Accident and Rescue Insurance Tips — Part One

(Update 2016, this article is under heavy revision. While most of it is accurate, please verify before basing any financial decisions on our information. I’m bringing this up to the front per the start of a new ski touring season here in the northern hemisphere. Avoid adding hurt to your hurt; be sure you have the appropriate rescue and medical coverage for the countries you’ll be skiing in.)

To begin this article I had a few paragraphs on the health insurance situation here in the United States. That’s in flux now and too confusing to cover in brief, so I deleted those grafs. Main point in regard to the backcountry travel and rescue insurance options covered below, is be sure you have some sort of accident-medical insurance that’ll handle your expenses AFTER the rescue. (Note, if you are truly indigent and have no medical insurance, contrary to worldwide mythology about the satanic U.S. you will not be turned away for emergency treatment and you’ll probably have your medical care paid for by the indigent care programs that many states have. Also note that those 64 years and older here in the U.S. are of course eligible for Medicaid, which is indeed the “one payer” medical insurance system that many would like to see extended to our entire population.)

Beyond your medical insurance, if you’re a backcountry recreator you need to be sure an injury and rescue isn’t going to bankrupt you. That’s what this article is about.

(Note, some rescue services are not technically “insurance” companies but rather provide a “service” and offer “benefits.” In this blog post, I use the term “insurance” loosely as a lay term of art for any service that you pay an up-front fee for in return for emergent services or possible later expense coverage.)

In our opinion the best general accident/medical insurance for traveling is that offered by Travel Guard as part of their trip insurance. Someone in our family had a major medical problem a few years ago. Travel Guard flew him back home first-class, and paid most of our medical expenses not covered by our medical insurance. Caveats with Travel Guard:

1.) Travel Guard only covers you while you’re traveling, according to the time period you specify when you purchase.
2.) After an injury or during illness, you must visit a doctor while you are traveling. Wait ’til you get home, and no coverage!
3.) Study the fine print and if necessary purchase the “extreme sports” rider, otherwise you may not be covered for skiing and climbing.
4.) Travel insurance is not cheap.
5.) We never buy travel insurance bundled with tickets, as doing so involves too many variables. Better to get the tickets first, then go to Travel Guard website and shop. You can get Travel Guard for an automobile trip but doing so is confusing as they’re set up for air travel.
6.) Some rescue expenses are included in the basic policy; read fine print and be careful not to throw money away by over-insuring yourself.

If you buy tickets with a credit card, you may have some limited medical coverage. As near as I can tell this only applies when you’re actually on the conveyance you paid for, and is so limited in scope (as well as not being primary insurance) as to be of little to no value. I actually attempted to use my credit card medical coverage once, and had zero success.

So, what about specific Accident and Rescue Insurance in addition to travel insurance?

Rescue in the U.S. and Canada is free, it’s usually a government service. But once you are transferred to an ambulance, then let the financial games begin. Rescue in Europe is not free, and rescue in 3rd or 2nd world countries is likely to involve expensive private services such as aircraft, not to mention bribes and such. You could even be asked to pay up-front. As in “DAME tu tarjeta de crédito, gringo!” which translates to (friend, use that good hand to hand me your credit card, then we’ll bandage the bad one!).

You can acquire rescue insurance or a “rescue benefit program” a number of ways. Beware, some of these are limited and lame — study the fine print like your wallet depended on it — because it does. For example, be aware that very little if any of this stuff covers the cost of a backcountry search. It covers the cost of rescue for a person or persons in a known situation and location.

1.) Travel Guard coverage, which of course only works for traveling. Study the fine print when purchasing and make sure it’s what you need. Beware of limitations but this can likely be all you need when combined with an alpine club membership that’ll take care of European rescue. As mentioned above, we’ve had good experiences with Travel Guard so long as we adhered to the fine print.

2.) Alpine club memberships.

American Alpine Club (AAC) has a member’s benefit program that they tout as “Protect yourself with $12,500 of rescue coverage.” Last time we looked at the fine print, $7,500 of that money is only available if somehow your rescue is “by or under the direction of Global Rescue personnel.”

It’s confusing.

In a _first world_ country, any astute backcountry traveler needing a rescue is going to call or otherwise contact the local authorities first who are the legal directors and commanders of any rescue. For example, in Europe you’re going to call their emergency phone number (is it 112?), or your guide is going to radio SAR directly. Again, you’ll need a club membership to be covered for that, otherwise you may be billed possibly huge amounts of money. In the U.S. and Canada, where rescue is nearly always free, you’re going to call 911 or even make a direct call to your SAR friends and the hospital helicopter service (or use something like a SPOT, which will result in their call center doing the same process of contacting local authorities).

BUT, if you’re in a third or second world country or in doubt about who to call for rescue, the best procedure is to contact the Global Rescue phone number first. Program their number into your satphone or DeLorme inReach, and test. In our opinion, having a 2-way comms device for this is mandatory. Global Rescue appears to agree. Thus, forget the SPOT device and carry either a satphone or inReach.

Adding to the confusion, the AAC website implies their coverage only applies if you are doing “human powered” activities. Does that pertain to Global Rescue? Or, does that mean the AAC rescue insurance of $5,000 is only for human powered activities?

Answer is that the coverage you receive through AAC is very inexpensive compared to direct coverage purchased from Global Rescue, but does have some limitations. Mainly, that you need to be engaged in a land based human powered activity (e.g., a kayak accident is not covered).

Thus, if your Global Rescue is acquired as part of AAC membership, one would assume that if you were in an automobile accident while doing a remote approach drive to a climb, say on a 4×4 trail, you don’t get any benefits? Further, apparently you’re not covered if you’re in an accident while riding a snowmobile, helicopter or other motorized conveyance, common situations for backcountry skiers. Also, be aware that the $7,500 provided by AAC membership can be minimal, I’d advise anyone to supplement with additional coverage (AAC gives a 5% discount on that).

Global Rescue gets mixed reviews. Even their example rescues on their website are mixed. For example, they describe a mission in Alaska they claim as a success, but as far as we know the same rescue would have occurred if the Alaskan authorities had been contacted, and Global Rescue had not been involved. Also, Global Rescue may require you stick perfectly to their fine print. From what I gather, that includes them hiring the helicopter — and you needing to be bad enough off TO REQUIRE IN-PATIENT HOSPITALIZATION. In other words, they’re not going to help you unless you’re so hurt or sick you need at least one night in the hospital. (More on this below.) Also know that Global Rescue does not organize or pay for searches, they deal with rescue. Further, their maximum rescue budget is $500,000, and much less than that for the transport of “mortal remains.” Their fine print is here for a direct purchase of Global Rescue, we are unclear as to whether any fine print is available for the specific AAC agreement with Global Rescue.

For example, let’s say you dislocate a shoulder and you’re in the middle of nowhere, three days walk from safety and you can’t carry a pack. Your injury doesn’t require hospitalization. In that case, it is possible Global Rescue (AAC or direct purchase) will not help you (though it sounds like they give benefit of the doubt, see comments below). Instead, you may need some other form of rescue insurance.

More about Global Rescue’s party line: “Global Rescue is not an insurance company – we do not reimburse members at a later date for costs incurred. We are a membership organization and provide upfront services only, not reimbursement… As a service provider, unlike insurance, Global Rescue or one of our contracted providers must perform the rescue. In order for this to happen, we must be contacted and a request placed for our services.”

In other words, if Global Rescue decides you need a helicopter, they hire it and pay for it. That’s why unless they are contacted first and “direct” your rescue, you’re not going to get anything out of them except a phone conversation. For example, let’s say you trigger a rescue using your SPOT device. The GEOS center that receives and acts on SPOT alerts is going to be the first “coordinator” of your emergency. This obviates any financial or other benefit you could receive from Global Rescue. Again, part of using Global Rescue is the pretty much mandatory requirement of a 2-way communication.

As of 2016 here are some of the the summarized “Transport Rules” available on the Global Rescue (GR) website. We’ve heard they’re fairly liberal in interpreting their rules. Nonetheless, as you can see they have broad discretion as they’re the ones to determine the situation after you describe it using your 2-way communication device. My notes notes in parenthesis:

• Hospitalized or in need of hospitalization more than 100 miles from home. (Meaning this is absolutely useless for those of us living in mountain towns and climbing or skiing local)
• Field Rescue services will provide transport to the nearest appropriate facility if the member’s condition requires hospitalization or is likely to cause serious permanent injury or death if they are unable to get to a hospital. (Gives broad powers of interpretation to GR, which they clearly need, but could result in your being refused service.)
• Country where patient is hospitalized must be able to safely accommodate Global Rescue aircraft, ground or sea transport. (Again, could be problematic, Antarctica?).
• If the member is able to safely fly commercially with a medical escort, Global Rescue will make all necessary arrangements for this alternative
• All services must be arranged and provided by Global Rescue. (The big gotcha, call them first using satellite comms or you’re out of luck.)
• Individual members are limited to two (2) transports per year. (Reasonable, but be aware of this, luck happens.)
• Family membership transports are limited to (1) transport each for a common accident or two (2) transports in aggregate
• Members who become ill on cruise ships must disembark at an accessible medical facility or port. (Please define ‘cruise ship.’)

The other $5,000 part of the AAC “benefit” is a “Domestic Rescue Insurance Policy.” You can only claim this after a rescue in the United States. Since most U.S. rescue is free, this benefit is of limited value though it could come in handy if your rescue involved a private party, or could perhaps be invoked to help SAR recoup some expenses. If you did need to hire a private aircraft for a rescue, $5,000 is a mere pittance in comparison to what you might end up owing a helicopter service. Again, beware the fine print, especially the need for you to be “Certified by a licensed medical professional to require evacuation to prevent serious imminent bodily harm, injury or death.” I’m not sure what that means. You break your leg, you call 911. Where in that process are you “certified!?”

Again, the tried and true way to avoid rescue costs in Western Europe is to purchase a membership in any of the major alpine clubs. To do so in English, use the UK website for the Austrian Alpine Club. Main thing is that while all the alpine clubs including AAC reciprocate hut discounts, you need a European club membership to have their rescue insurance.

Beware of over-insuring yourself. For example, if you are ski touring in Europe and have a European alpine club membership, you might choose to not buy other forms of rescue insurance, though you might consider travel insurance accident coverage as well.

WARNING: If you have multiple insurance policies, know that if you require reimbursement for an insured expense, they don’t all pay at once. The process can take hours of work and you may not see results for months or literally years. The gotcha is that the companies will attempt to point fingers and claim they are not the “primary insurer” and ask for proof that you’ve made a claim against primary insurer first. You can end up going in circles with this, while financing your expenses with a credit card loan. To prevent such problems, Travel Guard for example is specific about whether you’re buying “primary” insurance or not. Check and be sure your best insurance is your primary insurance, so you’ll get reimbursed quickly.

3.) Bundled with your purchase of SPOT or other personal beacon device.

Here I refer to the infamous $12.95 a year appendage you can purchase when you buy a SPOT. So much fine print and limitations this is obviously just a scam to drop coin in SPOT’s pocket. As I’ve written before, offering this cheapens SPOT’s otherwise good name. Can also be bought as stand-alone, if you’re looking for a way to waste money. Instead, cover yourself with Global Rescue and-or your travel insurance.

4.) Bought stand-alone from https://www.globalrescue.com/,
This is the same Global Rescue we covered above, that’s offered as part of an AAC membership. It’s expensive, with a few mixed reviews, but when used correctly for the right situations (and you’ve purchased a high enough level of coverage) this outfit is functional. Not necessary for U.S., Canada or western Europe, but might be what you need if you’re traveling in third or second world. Short term available, but beware of overlap and conflict with normal travel insurance. Remember you’ll need a 2-way satellite comms device and that this is a rescue and medical consultation service, they don’t do searches.

Conclusion: Covering yourself for rescue expenses reimbursement is a complicated endeavor. You can easily throw money away. One incorrect phone call or ignorance of fine-print can result in you receiving no benefits from “insurance,” financial or otherwise. Nonetheless if at all possible always cover yourself with rescue insurance if you’re mountaineering in a country without free rescue.

See Part Two – Accident Insurance. And please folks, all comments appreciated as I’m certain many of you know way more about this stuff than I do.