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 130feet. 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