travel claims australia

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ORIGINAL ARTICLES

Travel Insurance lainis Made by Travelers from ustralia

Pclcr.-\. Lcoî

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 eâeiiatioi 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 . ênciall v

and Tropic;il Medicine, James Cook University, Townsville. covers oi iK ' ei ii erênev 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,^.

.Îvised

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 -



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



; 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.



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 îc 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'î). and iâsrrnintesnnal (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 \ôun;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, sâsirciinresrinai. 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 iLârions 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 mvesittâi 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"'"), iieuroloLîe.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 ;âtu)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 unêsi 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 sêiicraily [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 \vâs 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



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,



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 invoKîiiL; loss, ihetl or daniaê. 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 âsll•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 ô 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\êl-

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, sên 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 "Lôod Saniai t tan' pliysici.uis

and l ie , ikh workers [u be prepared to render elleetuê

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 .



- - . 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 \êrs 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-.

l - \ .

I

sses ,iK , ih o i | u n e I. o - i i m o n t h es e J , i \ s o u i u , t u \ '

i l l I I I

•

Hk

I.

]H>lk

ies

.ix^.tiLihle Som e

I

Linus were uu dc i

t h e

1111

n-

ni rm s ki u v, /•, ,

\v

^

|,,. .h i,

,,.,,,

, , , . ^ 1 ,

t m h ^ m i h s

r

ih ^

1

Ni i u ' i i ,un on ni (• , i im, ih le

, n u i

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