A question frequently asked & discussed in detail on this board. Much can be located by doing a search of the archives.
For example, you might like to begin by reading this poll--->
http://www.scubaboard.com/showthrea...y=&pagenumber=1
My "Undercurrent" article in the Sep '02 issue of "Undercurrent"
http://www.undercurrent.org/ also may prove informative:
"ARE YOU DIVING NAKED?
'American Express. Dont 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 in Oct 2000. La cuenta? Two Table 6, two Table 5 treatments plus related expenses=US$14,050.10. Had this hapless diver sustained injuries so severe that they couldnt be addressed on island and required air evacuation to Mercy Hospital in Miami, transportation alone would have cost from $10,000 to $20,000 depending on logistics.
Also in Oct 2000, after a week of diving on Provo a physician with over 200 dives suffered an unexpected case of the bends on her last day. She quickly underwent a Table 6 treatment, followed by 3 more over the next 3 days. Her 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 & $4,600 for the ride.
An acquaintance of mine needed evacuation from a live-aboard off Panama to Miami following unexpected DCI sustained in August 2000. 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
Let me suggest that prudent divers will purchase dive insurance and view it as supplementary to their 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 exclusions/limitations for injuries sustained outside of the country.
The first step in assessing the adequacy of protection is to review your primary health insurance coverage. In particular, look into dive-related hyperbaric chamber treatment and emergency air evacuation, both at home and abroad.
Even when a primary health policy does generously insure against dive-related injuries away from home, some foreign countries want payment or credible 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 any monies or make any pre-authorizations for such contingencies. A dive insurance plan will almost always serve far better in this regard. Diver protection plans are often recognized, particularly in foreign countries, as reliable sources of payment, and in some cases may even provide cash advances or assurances of coverage. With chamber treatment alone running from $350-$1,000 per hour, depending on facility, number of personnel involved and other factors, costs can mount rapidly.
Dont, however, be lulled into a false sense of security by a dive insurance policy. In addition to the folly of not having strong standard health coverage, the fact is even the most benevolent dive insurance may not defray all eventual medical expenses. The long-term costs of treating such events as Type II DCS with permanent neurological impairment or severe pulmonary barotrauma can be extraordinary.
There are a number of agencies which offer dive insurance, including DAN, PADI and DiveSafe. Lets have an in-depth look at the offerings & workings of the most widely recognized and comprehensive plans, those of DAN & PADI.
DAN
While this not for profit agency did not reveal to Undercurrent the number of policies currently in force, it has about 200,000 members and reports that a majority of them subscribe to one of its plans.
DAN diver policies are not standard across its 5 international regions. The largest region, DAN America, encompasses the US, Canada & Caribbean basin. DAN America-Mexico, currently operating under the aegis of DAN America, is on the way to becoming independent. The remaining regions are DAN Europe, Japan, South East Asia-Pacific (SEAP) & Southern Africa. While these regions work closely together and share some resources, they remain independently owned & operated. They are free to formulate their own dive insurance policies and select their own underwriters. DAN America dive policies are underwritten by United States Life.
Policies offered by DAN Dive America are the Standard ($54), Master ($64) and Preferred ($99). Various family plans can also be purchased. All policies include up to $100,000 in TravelAssist coverage, the DAN membership fee of $29, a subscription to Alert Diver magazine & access to medical information services. Do be aware the Standard plan covers only Decompression Illness (DCI). Many divers, myself among them, would consider this inadequate protection given the range of possible dive-related accidents. DANs two top plans provide more substantial medical dive accident coverage (up to $250,00 per incident per insured 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 maximum benefit (with a $250 deductible) for medical non-dive accidents occurring outside of the country of permanent residence. There is also trip cancellation/interruption coverage for many of the losses incurred when an insureds ability to dive becomes substantially limited due to personal sickness or injury.
Nice as this is, the feature should not be confused with a formal vacation cancellation policy and there is a related $250 deductible. Vacation cancellation insurance, in addition to coverage of personal illness/injury cancellation losses, provides much broader protection that may incorporate losses due to strikes on common carriers, natural disasters, bad weather and terrorism.
Okay, what is the insured diver to do when an injury is sustained? If at all possible, the first thing is to contact DAN. In an emergency, DAN can be called at 1-919-684-8111, or 1-919-684-4326 (collect). This is a hotline staffed 24 hours, 365 days per year, by personnel from the Departments of Hyperbaric Medicine and Anesthesiology at the Duke University Medical Center. Although not a requirement of DAN policies that the diver alert the agency prior to receiving covered medical services, DAN personnel can provide expert medical advice & assistance in negotiating care systems.
As regards financial matters, DAN is able to supply hospital admittance/discharge deposit advances of up to $5,000 when provided with an acceptable guarantee of reimbursement for any non-covered services. This guarantee typically comes from the primary health insurer or the diver himself. According to Mr. Nord, diver sureties would include such vehicles as a personal credit card, or the card of a family member or other individual who agrees to participate. DANs TravelAssist claims & payments coordinator, National Baromedical Services, Inc., can arrange for other guarantees of payment of certain costs on a case by case basis.
Based on the need to maintain acceptable standards of practice & technology, and due to past abuses of its chamber coverage, DAN has instituted controls on services. Specifically, cases of DCI requiring hyperbaric treatment are referred to a member of its Diving Preferred Provider Network (DPPN). These
are chambers that meet standards of service in a cost-effective manner. Currently there are about 40 such facilities in the DPPN, all located within the US. Renee Westerfield, DAN Communications Director, told Undercurrent that a diver needing emergency chamber treatment will be referred to the nearest facility, whether or not it is a member of the Network. However, in nonemergency situations, DAN makes every effort to use a DPPN facility.
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