Several recent incidents got us thinking about dive
accident insurance. The first occurred last August when a
UK diver’s insurance carrier declined payment of nearly
$70,000 for DCS treatment because he had exceeded his
policy’s depth limit. He was only able to leave Egypt after
paying much of the local bill himself. Then early this year
ten recompression facilities for several months refused
to accept DAN’s “reasonable and customary” payments,
instead presenting the stricken diver with the bill.
Some policies restrict coverage to 130
feet. While you may never expect to dive
that deep, you may inadvertently. |
Dive injuries and related costs can run into staggering
numbers. Last year, a 10-year-old Discover Scuba student
in Grand Cayman, was bitten on the arm by a moray eel
while diving the Sand Bar. The tab for medical attention,
a private Leerjet back to the States and physical therapy
approached $100,000. The family, despite having a dive
insurance policy, had to put the money up front.
Points to Consider When Buying Coverage
Prudent divers purchase secondary dive accident policies
to cover claims their primary policies don’t cover.
To assess your primary coverage, inquire about diverelated
hyperbaric chamber treatment and emergency
evacuation, both at home and abroad. You may indeed
find that you are covered for dive accidents, including recompression treatments and air evacuation. However,
foreign facilities may want payment up front, or at least
require prior authorization from your insurance company,
before you are admitted to or discharged from the hospital,
or even allowed to leave the country.
Good primary insurance is important, because most
dive accident insurance policies are secondary and may
not cover all expenses, particularly rehabilitation. Many
primary health insurers don’t advance or preauthorize
payment. Dive insurance policies, however, often provide
for assurances that are acceptable in most foreign and
domestic locations. Otherwise, you’ll need credit cards
with high limits.
Some policies, especially the least expensive, have a
depth restriction, commonly 130 feet. While you may
never expect to dive this deep, if you’re rescuing a buddy,
chasing a dropped camera, being caught in a downcurrent,
or becoming impaired by an accident, you may
unexpectedly drop below 130 feet. A policy without depth
limits eliminates wrangling over your “real” dive plan or
“intent.”
All dive accident policies require care to be first prescribed
by a medical professional, documented in an
itemized bill, reported to the insurer in a timely manner
and other important details. You’ll need to follow your
policy rules to ensure coverage, not always an easy task in
remote areas.
Finally, all comprehensive scuba accident policies
provide trip cancellation and interruption benefits if
a medical condition precludes scuba. But, you’ll need
travel insurance if you want broader coverage againstairline cancellation, travel agency problems, and natural
disasters. And most don’t insure against nondiving accidents,
such as getting a foot crushed when a tank falls.
The six biggest providers are: DAN, PADI, NAUI,
DiveSafe, DiveAssure and Diver’s Security Insurance
(DSI). All but DiveAssure are secondary. While secondary
insurers may provide coverage on the spot, they will turn
to your primary carrier to cover medical costs up to it’s
policy limits. So, when you consider the limits of your
insurance, add together both the benefits of your primary
policy and your seconday policy. It may be that a dive
policy with a lower limit suits you just fine.
DAN
DAN has more than 200,000 paid members to whom
they offer insurance. DAN America offers three plans:
Standard ($54/yr), Master ($64/yr) and Preferred
($99/yr), providing dive accident medical coverage up to
$45,000, $125,000 and $250,000, respectively. The DAN
membership fee and access to expert in-house medical
information services are included.
They provide up to $100,000 evacuation and repatriation
benefits, including medical services and transportation
for injuries incurred at least 50 miles from home.
Evacuation and travel must be coordinated in advance
through TravelAssist, which will make arrangements and
provide a Letter of Assurance of payment, or advance up
to $5,000.
Ancillary TravelAssist benefits include monitoring the
injured diver, repatriation of traveling companions and
other services.
The Preferred Plan adds nondiving medical coverage
for accidents occurring outside the home country
and trip cancellation/interruption coverage when an
insured’s ability to dive becomes limited due to sickness
or injury.
To control costs, DAN refers DCI cases requiring
hyperbaric treatment to a member of its Diving Preferred
Provider Network, as long as it doesn’t put the diver at
risk.
PADI
PADI offers a range of dive-related insurance to PADI
certified divers through Vicencia & Buckley Insurance
Services. PADI diver protection plans include Silver ($54/
yr), Gold ($75/yr) and Platinum ($99/yr). The plans
provide $50,000, $100,000 and $275,000 of dive accident
coverage, respectively.
PADI plans incorporate dive-related death and disability
benefits, and provide optional non-diving accidental
death and dismemberment coverage. All dive accident
medical coverage is per incident, rather than the more restrictive lifetime maximum offered by some other insurers.
However, how many incidents does a diver have?
Assist America rescue and evacuation benefits are provided
when the diver and immediate family members are
more than 100 miles from home. Evacuation, repatriation
and treatment related to diving and non-diving emergencies
must be arranged by the agency. Assist America guarantees
hospital admission for divers outside the USA.
The Gold and Platinum plans provide medical and
travel benefits for accident-related emergencies of any
nature and dive trip cancellation and interruption benefits
to divers and their immediate family. These may
already be covered in your primary policy and trip insurance.
NAUI
NAUI makes its three policies available to every diver:
Standard Diver Plan ($30/yr); Deluxe Dive and Travel
Individual Plan ($60/yr); and Deluxe Dive and Travel
Family Plan ($90/yr). After a $250 deductible, these policies provide medical dive accident coverage of up to
$50,000, $300,000 and $500,000.
The two top-tier plans also provide medical benefits
for non-diving accidents up to $10,000. After a deductible
of $250, they also cover up to $10,000/$5,000 in diving
vacation cancellation/interruption expenses. There are
no distance restriction for covered diving accidents. For
non-diving accidents on a covered diving vacation one
must be outside his primary residence country or more
than 50 miles from his primary residence.
DiveSafe
A newer player, DiveSafe, Inc., administered by
Willis Recreational Dive Programs, offers coverage to
certified members of SDI, TDI, ERDI, IANTD, YMCA,
NASE, WASI, ACUC, SSI and PDIC. The considerable
appeal of DiveSafe is simplicity. It sells only a
single policy ($60/year) with no depth limit or exclusions
for tech diving, deductibles, options or preapprovals.
The maximum lifetime limit is $100,000
for dive accidents.
The plan has dive vacation cancellation or interruption
coverage. The policy includes emergency medical
evacuation and repatriation benefits up to policy
limits. DiveSafe will assist the injured diver to arrange for
hospital admittance/discharge deposits or other advances
for medical services and can pre-authorize/guaranted payments
once an incident report is received. If you sustain a
nondiving accident, injury or illness, you’re on your own.
DiveAssure
The newest insurer, DiveAssure offers Gold ($75/yr),
Platinum ($115/yr) and Diamond (starting at $155/yr)
plans. The plans are open to all certified divers and dive
students. None have depth or mixed gas restrictions.
If you want to be heavily protected against medical
costs, these provide $250,000, $500,000 and $1,000,000
of dive accident coverage, per incident, respectively. All
cover medical rescue and evacuation expenses following a
diving accident.
The top two plans cover nondiving-related accidents
and medical expenses incurred during a diving vacation
with the same limits. That might be important for someone
whose primary insurance doesn’t cover accidents
outside the U.S. Medicare is an example. If a hospital
demands a cash deposit or settlement prior to leaving,
AIGAssist will advance on-site medical expenses.
The Diamond policy provides comprehensive dive
vacation cancellation and interruption benefits. Unlike
the other plans, the insured can tailor this coverage,
and purchase $1500/$3000/$5000 of cancellation and
$2250/$4500/$7500 of interruption protection. And they
go beyond diving problems. Uniquely, they cover sicksickness,
injury or death of a family member or traveling companion;
weather or natural disaster; even being required
to serve on jury duty or being delayed due to a traffic
accident en route to your departure.
DSI
Diver’s Security Insurance, a division of Capital
Investors Life Insurance Company, was formed by divers.
Policy costs vary by coverage and a five percent deductible
applies to all charges. You must have a primary health
care plan.
Unlike other policies, DSI offers a menu of benefits.
Class A ($25/yr) covers chamber charges and related
physician’s services and supplies (certain depth and gas
restrictions apply); Class B ($10/yr) covers all other injuries
sustained while diving or snorkeling; Class C ($5/yr)
only covers ambulance services, air included, to the nearest
emergency facility and Class D ($20/yr) covers other
watersports. Each Class provides a scanty $15,000 in benefits.
Which is best?
If a plan fails to cover dive injuries other than DCI, or
has depth restrictions, it isn’t suitable. If you don’t have
primary insurance, maximum medical limits of $50,000 or
less are inadequate. Beyond this, the policies serve different
needs and not all are suitable for everyone.
For example, if you dive frequently you may prefer
coverage per occurrence rather than a restrictive lifetime
maximum basis. Look at PADI, DiveAssure and NAUI v
DAN Standard and Master and DiveSafe.
If you use Nitrox or other gas mixtures, you will want
a policy without gas restrictions. Other than DSI, all policies
cover you.
If you want traditional travel insurance benefits, consider
the upgraded DiveAssure Diamond plan. If you only
dive locally, you don’t need trip interruption coverage, so
look to more basic plans. However, if you travel to distant
venues and want generous benefits, consider DiveAssure
Gold and Platinum and DSI upgraded DiveAssure
Diamond.
If you have a medical condition that could result in trip cancellation, consider DAN Preferred, one of the
NAUI Deluxe Dive and Travel Individual Plans, and
upgraded DiveAssure Diamond.
Finally, keep in mind that if you’re injured, you’re
dealing with hard-nosed insurance agencies, not dive buddies.
Don’t have a naive expectation that a benevolent
DAN or PADI or NAUI will treat you like family. They
won’t. This is the insurance business. We have seen cases
where injured divers wrangle with their dive insurance
companies for months, eventually learning that what they
thought was covered, wasn’t. They hadn’t read the fine
print. All the more reason to have a solid primary medical
insurance policy.
– Doc Vikingo