(.l travelers concerning
travel insurance. In
addition,
54 % of (il's in New Zealand
,ilso itstially advised trawlers about finding medical assis-
tance ,ibroail.btit oEily I'J% ot (Il's recommended travel
insurance companies as a source of medical assistance
when traveling.^ However, it is iK)t known what pro-
portion ot travel agents or airlines gi\^e advice rotitinely
on travel insurance.
Little is known about travel insurance claims made
by travelers returning from abroad. This stiuly was tiesignetl
to investigate travel insurance claims reported by tra\el-
ers [rom Atistralia. partictilarly exaniining ilemographic
factors, type of travel instirance coverage, nature and
duration of
travel,
wiien treatment wasM>ught during travel
or when tbe problem arose, tise of emergency assistance,
nature of claim, ,intl claim OLitcome, inckiding cost.
Methods
In I9W. a random sample ot approxitiiately one in
five claims reported during the perioil 1 V'Jfi to I'J'.)H. to
a major Australian travel instirance company, were exam-
ined. A data collectitin form was tised to reconl infor-
Table
Distribution of Number (Percentage)
of All Claimants by Sex and Age Group
<2(i
2(1 2-1
25-2v
3(1-34
35-3<>
4 < l - 4 4
4.5-4<)
.=>( •-.54
.55-5";
'ill aiul over
f inal
.\h,U-
34
If.
21
12
13
13
2(1
47
154
35'>
(42.'J)
-Scv
t i nitik
2 )
33
2')
24
24
21
.M
43
57
IS7
477(57.1)
•y;. ,,/ r,.;
M
(7.5)
4*> (5,>J)
5(( (6.(1)
3( . (4.3)
37 (4.4)
.14(4.1)
.5(1
((>.( )
72 (S.f,)
1(14 (12.4)
341 (4<t.N)
S.V, (lon.(i)
mation concerning the claim, including age, sex, occti -
pation, duration o f insurance cover, dtiration of travel,
numher of tlays into travel that treatment was sought, sea-
son, level of cover, countries of cowr, country of injtiry,
type of
treatment,
cause of
injnry/diseast",
agency related
to the ct>nditions occurrence, medical investigations,
appliances rec]tiired,iise ofthe travel instiraiu'e companys
telephone emergency ser\'ice (Teletech). outcome of
claim, and cost of refund.
Data was analyzed i ising the Suiii^nuul l\hki i- for IIH
Sthiiil ,SV/cjw.\-.'" Missing data has been e.xcluded f ro m
analysis.
Results
A random sample ofiS,5,T claims was e.xamined from
claims reported dtiring tlie period W)(> to I' 'JH.
Demography of laimants
I he age and sex distribution of these claimants is
given in Tabie 1. The majori ty o f claimants were
retired or not in paid employment (.i7')/7,>8, 5
i he remainder were in paid employment ( ,
4X.f>%). There was no significant difference in age by
sex (p > .n.i); however, older tra\'eiers (^dll) were sig-
nificantly more likely to be retired or not in paid
employnient (X" = 27l.(t5,df = 9, p < ,O(KK)()1) and
males were signi ficantly more likely to be in paid
employment (x ' = 47.22, d f = l, p < .itlt(tiKH).
Travel History and Insurance overage
The tlistribution of intendetl major travel destina-
tions by se.x is given in Table 2. There was no significant
difference in intended major travel destination by sex
(p > .05); howe\ er, those who were retired or not in paid
empk)yment were significantly more likely to indicate
that they were traveling to Europe (x' = 211.,58, df = 4,
p < .n(M),iH) and older claimants were significantly more
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; I H L e g g a t T r ^ i v e l h s s u r a n c e C l a t n i s
61
Table
2 Distribution of Number (Percentags) of All
Claimants by Sex and Major Intended Destination
I S . i i u l
. i i i . i i i . i
I i l'i'|H'
-H
,11)
ke h
[o
l i iduMie ih.u the\ wvre going
lo
Ti irope . i i id N ew
'e. iL iud i Krt isk al-W all is one w, i\ ' an.ilvsis
ol
wir i . inee
'\.N( ~>VV\|; \ ' I i .S' ) ,d f - 4. p •• .03) Most ot the e l in
is
exanm ied were re j 'o r ted du r in g snn ime - (3 l3 . 'S. -^4 .
•W,.')•'..I aiKJ --pi-ing i2o 4''N 3 4,23.'J".'.}. wu h the rest be mg
l e f i o n e d m . m t t m i i i (1 ^4^^ S34 . 22 .7 " . i ) AU:.\ w i n t e r
' i
H
S34.
I
(v3''ii)- 1 here was no ••igniiuMni ditler eiiee in
VI'
iso i i du ru m •^ h ieh the
i
laiins were reported by sex or
oCkup .u io i i
(p ~"-
. 0 3 ) . h o we wT
the
o lde r age g roup
(> (i( i were su 'm ru 'a i i t lv more l ikeK" lo repor t the i r
J. i i ins d t iru iL: Ni immer and .n i l tm m (x - S3.MS. di ~ 2 /.
p - .ii iK ion h. The iiieaii durati on ol"travel was (.4.7 (stan-
t lard de\" ia i ion |Sn| .t (i'7.3) tlays tor males ,ind o3.3 (SI 1
'.. fw.2) days for females. I )nr. i t io n
ot
cra\"el was s ign il-
K j i i i K s h o r i e r for t ho s e t r a w l in g to New Ze a la n d
(Kru sk.ii W.ilHs one WMN A N O V A ; \ ' --" I 4(..3 I. dt" - 4.
p • .(HHiOfi. .\lo^t elaimaiits had taken out enher lo p level
[:A\\:\ insiir.ince t'oveni^ e (3NS. 73S. 32.(i'Si)
or
i n te r i i i e -
iliate eo\e rai;e (271 73S, 3C).7"i-). O n h ' .i few- elaimatits
h.id opted for btu lge i eo\'erage (7') /73 S. |O.7'3i). There
w.iv no siunitieaiti ' diflerence m the lewl ot coverage taken
ou t
b\'
el.i
1111
ant-.
In
sex i.>r age
(p "
.03). ho\ w\ 'er those
ih.u were IU pa id emplo\"m ent were ^ignih c. in t ly mor e
hkeK' to lake oui top le \ 'e l tr . i wl insurance cow rage
•
\ ^.4 4. dt" ' 2.
p
< .03).
'I
he i ,hstr ibnt ion ol iex'el ot
(.merage taken otit b\' mie ndc d ma jor tr j \ -e l desi in . i t ions
b m\en in lab le 3. d"rawlers exelu^iwly took ou t top lew l
.o\ 'era i;e i t ' i ] ie \- were going to tbe Un ite d Si.ues (US)
IX -" 3 3 ' i . I 2 . d f - S ,p <
Table 3 Distribution of Number (Percentage) of All
Claimants by Level
of
Coverage cind Major Intended
Destination
I .nr cl
li\ ty hi'iii.uiu ('.t'i\'ui'.;c
ltki
V
jii.iil.i 2
^ ^ M
2 M' 2 (42.41
2 2"
[:-'.2]
2
\2Ji
1 ,13.1)
2*1 i
S7
(in.2)
S3
Table
Distribution of Number (P ercentage) of A ll
Claimants by Sex and Where the Problem Occurred
. ^ ^ • . \ •
A /,(
Tohil
(".<
L S
.IIKI
f.uiaJ.t
(riv.ii Hrii.tm .in
Irekin,
Other Fuiope
New /e.il.ti id
.Asi.i
Middle i'..iM
Afrua
AiiNir.ili.i
On lhe piane
( l i lu-i-
lol.il
SI
1112
.4
123
t3
- 1
n
IS 3
i i l U
>
l . 2
Ml
1 21.3
( I t . 7 )
t2{> .7)
( 2 . T )
( 1 3 . 3 )
2S
3i .
(4.2i
2S i2.'l)
S 3 3 ( 1 ( 1 (1 . D )
Nature of Claim
I h e p ro b le m iw i t i i n n i ; t r e. i tn ie nt
or
the p ro h le n i
les t i i t inu 111 the ek iim was rei'oriei.1 lo oeeur at .i mean
o f 33 .2 (Sn 2- 4('.(i) d.ivs MHO travel for males a nd 2'). )
( S n T . 42-5) da\s in to travel for teinales.
'\
here was no
siOiiiifuMnt differenee bv sex {p > .03 ) . Overa l l , the p rob -
iem repor ted ly necur red
.it ,
median
ot
17.0 (range ~-
3(>5.o'i davs into ti.nel.' l he problem reptsrtedU' in-etirred
at ,1 mean of5 3.7 "i> (SP •" S7.4"u) . i f t he way ih i-ough
a louriiey for males and 4~).1"'> {SD 1 4 i l3" i>) of th e wav
lhrou g]i J journe\ ' ror tem;i les. Th e d is tr ibu t ion ol where
llie problem reportedly oeetirred is gi\ eii
iu l.ible
4- There
w.is
uo
s ign i f ie .n i i d i f fe ience
m
wh e re
the
p rob le i t
oeetirred b\'sex (p
>
.03): l iowa' \er. the o lder. i ge groups
(33
\o
3^'. > (lO) were s ig r i i lk ant ly u iore l ikeK' to i n d i -
eaie that the p ix 'b lem oeeurred iu the U S a m i C i n a d j
o r Lu rope . ine lu d in^ (.near B r i t a in and Irel.ind (X" -
|U') , (>2. dt""- S l . p * - .03) .md those thai were ret ired or
not t l i l l - tHi ie employees were s ignihe.u it ly more l ike ly
u> ludie. i te that ihe pro l i len i oei t i r re d
in
Rnrope. other
thau Chear Britain , ind Ireland (X"' = T ' . 0 2 . df = ') . p <-
.03). hi ad dit i on, ihose w ho i . lahned lu the suiuiner sea-
VO11 were s iguihe .iiitK mo re l ike ly to uidieate that ihe
pro l ' lem had oeeurred in tite
US
or L u i x ip e . i i i e lu d i i i i :
Crreat Britam and I re land
(,x' '"
7S. f i3 .
dt =
2 7 ,
p --
.0(H)Oii |) .Those trawlers whose problem oeeurret i in tbe
LJS were s iguit leantly more l ike ly to have selected top
level eoxerage
tx '
=
430 .33 ,
d f -
I S.
p
<
.000001) .
da in is assoeta ie ii wi th medie. i l and denta l treatment
made up about two-thirds ot'all elaims (3(»' ' />^34.li(i.( '"a)
wi th ihe re mainder be in i; assoeia led w-ith loss, theft , and
d.imaue I 2 S 3 / X 3 4 . J 3 . 4 ' 3 > ) . 1 l ie d istr ib i i l io i i o l ' rhe natt ire
ot elaims b\' sex is gi\en in Table 3.
i
" . tiu e l la i i o i i or eur-
ta i lme iu were s ign i fkau i ls more hke ly iii the o kie r age
gr inips (>00 )
(x '
[ 0 0 .7 7 .d f = 7 2 . p < .03). 'There were
\}o
s iemfu.mi d if tereuees lu tl ie nature ot e la im
bv
sex.
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6 2
J o u r n a l of T r a v e l M e d i c i n e . V o l u m e 9 , N u m b e r 2
Table Distribution of Number (Percentage) of Claimants
by Nature of Claim bv Sex
Nrv
'lypr 1*/ < :hiiiii
M.ih-
\
..ttRell,itio[t
( 111
l . i i ln ie iu
'.il
{[
l
1' '
(>4
3
2 .^ {1. ))
1 I ' ' 2 (1(1, )
•| 131 (15.,^)
I 2 1 ( 2 . S )
2 4 1 i 4 . S )
3/n (43 3)
occ upa tmn or wh ere lhe pr( ib lem OLCiir ivd, I he d ist r i-
b t i t io t i o f ' the u.trure o ft h e illness b\ sex is ;4iven iti bible
().
Maies wei'e siL^mhc jtuly ninre lik ely to make cl.ii in s
or o pht hal n iK . ear. nose, and th ix iat . tnd ne ur olo ^ic j l
pix^blenis (X"' " 52 ,32 , tif" = Id , p -'' ,01). O nK t\ \( i
deaths were rep ort ed . O f rhe small nttm ber ot il lnesses
(23 /53 ' ' , 4 .3 " '( i) . \ \ ' h ich repor ted ly e om me me d on rhe
plane, the most co mm on ai lments were respiratory (5 /23 ,
21.7'- .), tnuseuloskele t,il (5 /2 3, 21,7'K,), eardio\ .iscular
- </2^. L^.n'^i). and i^asrrnintesnnal (2 ^2 3, S.7"'r.). 'I here
was otiK one c.ise nt wn ou s rhro miio sis I'ep orted. se(--
nndary to a iower l im b m tee t inu .
Use of tbe emer;j:ene\- telephone service ]iro\-ided
by the
ir.wc]
insurance eompariy was reported in less ihan
on e-l i t th of c la ims (14 6/8 53 . 17. T' /i ), I t was s iL in if tcantK
mo re l ike ly t(i be tised in \^oun;j:er as e ij;roups (esp ecially
25- -2 '>a iK i3 ,5 - ,V) ) (x ' = 76 .22 .d f "
').p <
.noooo l ) and
by those Trav'ehn;^ to the LIS (x ' "" 25.S'.i. d['= ').p -^
. ( i | ) ,
Ir was also sii^nihcantly more itkeK" to be used bv those
rcportiiiL: lnttscttloskeletal, s^asirciinresrinai. and iiental
Ci ind it io t is as wc l i .is | iyre\ i . is ot un kn ow n or i i^n i (X" -
4 6 . 7 1 . d f -• 6. p < .1)1101). There were no si pi ii ic in t di t-
terences iti reported use of these emer[;eney services by
sex aiul Ol. e t i i i . i t inn (p > J )5).
The reported medical af ip l ianees needed lor tn. tn-
aiiii iLi medic.ll
Mtd
i lental eotKlitii i i is nf claimants mcltided
e\'e glasses (62/
I
4i),44.,V''ri). dent tires. bridL;es,and crow ns
(23/1411, I 6.4'V). braces, splints, and pins (7 /I 41). 5.i I'M,),
]i laster (4 /I 40 . 2,'r>,\), ertitches f 1 / 1 40. (i.7%,), and hear-
inLf aids (1 / 14ii. i),7"',,). The repo rted n om ned ica ap pli -
atices inc lu de d stitiL;kisses (14 '' 141). lO.O"- .) and je w el er y
(2H /14I) , 20,(I'M,). "There w.is no sionit ieant diftevenee
between e la in is report ing turther i inest iL^arions fnr med-
u al aiul dental co nd itio ns and sex. a i e.
d\u\
lc\'el nt cov-
er,iL;e (p > ,05), I he m.iioritv' of tne die j] ,uid d ental
eot id it io i is dui not requ nv iu rthei" medical mvesitt^ai ic^n
(427
••'56*).
75"i'.}. M ed ica l iiives ti;j;.ui(ii is. \\^liere r(,'i.]uired,
inc lu ded labo r. i torv iests (3 'J / i 42, 27.5 '' , ', ) . radio lou,y
(5 2/ 14 2, 36.("i"-;.). lalK)r,U or\' ,ind radiolo^N^ (31^'14 2,
Table 6 Distribution of Number (Percentage) of Claimants
Wbo Required Treatment by Nature of Illness by Sex
•>
ofllhh;-
hail.lie
< i , is t roi iucsini. i l
(\n"dio\^,iM.
ti l .I
I ) .• nta tol ng u .li
f.,u",
nose, .nui throat
Specif ied Vlr. l l i l ini 'ss
iVlalan. i
2 S
-14
14
14
i.i ol
T\Mth
OUu-r
lo ta l
• | ( I I . I l l 3 I S
i i ' i . i i )
^ 5
( 1 3 . ' ) )
2 t l 4 }
, > 3
' f l 1 ' ^
i 111 i2n,4)
M> 1^.2)
"> (M
4 1
2 4 f 4 . 5 )
• f . - , . J t
i ( t i . 2 )
4 (n.7)
3( , i ( i .7 |
. .V) ( inn, i
21.8'/ii),e.\ei-cise stress test (1
^1
42,(1.7"'"), iieuroloL^ie.i tesis
(3 /
I
4 2 .
2. r'i.).
elecu-oejrilioi. 'niph (H( X i) {I I /
I
42 . 7.7"u).
.wn\ e \e e\an iu i a i i on (5- ''
1
42 , .i., '-' ). Kadio o i j ; ic . i l in \ 'es-
r i ;^atu)ns were c i in in ioni\ re i |Uired tor miis t-u loskeleta l.
respiratory, de ntal, and L^.istrointesrnial i oiK liticiiis . [.ab-
oni tory un^esi igar ions were conti non iy r equ nvi i tor ^. is-
i r o i n r e s r i n a l a n d i ; e n i t o u r i n,i r y p r o b l e m s , l i y e
e,\ainuiations were s^eiicraily [lari ot ihe work ti[i of
ophrhalnioloLi:ie.il problems .md liCXIs were iieneralK-
relare^l to invesiiiianon of c.inltovascular coikiirinns. Keo
h u n d re d M\d n ine iy - f iw c la ims invo lved pharmaeen i i -
eal item s (2'J5 /S I 5, 36.2".'-). 1 hese mcludei i ant ib iot ics
(167/2'J5,5(>.f>"'(i),aiHiiliarrhe,ii and aiuacid drujis (26/2'J5.
^.<S' 3), an ti- m fla m ar nr ies ('24 ' 2 ' ' 5 , S. i'.*.,), a n n h y p e r te n -
sives (I 5/2'>5. 5.1 "-Mi,deconL;esi.inis{
I
2 /2 '>5, 4.1 •>:.). anal-
gesics (12/2 ' '5 , 4 . l"- i i ) , a iu i lun i ia l annb.ic terta l creams
(' ' / 2 ' ' 5 , 3 ,r ' ' i '0 . : in t ih is tamine s ( 'X/2 'J5, 2.7"o),a i id a \-ari--
ery nl oth er ,ii;enis. Th ere \v^as nn siL^nificaiu d itlere iiee
be tween c la ims repor t ing [ i resc r i in ton ( i t pharn iaceu i i -
e,ils
.Uid sex. a^ e. and l e w l o l cn\"er.iL;e (]> > .05),
Etiology of Claims
The (aiise of probletns reitorteil in claims w.is spec-
itied in (inl y snnie eli ini s (l 22 'iS 55 , 14.,>"';i). W her e a cause
was seated, these in cli ide tl accidents (4 5/ 12 2, 3' i. '>'>;.).
mJeetious diseases (2')/122.2.1S";,), bites and srinLi:s (7/1 22,
5.7";,). bad weather (14/122.
1
I ..5''i,). tall (1 5/ 12 2, I2.3'.'i,),
air strike or ot her unrest (6/1 22, 4.'> ^<^). .un\ he.irr aicaek
or strnke {(</ I 2 2 ,
-4,''%),
lu iren er.i l. carei,;ories \\'ere rn o
siuall to ivLite specifie catises ro ilittereiil illnesses: bov\'-
evei-,,ieeidents{13/S'>, I4.f."-) .md tails (I 3/S'). 14.6"',>i con-
tri bu te d to m ttsct iloske letal (.hs<irdei"s, 'I he eatise ol d eath
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L e g g a l a n d L e g g a t , T r a v e l I n s u r a n c e C l a i m s
6 3
Table Distribution of Number Percentage) of All Claimants by Nature of Claim and Outcome of Claim
ryt,c.;ia,,,m
(k'lierai iiK'dic;il
ClL'iK'r;il dental
t?aiKv :itioii
t Airt.iiliiiL'nt
Assniik
Tln-ft
i-OSS
Opticil (Loss)
);ni1;tgc
T o t a l
,3(15
27
iH
18
8
70
8 3
8
22
5.5') ((,5.5)
Allowftl
17
X
.=1
7
0
4
2T
it)
82 (V.6)
CUiim
U S.S llitiii
4H
2
0
i)
8
I
2
62 (7.3)
Onlsiilc
liiiu l.imil
111
1)
1)
1
1
1
4
(1
2
ly {2.2}
Pm d ll
Pcir,/Ca,scd
41
h
1
8
1
16
11
2
4
90 (10.6)
ti lchxy Only
2'>
0
(1
0
4
1
I
41 (4.8)
45(1 (52.8)
48 (5.6)
25 (2.y)
34 (4.(1)
10 (L2)
92 (lO.K)
l.?2 (15..5)
21 (2..5)
41 (4.8)
K.53 (KIO.l)
s IS ll if st.i]ul:iril .inunint p;iy.ibli' hy (hi' insured O[i .ill l.iiiiis.
I h IS [ho rr.iVL-1 nsiiT.iiuL tornp.iiiys iflfplunif t-nuTj viKy st-rvjrt'.
\v;is nott'd
ill
only on e claim
as an
acute myocardial
intnrttioii. Th e agcticy rclatetl to tlu- occu rrenc e of th e
problem reported in the clnim was alst) only specified in
some cliiims (131/K55, 15.3%). Where
.m
agency was
stated, theso incltided plnnes or airports (63/ 131,48.1%),
animai (11/131,8.4%). water (8/131.6.2%), skiing or snow
(7/131,5.3%), lx>at (2/131,1.5<X,), fire
{1 /1 3 1 ,
().«%), an d
bike,
car or other transportation {8/
i
3 1, 6.2% ).
Claim Outcome
Almost two-thirds {,S5*VH53,65.,S%) ot'claiins were
ftilly accepted. Claim outcomes for various types of claims
are given in Table 7. C^lainis for general medical prohlems,
assault, and theft w ere significantly (X"
=
127.78 , df = 4(1,
p
<
.0(10(101) mo re likely to be accepte d. Of th e claims
not p;iid,soniL' claims were accepted, btit only approved
to be paid
in
part (62/853, 7.3%), and
a
few wer e n ot
claimed within the allowable perio d (19 /85 3, 2.2%).
On ly abon t one- ten th
of
claims w ere not accepted
(82/853,9.6%). There was no significant dirteirnce in claim
outc om e by sex or occupation (p > .05). However, older
travelers {especially 2: 6(1 years) we re significantly mo re
likely to have their claims accep ted (x"
=
109.6(1, df = 45 ,
p
<
.0(100(11), Th ose claiming prob lems arising in Asia
or on the plane were significantly less likely to have their
claims accepted
or
me et t he ciainis threshold
(x' =
131.16, df = 45. p
<
.()(KW)(11),althougli these results sliotild
be treated with catition
as
many
of
the categories
of
anah'sis v^ere less than five. Claimants who had tised the
emergency telephone service were also significantly more
likely to have their claims accepted (x'
=
215.34, df = 5,
p
<
.O(1(M)O1). T ho se w ho claim ed m edic al tre atm en t,
assault, and theft w ere significantly mo re likely to have their
claims accepted compared with those cbiniing dental
conditions, cancellation, curtailment, loss and damage
(X- = 127 .782 27,d f= 40. p
<
.O(1(HU).
Th e mea n cost of payouts of claims was in Atistralian
dollars (AUn)7l9 .37 (SI)
±
AUn3736 .04 ) overa l l .The
mean cost of payotits of claims was AUD991.3
I
{SD
±
A U n 5 4 0 (1 . 7 6 )
for
males and AUD 5()8 .9O {SD
±
A U D I 446. iO) for females. Th er e w as no significant dif-
ference
by
sex
(p >
.05). Th e m edian paym ent was
AU D 163.00 ( range AUD i-AUD 78 ,349 . ( ) ( ) ) .The h igh -
est claim refund was AUD78,349.()() and the distribu-
tion of mean reftmd per claim is given in Table 8. Claims
for assault, cancellation, and curtailment were significantly
more expensive than other types of claims {Kruskal-
Wallis one way ANOVA: X"
= i
06 ,87 , ^\i
=
8 ,
p <
.000(11). T he distribu tion of the mean refunds for me d-
ical and dental claims by nature of illness is given in Table
9, C'laims for treatment of gastrointestinal,cerebrovascular,
cardiovascular, musculoskeletal, and pyrexias of tm kno wn
origin were significantly more expensive than other
medicat and dental claims (Kruskal-Wall is one way
ANO VA; X"
=
f>l •f'8, df = 15, p
<
.00(1(11).
Discussion
Medical, dental, optical,an d loss and theft claims rep -
resent most ofthe claims made against travel insurance.
O ne oft he major limitations of reviews of cLiiiii records
was that what people report may differ from what actLi-
ally happ ene d. C'omparison data was not yet av,iilable for
all claims and for travel instirance policies. In addition,
data collected for another purpose does not always pro-
vide the information n-qtiired for epidemiological stud-
ies.
Altho ugh the travel insurance co mp any used was a
major insurer in Australia, this company, like othe rs, has
links to variotis groups, in this case to a private liealth
instirer, which may have restilted in some differences In
the population of travelers studied. He nce, generalizability
may be limited. It is also possible that some conditions,
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K i l
of
T i i i v e I V I e d r c t n e , V n l i i i i i o
9,
N L i m b c t
2
Table 8
Distribution o( Number (Percentage} of All
ClaimantsbyNatureof Claim by Refund Paid {Mean
SO)
Table
9
Distribution of Number (Percentage) of All
Claimants by Nature
of
Illness by R efund Paid {Mean
SO)
•\ i ' / " ( . 7 j
\{,'\\{itd \\\i:
. W - i f
SI)
SI I \l
1 )1
\
c
\
1
I
1)
i
• \
C l K ' l ,
I I K e l
I I I L l l l
\ s m i l
k-n
p I K .1
I I I L I L '
I t :
•1 1
i i i r
d c i
• i i i u
l i e n
,1ns
IK , I I
S'13,'13
l a l 2 2 h U i ,
1 1222 7 '*
1 1411
'
2s,T,i i7
323 ni
>
3 11 (M
U . I , ' . 4
-p ,
r-
I I , I L J o l L i . M . - i , i ; i , l
3 1 I S '
31
22 }
nil'
• '72
31 ' )
3 2 3
1S4
1 7 ' ^
.>7.ii
,1
. l n n [ ,
i i 7
7 n
i
\
1 1
,>7
~ i I
(.1
3 , ;
S 7
11 4
'11
3 1
3
2
s
(
2
1
1
-
1
•s
•
1,2
(3
i
[ 1
ll
I
(4
11
2 , S )
h
<})
•> ]
4 i
v 2 ;
4 , S i
7)
21
ID )
(iastr(Mi
C\ ' i v t i r .
Canlinv
Vhls ,
111
' r i i i a l
1
I K 1 O ( r
C e i m o i
)et ni,u
I '", ir,
i i n s
S p c i ilk
{)plllll,l
i c s u i s . i
\ a s c i i l . i i
1 st i i l a r
) sk eK ' i , i l
[or\
1 t i i , i r \
>lo^[ka
c , a n d l h r (> , t l
1 i l l
(1 \ ' l l I
l l l l k ' s s
n i k
1
1
2
1
\
t i l l . ' ' 2
>i)2,nn
.N",3^l
> = , S . "••->;
H H o
SdJUl
,?-(., '3
n i t . ' i l
S 3 . S S
i( IJ K 1
3 1.23
in.}.\-.i
T3')n,7
Vo2 ,4
2 2 " ^
,2
3 | K , { i
\ ' 3 . 113
1 Mi 2
^ 2 ( l l .
1 ( i S . l l .
1 'J i 22
'' 2S (I.
.1
2 . 2 4
2
(11,3
2S2 .3 I
s i s , I I
, ^( . s ,3
• u . \
1
2n
;4 .
2 2 i ,1
l^ ..,
1 2 : 2
(, l
1
li
4 i
}
)
^
;
})
ulm' i i in . i inkAt - .n i ik ' unu- J H I T i o i i i j - iL ' i io i i ol i\\\\x\. n i , i \
Mo( ji,iw [ H C I I
i
L i in in l . i i i . ii i iNi U . U T I ins in . i i i rc .
Demograpby of laimants
' he liiscribiuit))
ul
(•l.'iini.inis m rhh s.niiplc is in,n iK"
ni I I K u lJ c r ,iiii' i irnii|is., \\ lth n io iv rh.in li. i l l oi r l .u i iLnus
hci i i i j ,
55 vc irs or
K ^ W X
. H K I .li nni r 4i i"'- ot \\\<: *. l.nm.nit'-
i C M a
ot
i n i k i i o w
431
4
I I I S . , ' ' 24
4 i . ( > 2 . ' ' i ) 2i' I
ll
liuk^^ iiiM i-->tul
,
.mi l
V,
i r i l i i 'd i i
-r i
i i i i i i L
\ l
i n
,'\ir.M,sli,ii,
> k. l , i : ,M
•
M i i i i l . i i j
, 1 : - ,
nn .M,
Travel History and Insurance overage
,Miis: lt".i\clcrs iiu^lLidctl l,uropc or No i - i l i A I I U T H M
in i lu ' i r i tMvci u i iic iMncs , dk i c i '
r, i\ ' fk' i ' - .
W L I I .
niori. '
l i k f K lo itM\^L-l to [A i ro p c J i i d Ne w / iM l .n u i , M o s t
[ i \ i \^-
clcrs
lo the LIS
Vo<ik O L I I
lop
t e w i r . iw l l i iM i i' .U Ke ,
\\ h i . h I L I S been I 'eeoi i in ie i ide i l
in
rhe l i ie r .u i i re , ' ' ' I 'o i
iho^c n",i\eiers who nuy he un i i iM ir , i i ' le Ix 'e.utse ol
.uK .inr eLf , ij,e or ,RKMiieed ill h e j i i h . i i jn ipo rLnU rh ,u
U i e \ are ,Hi\"i '-Cil jh o i i l . le^nnaMon^ wh ere lhe\ cou L
ti",i\ 'el ^.l(ely, |xi] 'UeL il.irl\ ' wheri. ' bilaie r.i] L I O W T I I I I K - I U
he.ilih ,igreeineius eMM loi' t.'iiierm.'iiL"\ e,ire J I K I prox uieil
the ,ii i i i ites ,u"e [irep.ircJ
to
ae ioi ne Ju ,il ly e\',u'uare th e
iiMvelec, It l im po ri. in i u» liiseuss ilie "'wo rst c.ise see^
n . ino" r isk .\\\\\ th e L - O M io i l i e n i il il oreniTL-d, il is n ot
kn ow n wh et he r tre(.|uene\- oT [v.ix el may ha w a bear-
i i iu on HK k lem e ot r i .un is, as toniu l for [isyeholo<^K\il
l i isorilers m a stnLi\
ol
W oik hank stal l and eoi is ii l ia i i rs .
This \ \ 'ouUI re i, ]u i ie tu rthe r invesi iL ;at ion,
Nature of laim
\ ' loM eknn is reponed Kir rr , iw i n isnrani. e w ere
ri'i.ued lo inedieal and denia l U vain ie i i l , w uh [he reni,nn
der invoK^iiiL; loss, ihetl or dania^e. A raiiLje ol n iedu ,il
eo i id i l ions were re i^ i i r led wi ih more i l l , in ha l l
ot rhe
medieal ,ind deni,:
i
lam is loi res|iiral"oi-\, ninseiilo^ kelei,il.
aiitl ^asll•tlinn.•stiI al i- ond uio iis, Lo nsisreni \\ ih o ih e i
studies oi ir,i\ i- ' lers maladies. ' ' ' ( d a in i s lor i r o p u \ i l
dise,ises were uiieonmion m this suidv. L.'se ol ihe emer--
L ie iR\ te lephone serv ice provided
by rhe
i r a w l m M i i -
ani,'e
i
on ipany was re la tue ly r i in m io i i , l ^o ru i i ia teU , lew
deaths were reporled. I'he i ause of the de,ith rh,H w.is
repo riet i w. ls consis ie iu w l ih l l ie l i ik lm ^s of sindies ol
dearbs ol i iMvelers ,ii iro,ki. w I I I L I I i iu l ieated ihar
ira\^el-
ers were mosi likeK" to die i^t" natnrai eanses owrseas, M R ll
• S ,u-ure myoeardia l mlaret ion, lo l low ed b\ o the r
i.
a uses
siu h ,is aeeidenis, l lteres rm^ iy, 1 death oeei ir rcd
on
the pi,me .md 23 other elaini,nils reported an illness e<.m •
m e i i e i i i i ; on the i^lnic. w h i c h m e l n d ed a \Mi"K't\ ot
j io te iU ia lK sei 'ions in-[hL: lu i on di ti on s, s uch as (.•ai\Jiae
and respnMtoiA enierLjen cies, s^en in prcxaons stud
le^ , ' '
' '
T ill s ein[ihasi/i.-s U te \ <:c^\
lor \
it;i laik-e
bv air-
I n l e crews
, u ) ^ \
\-.\ poteiinai "L^ood Saniai t tan' pliysici.uis
and l ie , ikh workers [u be prepared to render elleetu^e
t-irsi aid 111
tlii^du,
horEunately, ,iir li i ies .uv h e i o m i i i i ; b e t -
ler pr ep. iretl t o ,insist stia cke ii pass(,'ni;i.Ts. p,iri iL-iiia rt\' w i ih
c i ie incr iMsuiL; avat l ib i i i ry of in-t is j ; lu d ehi ir i l ia to rs.
Etiology of laims
"I ' l ie ie v\ .is n isn l t lc ien i m lor fna i io n p rovuied m die
claims sampled to esKLblish a pa i te rn ol erioloiiiy; ho u --
e\'er.
it
was reason,(bl\ elear rhal nian\-
of
rlie n iiisen
loskelet, i l condit ions rcsuked Irom acckle i i is ,\I K\ ialis,
ll
w o u k l in- nset i i l it descr ip to rs lor eatisc .UK\ agency
r i ' l i l e t l to [he p io bk ' i i i were req i iesu 'd on che i r a w
insniMiiCi ' ck i im (or m .
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- - . M u j a i , ^ i i t , - | L c j i j a i , \ i . ? ) - v « \ I n s u
r
j m c - i . - C l a i m s ;
^ ' ^ ^ • ^ ^ ' ^
i r , , v e l l n s u n i k - e . l i n s k , n e , A t , s , r , t l i , , We woukl, ,Iso l ike
• ^ ' ' - " ^ i ^ f ' - ' - ' ' l ^ i ^ -
P r u p o r i i o n
o[
.kmi is weiv un r u> ih,,nk Ass,s(,,i,t holossor Uivpot n Kcd,,n-uiie, I le.id
- >
T'^' ' i
-
lu lK ,ie. epted
[
h,s needs Inr th er invest,^,,-
|
)ep,,runcut
o\
),,, ^ , o l u , ^ ^ ,nki
(
V e i u s i o u , Kk 'n i tv
ol
H o n ,
Mii IS ii(oh,ihK^ du e ro prohlems wi ii i el,nuts ,,ris I )c i tis ir\ . I'r iuee oTSou -k ki L dt n v^tsiK, I kit Yai . rh , n-
iii;-', l u i n x e i e i s w i ih p i e e x t s t n - . o iu l i n o u s o i
iiisnrkkieiH
k i n d ,
l or her sLirisfk ,,l .idek e
1
hiMese.ii xb w,,s p,irii,i lK
^ ^ ' ^ > n n e i u . ,u o u , iMitienki rlv those wi th den,,il
, o n d i -
supporred hv
A
Meru Kese,,i vh ( i , m t . |,ni,es C oo k
ol os M,i,iiu.iti.eu iteiiis, ii tsimpoiT.int , i ls(i (.ir Lhi i \^ers i i \ '
[ I , \ •,'k'i
s,,
v'spes I.I Ih ekierK^ i r. iw ler s, ri > hi.- ni .k le iw ,ire t li,i i
it.nci insULiike m,i\ nul .. o\ e; .nu known
prec-\isliu^
References
l i i e d k .l l orde i i k i l [ ' ro l i lems ,
I
l i i w e \ er ,
il
iss t i l l i i n p o r -
l . i i i
t o i
these tr, i \Tk' l-s
lor . ike o n i ,i
i r , i \e l i i i smMiue
p o | 1
SiftU-n
k. K h
ki--n|-iidi
W V
I I I K
In, U,
,•;
J
l , . , i | i ] , pinhkinv
k \ , Mik- e I M I U r (o n d i t i o n s . n o t d i r e c t k l i n k e d toI I K r •in---i ii,i\i.-l n» ,k^vr i,.pr i;.. ,,(,iiiM..--, | I n k k i IMs p -S"-
e i \ ' d ,
I>oi
u i n e i u i t i o t i
,
o u e e r n i i i u
t h e
r i v , i t i n e i l l , i h r o , i d
""• ^' ' " ' 'n l< I I I I ' M I H I l
l i . r ,c l ( I K ^ J I ,
I H L - u h . H ' - i l m - | I I I\T.'I
•i^ i l l he
u i - jUMei i
h\r h e I I M W I
l u s u r u ' -
"I he
tJMv e lu sn ier ' '^' ' ' ' '
' ' ' ' ' - ' ' ' ''
m.t\ . i lsn re.p ii R .1 l e p o r r t r o m t h e d o u m o r d en i i s ; w h o ^ Ik-wi.-, I ' l ' I m u n , i i , , l K , . , l r i i r , p,,,, n> il i -po . . . . (dk^ p r -
uor i iK i lK i re ,i l s d i en i , i k , i eL t i i i i
is
k i d d e d t o r i re i t ment vu i i u -n ,u u i i Lun- . n i k hi ,-1 ir, i i i i i
1
,^ssn. i,ti.
J
vMih
n
.u^l
I
\ , • H I M. J
Mnil
\ » i}: [•'•-jSI li.-i
' ' I A possthle preeMsin iL: •o u e i r i o u . , ,
I
- . , '- I , '
l ; , i " k k . , i - l i S - k . < i | - . M , ,,| Ik . ihh
.
tK i-k-,.'UK'iif, iiid •\n-.
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