Why you need travel insurance


First of all, I must declare any conflict of interest – I do not work for an insurance company or a travel agency. However, I have worked as a repatriation doctor in the past.

What is repatriation?

If you become unwell/injured while abroad on holiday and it’s serious, you will inevitably be treated in a local hospital until the point where you are stable enough to be transferred back to a hospital in your home country.

The reasons for ‘repatriation’ are that:

a) you are in a developing country where they may not be able to offer you the operation/procedure you require or even have a high quality intensive care unit for you to recuperate

b) the astronomical cost to the insurance company of letting you remain in a foreign country where you may not be entitled to free healthcare. Particularly the case for places like the US where paying for healthcare because you don’t have substantial cover could cost hundreds of thousands.

c) you are not well enough to simply return home without a medical escort/the airline insists on a medical professional.

Do not underestimate the cost of medical care. A night in intensive care can cost over $1000. An operation can range from $1000 to over $50000 depending on complexity, duration, equipment used and country that it takes place in.


Factor in the cost of actually repatriating you and you will be amazed. Your insurance has to pay for liaison between your treating hospital +/- interpreter and the insurance company. They then discuss your case with a medical repatriation company. They then pay to fly out a doctor/nurse to wherever you are to assess you and decide if you are fit for travel. In the meantime they will put the doctor/nurse up in a hotel and pay for their meals.

If they decide you are fit for travel they pay for either a private air ambulance (imagine how much that costs). If you can be repatriated on a standard passenger aircraft, you will inevitably require either 9 seats so that a stretcher can be laid out, or you will need more space than an economy seat, so will be in business/first class, along with your medical escort.  Don’t forget all the ambulance transfers between your treating hospital – airport – home hospital.


I thought about how much it cost the insurance company on my last job. It was a gentleman who had slipped a disc in Sri Lanka who was originally from New York State.

My costs alone included flights from London to Sri Lanka, hotel and food in Sri Lanka, Business Class flights to New York via Abu Dhabi, hotel and food in New York State, flight back to London and all transfers in between.


Of course, I’m talking about the extremes of repatriation, sometimes all you need travel insurance for is attending a local clinic for a scrape/cut, but those simple things can cost foreigners a lot. At the other morbid end of the spectrum, if you are unfortunate enough to expire abroad, the costs to your family of repatriating your body are an unsavoury additional nightmare to deal with.

The patients that I have repatriated from exotic countries have often been stuck in a non-airconditioned ward where none of the nurses speak English, there is no TV and the food is dodgy at best. Their friends/travel companions haven’t been able to afford to stay the 2-3 weeks it has taken for them to be operated/stabilised and so they have been alone. So when I arrive, they are so grateful to have a friendly, English speaking, doctor that they trust and they are desperate to get home.

Lesson of the day –  Always buy travel insurance when you travel!!!

For those who find these things interesting, there is a great book written by a repatriation doctor.