Are You Diving Naked?

“American Express. Don’t leave home without it?” Piffle. A far more reckless action would be leaving for a scuba trip without adequately insuring against dive injuries and related costs.

I recently saw a bill from a hyperbaric facility on Cozumel for the treatment of unexpected, uncomplicated DCS sustained last October. Two Table 6, two Table 5 treatments plus related expenses, a bargain at $14,050. Had this hapless diver sustained injuries so severe that they couldn’t address them on Cozumel and required air evacuation to Mercy Hospital in Miami, the flight alone would have cost from $10,000 to $20,000.

After a week of diving on Provo last October, a physician with more than 200 dives suffered an unexpected case of the bends on her last day. She quickly underwent a Table 6 treatment, followed by three more over the next three days. Her 600-mile return trip was on a private charter, pressurized Lear Jet to Ft. Lauderdale, a flight of about 600 miles. The damage? $7,200 for hyperbaric services and $4,600 for the ride.

An acquaintance of mine needed evacuation from a live-aboard off Panama to Miami following unexpected DCS sustained last August. The air service secured a charge of $20,000 against his credit card before rolling the craft onto the tarmac.

Had any of these divers been stricken in remote Indonesia, the cost of air evacuation could easily have hit $35,000. Dan Nord, Director of DAN Medical Services , told Undercurrent of an $80,000 tab for an emergency evacuation from Southern Africa.

Do I have your attention? Good.

Getting Covered

A prudent diver purchases dive insurance as supplementary to his general health coverage, as a hedge against services that primary medical policies deem outside their obligations. Be aware that some standard health policies contain exclusions for diving related accidents, including chamber treatment, not to mention limitations or even exclusions for injuries sustained outside the country.

To assess the adequacy of your primary coverage, look into diverelated hyperbaric chamber treatment and emergency air evacuation, both at home and abroad. Even if your policy insures dive-related injuries away from home, some foreign countries will want payment or proof of payment before you are admitted to or discharged from the hospital — or allowed to leave the country. It is a near certainty that your general health insurer will not advance payment or make preauthorization for such contingencies.

A dive insurance plan will usually serve you better. They are often recognized, particularly in foreign countries, as reliable sources of payment, and sometimes may even provide cash advances or assurances of coverage. With chamber treatment running from $350-$1,000 per hour, costs can mount rapidly. Yet, even the most benevolent dive insurance may not defray eventual medical expenses. The long-term cost of treating such events as Type II DCS with permanent neurological impairment or severe pulmonary barotrauma can be extraordinary.

Let’s have a look at the three providers: DAN, PADI and Dive Safe.

DAN

DAN, a nonprofit organization, has about 200,000 members and reports that a majority subscribe to one of its plans. DAN’s policies are not standard across its five international regions, which formulate their own policies. DAN America policies are underwritten by United States Life.

DAN America offers three policies; Standard ($54), Master ($64) and Preferred ($99). Various family plans can also be purchased. All include up to $100,000 in TravelAssist coverage, the DAN membership fee of $29, a subscription to Alert Diver magazine and access to medical information services.

The Standard plan covers only Decompression Illness (DCS), which we find inadequate given the range of possible dive-related accidents.

DAN’s two top plans provide more substantial dive accident medical coverage (up to $250,000/incident with the Preferred Plan), and incorporate death/dismemberment/ disability and reimbursement benefits for dive gear lost as a result of dive injury.

The Preferred Plan has some exclusive benefits, such as a $10,000 lifetime benefit ($250 deductible) for medical nondive accidents occurring outside the country of residence. There is also trip cancellation/interruption coverage for losses incurred when an insured’s ability to dive becomes substantially limited due to personal sickness or injury. General trip cancellation insurance, however, offers much broader protection, however at greater cost.

In addition, DAN supplies hospital admittance/discharge deposit advances up to $5,000 when provided with a guarantee of reimbursement for noncovered services. And, to control costs, DAN refers DCS cases requiring hyperbaric treatment to a member of its Diving Preferred Provider Network (DPPN), which has about 40 chambers in the United States. Renee Westerfield, DAN Communications Director, told Undercurrent that a diver needing emergency chamber treatment, however, will be referred to the nearest facility, whether or not they are a member of the Network.

All DAN policies provide up to $100,000 DAN TravelAssist evacuation and repatriation benefits, including covered medical and visitor transportation for injuries incurred at least 50 miles from the insured’s permanent residence. Travel must be coordinated in advance through TravelAssist, which will make arrangements and provide a Letter of Assurance of payment. This in hand, emergency air service companies feel comfortable in waking crews from their naps.

Ancillary TravelAssist benefits include continued medical monitoring of the injured diver, repatriation of traveling companions and dependent children, return of a rental vehicle, cash advances up to $250 for medical emergencies, help in the recovery of lost or stolen belongings, and a range of personal services such as contacting relatives and employers. They will even send a needed prescription you left behind .

An important consideration in deciding on a particular DAN policy is depth limit restriction. While both the Preferred and Master Plans have no depth limit, the Standard does not cover injuries occurring deeper than 130 feet. One may expect never to dive deeper than 130 feet; however, rescuing a buddy, nitrogen narcosis, chasing a dropped camera or that once-in-a-lifetime photo, or even the accident itself may result in an injury deeper than 130 feet. With a no depth limit policy, there is no wrangling over your “real” dive plan or “intent” when it comes time to settle, as can be the case with policies containing such limits.

And, keep in mind that DAN’s hotline is staffed 24 hours, 365 days per year, by personnel from the Duke University Medical Center, who provide expert medical advice and assistance in negotiating care systems.

PADI

Laurie Vicencia Painter, Manager of the PADI Diver Protection Program, told Undercurrent the program has about 16,000 diver plans in force. All policies are sold and administered by Vicencia and Buckley Insurance Services of Cerritos, CA, and underwritten by American National Insurance. PADI, of course, is a for-profit organi zation .

PADI diver protection plans include the Silver ($40), Gold ($60) and Platinum ($89), with all covering medical expenses for any dive injury. Furthermore, PADI ’s dive accident medical coverage is on a per incident rather than the more restrictive lifetime maximum basis in all but DAN’s Preferred plan. As with the DAN Standard Plan, PADI Silver Protection has a 130-ft. depth restriction. All PADI plans include death and disability benefits, and provide nondiving accidental death and dismemberment coverage as an option and at an extra premium. The optional coverage available, and the size of the premium, is plan dependent. Death and dismemberment coverage, however, is commonly part of individuals other health policies.

PADI plans use Assist America to provide comprehensive worldwide assistance which, like the DAN policies, can include hospital admission guarantees.

Additionally, the top of the line Platinum Protection provides divers and their immediate family with travel benefits for accident-related emergencies of any nature. While Assist America affords many of the same benefits as DAN’s Travel Assist, it has the additional advantage of covering divers at any distance from their permanent residence for diverelated medical and air evacuation services. However, PADI’s TravelAssist emergency number is not staffed by university-based dive medicine experts and does not provide a comprehensive non-emergency dive medicine information service.

Dive Safe

The newest player is DiveSafe of Blaine, WA. According to Peter Meyer, VP of the plan’s administrator, Jardine Risk Management, Ltd., the policy was launched this January, and has upwards of 100 subscribers now. The premium is $55/year and it’s underwritten by the National Accident Insurance Group.

Dive Safe simplicity has considerable appeal. There is only one policy. It has no depth limit or exclusions for tech diving, contains no deductibles, offers no options and requires no preapproval for covered services. It is competitive with DAN and PADI plans in this price range, with lifetime limits of $100,000 for medical dive accidents; $10,000 for death and dismemberment, and up to $2,500 each for repatriation of remains, replacement of lost dive gear, and diving vacation cancellation or interruption. Unlike the PADI and DAN plans that cover dive trip cancellation when diving ability is substantially limited by personal sickness or injury, the DiveSafe policy requires that the cause of cancellation be a covered diving condition.

Like DAN and PADI dive accident coverage, the DiveSafe policy includes $100,000 emergency medical evacuation benefits and all the customary support services, which are handled by WorldNet Services. DiveSafe will work with the diver or his or her representative to arrange for hospital admittance/discharge deposits or other necessary advances for medical services. DiveSafe hopes to offer pre-authorize/guaranty payments for services by summer.

So, Which Plan is Best?

As with most insurance, there is no “one-size-fits-all.” An individual living in a rural area who only dives a nearby quarry will not be heavily influenced by the $10,000 dive trip cancellation coverage offered by DAN’s Preferred Plan. However, he will be interested in the requirement that the diver must be at least 50 miles from home before DAN TravelAssist benefits become effective. On the other hand, for the individual who primarily dives exotic and far-flung venues, this situation will be reversed.

When comparison shopping, consider such important features as lifetime maximum vs. per- occurrence benefits, depth limitations, coverage for non-diving related injuries, coverage for significant others, and availability of both emergency and non-emergency expert medical assistance. By all means, don’t pick a policy just because you want to support the organization that offers it. Pick a policy that meets your needs.

Don’t get caught diving naked.

- Doc Vikingo

DAN : www.diversalertnetwork.org/insurance, (800) 446-2671. (PADI - www.padi.org)Ph.: (800) 729-7234 ; (949) 858-7234 DiveSafe www.divesafeinsurance.com or call 800-708-1144