Leggat Peter A, Leggat Frances W
School of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, Australia.
J Travel Med. 2002 Mar-Apr;9(2):59-65. doi: 10.2310/7060.2002.21444.
Little is known about travel insurance claims made by travelers returning from abroad. This study was designed to investigate travel insurance claims made by travelers from Australia, particularly examining demographic factors, type of travel insurance coverage, nature and duration of travel, when treatment was sought during travel or when the problem arose, use of emergency assistance, nature of claim, and claim outcome, including cost.
A random sample of approximately one in five claims reported during the period 1996 to 1998 to a major Australian travel insurance company were examined.
A total of 855 claims were examined, of which 42.6% (356/836) were made by male travelers and 57.1% (477/836) were made by female travelers. The majority of claimants were in the 55 years and over age groups (445/836, 53.2%). Medical and dental conditions accounted for 66.6% of claims (569/854), with the remainder associated with loss, theft, and damage (285/854, 33.4%). The most common medical conditions were respiratory (110/539, 20.4%), musculoskeletal (90/539, 16.7%), gastrointestinal (75/539, 13.9%), ear, nose, and throat (67/539, 12.4%), and dental conditions (39/539, 7.2%). Only one case of venous thrombosis was reported, secondary to a lower limb infection. Use of the travel insurance company's emergency telephone service was reported in 17.1% of claims (146/853). Almost two-thirds (559/853, 65.5%) of claims were fully accepted. Those who claimed medical treatment, assault, and theft were significantly more likely to have their claims accepted compared to those claiming dental conditions, cancellation, curtailment, loss and damage (chi2 = 127.78, df = 40, p <.00001). The majority of medical and dental conditions did not require further medical investigations (427/569, 75.0%). The mean cost of claim refunds was Australian dollars (AUD)991.31 (standard deviation [SD] 6 AUD5400.76) for males and AUD508.90 (SD 6 AUD1446.10) for females. Claims for assault, cancellation, and curtailment were significantly more expensive than other types of claims (Kruskal-Wallis one way analysis of variance [ANOVA]; chi2 = 106.87, df = 8, p <.00001). Claims for treatment of gastrointestinal, cerebrovascular, cardiovascular, musculoskeletal conditions, and pyrexias of unknown origin were significantly more expensive than other medical and dental claims (Kruskal-Wallis one way ANOVA; x2 = 61.68, df = 15, p <.00001).
This explorative study highlights the importance of travelers taking out appropriate travel insurance. Claims for medical and dental conditions represent the majority of travel insurance claims made by Australian travelers returning from abroad, although travel insurance also covers against such contingencies as loss, theft, and cancellation. The most common medical conditions claimed were respiratory, musculoskeletal, and gastrointestinal disorders. Travelers should be advised to take out appropriate travel insurance before departure overseas and to take care with preexisting medical and dental conditions, which may not be able to be claimed against travel insurance.
对于从国外归来的旅行者提出的旅行保险索赔情况,人们了解甚少。本研究旨在调查澳大利亚旅行者提出的旅行保险索赔,特别考察人口统计学因素、旅行保险覆盖类型、旅行性质和时长、在旅行期间寻求治疗的时间或问题出现的时间、紧急援助的使用情况、索赔性质以及索赔结果,包括费用。
对1996年至1998年期间向一家主要澳大利亚旅行保险公司报告的约五分之一的索赔进行随机抽样检查。
共检查了855项索赔,其中42.6%(356/836)由男性旅行者提出,57.1%(477/836)由女性旅行者提出。大多数索赔者年龄在55岁及以上(445/836,53.2%)。医疗和牙科状况占索赔的66.6%(569/854),其余与丢失、盗窃和损坏相关(285/854,33.4%)。最常见的医疗状况是呼吸系统疾病(110/539,20.4%)、肌肉骨骼疾病(90/539,16.7%)、胃肠道疾病(75/539,13.9%)、耳鼻喉疾病(67/539,12.4%)和牙科疾病(39/539,7.2%)。仅报告了1例因下肢感染继发的静脉血栓形成病例。17.1%的索赔(146/853)报告使用了旅行保险公司的紧急电话服务。近三分之二(559/853,65.5%)的索赔被完全接受。与索赔牙科疾病、取消、缩短行程、丢失和损坏的人相比,索赔医疗治疗、袭击和盗窃的人其索赔更有可能被接受(卡方检验=127.78,自由度=40,p<.00001)。大多数医疗和牙科状况不需要进一步的医学检查(427/569,75.0%)。男性索赔退款的平均费用为991.31澳元(标准差[SD]65400.76澳元),女性为508.90澳元(SD61446.10澳元)。袭击、取消和缩短行程的索赔比其他类型的索赔费用显著更高(克鲁斯卡尔-沃利斯单向方差分析[ANOVA];卡方检验=106.87,自由度=8,p<.00001)。胃肠道、脑血管、心血管、肌肉骨骼疾病以及不明原因发热的治疗索赔比其他医疗和牙科索赔费用显著更高(克鲁斯卡尔-沃利斯单向方差分析;x2=61.68,自由度=15,p<.00001)。
这项探索性研究强调了旅行者购买适当旅行保险的重要性。医疗和牙科状况的索赔占从国外归来的澳大利亚旅行者提出的旅行保险索赔的大部分,尽管旅行保险也涵盖诸如丢失、盗窃和取消等意外情况。索赔最常见的医疗状况是呼吸系统、肌肉骨骼和胃肠道疾病。应建议旅行者在出国前购买适当的旅行保险,并注意已有医疗和牙科状况,这些状况可能无法通过旅行保险索赔。