What to do when you need treatment somewhere unfamiliar

Insurance is bought calmly and used urgently. The steps that decide whether a claim is paid happen in the first hour, when nobody is reading policy documents.

Knowing the sequence in advance is the whole of the preparation.

The order of operations

1. Get treatment if the situation is urgent. No policy penalises emergency care taken first
2. Call the insurer's emergency line as soon as practicable — this is a 24-hour number, not the office
3. Let them direct you where the situation allows; many insurers have arrangements with specific facilities
4. Get pre-authorisation for anything not immediately urgent
5. Keep everything — reports, receipts, prescriptions, discharge notes
6. Ask for records in writing before leaving the facility

Step two is where most claim problems originate. Insurers frequently require notification within a defined period, and can decline or reduce a claim notified late, even for treatment that was entirely covered.

Step four is the companion error. Paying for non-urgent treatment and claiming afterwards feels reasonable and is often outside the policy — the call before treatment is what makes the difference, not the receipt after it.

Direct billing versus reimbursement

Two ways a policy pays, with very different cash consequences.

Direct billing — the insurer settles with the facility. No money from you, but usually only at facilities within the network and usually needing authorisation first.

Reimbursement — you pay and claim back. Works anywhere, and requires you to have the funds available.

The practical implication for anyone travelling or living abroad: a serious hospital admission on a reimbursement basis can require a large payment upfront, and some facilities will ask for a deposit or a guarantee before admitting a foreign patient at all.

This is exactly what the emergency line exists to solve. An insurer can often issue a guarantee of payment directly to the hospital, which removes the deposit problem — but only if they are contacted.

Documentation that gets claims paid

Collect while you are there. Obtaining it later from abroad is difficult and sometimes impossible:

• Itemised invoices, not a total
• The medical report, with diagnosis
• Proof of payment — the receipt, not just the invoice
• Prescriptions and pharmacy receipts
• Referral letters where treatment was referred
• A police report where an accident or theft is involved
• Translations where the insurer requires them

The first is worth insisting on. A single total figure is frequently rejected as insufficient, because the insurer must assess each item against the policy — and going back for a breakdown months later, from another country, is a slow process.

Repatriation

The benefit most likely to be needed in a genuinely serious situation, and the one least understood.

• It covers medical transport home, which for a stretcher case or an air ambulance is extremely expensive
• It is almost always the insurer's decision, not the patient's, and requires their authorisation
• Medical escort may be included where required
• Repatriation of remains is a separate benefit and should be checked
• It is not covered by public health systems, as noted elsewhere in this material

The second point matters for families. Arranging repatriation independently and claiming afterwards will usually not be reimbursed, so the insurer must be involved in the decision even when the family is certain of what is needed.

Preparation that takes ten minutes

• Save the emergency number offline in your phone, and on paper
• Save the policy number the same way
• Carry a card stating blood type, allergies, conditions and medications
• Note an emergency contact reachable across time zones
• Know your consulate's location and number
• Tell a travelling companion where all of this is

The last is the point of the exercise. In the situations where this matters most, you may not be the person making the calls — so the information has to be findable by somebody else.

Frequently asked questions