Are You Diving Naked?

Are You Covered?

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 exceed 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 bill.

Dive injuries and related costs can run into staggering numbers. Last April a 10-year-old Discover Scuba student was bitten on the arm by a moray eel while diving Grand Cayman’s Sand Bar. The tab for medical attention, a private Leer jet 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 dive-related 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 will want payment up front, or at at least require authorization from your insurance company, before you are admitted to or discharged from the hospital. Or even allowed to leave the country.

Many primary health insurer don’t advance or preauthorize payment. Dive insurance policies, however, often provide for cash advances and coverage assurances that’s acceptable in most foreign and domestic scuba venues. With hourly chamber treatments running from $300 to $1,000 or more, depending upon location, and air evacuation in five figure, costs mount rapidly.

Yet, even the most benevolent dive accident insurance may not defray all eventual medical expenses, especially rehabilitation. And if abroad you sustain a nondiving illness such as a heart attack or bird flu, no dive policy will pay that bill.

In the fine print, 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.”

Also, the fine print is where you’ll find that all dive accident policies require care to be 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, no matter how basic the hospital.

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 against airline cancellation, travel agency problems, and natural disasters.

The six biggest providers are: DAN, PADI, NAUI, DiveSafe, DiveAssure and Diver's Security Insurance (DSI). Each of these policies are secondary, except for DiveAssure which is primary. 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 is built into this cost.

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) & Platinum ($99/yr), all covering DCI and other dive injury medical expenses. 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 basis 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. As with the other dive accident plans, arrangements for 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 everyone: 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, respectively.

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.

Dive Safe

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 pre-approvals. The maximum lifetime limit is $100,000 for dive accidents, enough to cover most dive accidents

The plan has competitive diving vacation cancellation or interruption coverage, but reimburses only for a covered diving condition. If you sustain a non-diving accident, injury or illness, you’re on your own.

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/guaranty payments once an incident report is received.

Dive Assure

The newest insurer, DiveAssure offers Gold ($75/yr), Platinum ($115/yr) and Diamond (starting a $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 are worth a close look. They 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 accident assistance and medical expenses incurred during a diving vacation at the same limits. That might be important for someone whose primary insurance doesn’t cover accidents outside the U.S. If a hospital demands a cash deposit or settlement prior to leaving, AIGAssist will advance funds to cover 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 sickness, 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 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 decompression 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) covers ambulance services only, including air, 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 only dive locally, you don’t need trip interruption coverage offered by most top plans and a can look to more basic plans. However, if you fly off to distant, venues and want generous benefits, consider DiveAssure Gold & Platinum and DSI v upgraded DiveAssure Diamond) .

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 & 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 to traditional travel insurance benefits in your dive policy, consider the upgraded DiveAssure Diamond plan.

If you have a medical condition that could result in trip cancellation, you may desire DAN Preferred, one of the NAUI Deluxe Dive and Travel Individual Plans, and upgraded DiveAssure Diamond v DiveSafe).

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, occasionally with unsatisfactory outcomes, although this often was the result of insured divers not following specifically stated policy requirements. Dive insurers are businesses and the insured is expected to honor his obligations under a policy. By the way, if your primary carrier is Medicare, you are not covered for accidents outside the country.

Don't get caught diving naked.

DAN - http://www.diversalertnetwork.org/insurance/plans.asp
PADI - http://www.diveinsurance.com/dp/DP-index.htm
DiveSafe - http://www.divesafeinsurance.com
NAUI - https://insurance.nauiservicesgroup.com
DiveAssure - http://www.diveassure.com/new/usa/

© Doc Vikingo 2006
Reprinted by permission of Undercurrent

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