Explained: What Happens If You Fall Ill Abroad (And How to Make a Claim)

Today, on Redhead Mom, I’m sharing a partnered guest post about what happens if you fall ill abroad and how to make a claim.

There’s never a good time to fall ill. But when you are in another country and you are struck down by some nasty bug or the symptoms of a pre-existing medical condition flare up, it can be a truly rotten experience.

For a start, a bout of illness can ruin a holiday you might have been planning and looking forward to for months. Plus, when we’re feeling less than our best, all we want to do is surround ourselves in our home comforts and ride it out. Nothing’s more likely to make us feel homesick than actually being sick. 

Unfamiliar surroundings, and worrying about whether we need medical attention, where to find it and whether we’ll be well enough to travel home, can all contribute to making us feel even worse.

The icing on the cake of all this is the fact that, if you do end up needing medical attention, it can be very expensive. That’s because foreign visitors are largely excluded from state-run healthcare schemes designed for citizens (which vary greatly in how they are administered and funded, and in what patients have to pay at the point of delivery, anyway).

It obviously costs money to build and equip hospitals, pay doctors and nurses, buy medications etc. In your own country, you will get access to urgent care services at a discounted rate. But as a foreign national visiting another country, if you need treatment, you will have to pay the full rate.

And that’s far from cheap, especially if you are hospitalized. Worldwide, the average claim against insurance (see below) by travelers who need medical treatment abroad is $2,580. Some countries are much more expensive than others – in the US, for example, the average claim is nearly four times that much, at $9,941.

Certain types of treatment are also much more expensive than others, further pushed up by how long you might need to stay in hospital. UK government figures suggest that treatment for a serious stomach bug in the US plus flights back home could set you back a cool £100,000. A broken leg somewhere as close to home as Spain would cost you around £15,000. 

More than any other reason, this is why travelers are strongly advised to take out travel insurance whenever they head abroad. The financial risks of falling ill on your travels without insurance are simply not worth it. As well as covering potential losses from things like flight cancellations and lost luggage, travel insurance is designed to offer comprehensive financial protection against medical costs. Even budget policies will typically pay out up to £1 million for medical treatment.

So how do you make sure you have adequate cover for your trip? And what happens if you do fall ill? How do you make use of your insurance? Here’s what you need to know.

Before you go – buying the right insurance

An important point that isn’t always made clear to travelers about the medical cover on travel insurance is that it isn’t designed to pay out for all medical scenarios. On standard policies for example, the medical cover is there for emergencies only. So situations where you get sick in completely unforeseen circumstances, either because you pick up a virus or eat something that doesn’t agree with you etc.

What general travel policies don’t cover you for are pre-existing medical conditions. From the insurer’s perspective, if you have a medical condition, you are more likely to fall ill and make a claim. Plus, specialist treatments for specific conditions might cost significantly more than general medical care.

For that reason, whenever you apply to buy a travel insurance policy, you will be asked to disclose limited details of your medical history. This will usually cover any diagnoses or treatments/medications you have had in the past two years, plus any history with certain conditions (such as cardiovascular disease) no matter how long ago it was.

It’s essential that you answer fully and truthfully. If you don’t and then end up falling ill and making a claim, your insurer will look into your medical records. Anything that shows up that should have been disclosed but wasn’t gives them grounds for refusing your claim.

Many people who declare pre-existing medical conditions have the negative experience of either being refused cover by an insurer, or are quoted an unaffordably high price. This is because a lot of mainstream insurers aren’t prepared to take the extra risk. 

But medical travel insurance designed for people with specific conditions is available through specialist providers. Rather than only covering emergency and general treatments, these policies will cover treatments for named conditions.

On your travels – what to do if you fall ill

The most important thing if you or a member of your family or party falls ill while you are abroad is to put your/their health first. Don’t try to brave it out if your symptoms are deteriorating, either because you don’t want to cause a fuss or you’re worried about what will happen. Medical services are there to help you whatever country you are in. If you are ill, use them.

The UK’s Foreign, Commonwealth and Development Office (FCDO) advises British travelers that its consular staff are available to provide assistance such as translation services and contacting friends and relatives at home. 

The FCDO website advises people to contact their insurer as soon as possible if they are hospitalised (or get someone to do so on their behalf). It’s a good idea to carry contact details for your insurer with you, and pass a copy on to a friend or relative at home who can liaise with them on your behalf. 

It’s also important to tell the hospital that you have insurance and provide details. In some countries, such as Spain, patients without insurance can be automatically treated as private patients (there is a lot of crossover between the public and private health services in Spain). Being treated privately could be grounds for your insurer to refuse your claim.

You should also ask for and keep copies of all doctors and medical notes relating to your case.

Once treatment is complete – making a claim

If you have contacted your insurer promptly on being admitted to hospital, they will be expecting a claim. They will probably already have put the wheels in motion, such as sending you claim documentation via email, by the time they are discharged from hospital.

You won’t be required to pay for your medical care on discharge, provided you have provided details of your insurance. This will be registered by the hospital administrators and the claim dealt with between them and your insurer. Only if your claim is ultimately turned down will they come back to you for payment.

Your insurer will request all documentation relating to your case from the hospital or clinic that treated you, as well as details of your medical history from your doctor back home. Asking for and keeping your own copies of your case notes is a good idea just in case something doesn’t get passed on to your insurer.