Initially, I wanted to write a casual blog post about travel insurance for scuba divers with a few tips to let you pick the right plan for you. As I started to do research, contacting hyperbaric chambers, emergency services, and health insurance companies, I discovered more to it than I could ever imagine. While I will always be a diving insurance advocate, I wanted to share my findings. And because it would be impossible to evaluate every country health system and everyone’s personal situation, I hope that through my own situation, you can check how it works in your case by following the same steps.
Sure, you could cumulate all sorts of insurance plans without bothering too much and hope for the best in case something happens. But don’t you want to know? OK, let’s dive into the complex world of emergency services and health insurances.
Diving insurance 101: what does it usually include?
As scuba divers, we are taught, very early on, safety and emergency procedures. While scuba diving is generally safe when we mindfully apply them, we can’t ignore the risky nature of our favourite sport.
My intention is not to be overdramatic, but scuba diving, like any other sport involving swimming, often appears on the list of the most dangerous sports in the world in terms of yearly casualties. But you know what? So does soccer or even cheerleading! While nothing beats the base jumping accident rate, avoiding going beyond your training and maintaining a good level of fitness will usually keep you safe while diving.
Unfortunately, while reading DAN annual reports, even if most diving casualties have clearly identified causes, there is still about 5% of accidents we can’t explain. This is why we all need diving insurance.
In most cases, the risks involve drowning, a heart attack or DCI (decompression illnesses) that come in many forms (pulmonary overpressure, air embolism, skin bends, etc.). In this case, medical evacuation, sometimes remote at sea, and emergency treatment such as hyperbaric chambers are required without delay. We also need to think about a potential hospitalisation and/or repatriation when abroad.
However, beyond our personal health, remember we don’t scuba dive alone. Involuntarily you could cause personal or material damage to another diver underwater, on the boat or at the dive centre. Hence third-party liability insurance can save you from a legal nightmare.
Finally, scuba diving means travelling for most of us, so we need to consider aspects most travel insurances would bring regarding international assistance in your language, cancellation or interruption costs, luggage insurance, etc.
The current pandemic of COVID-19 brought another layer of complexity. You need to double-check what is actually covered in terms of testings, medical care, quarantine, or repatriation if you’ve tested positive. It’s essential as now some countries require such insurance to enter their territory.
The surprising effect of the pandemic for us, scuba divers, was the discovery or rediscovery of our local waters. I had scuba dived in France before, but never so frequently. I recently started studying in detail what would happen in case of a diving emergency cost-wise in my own country and in the EU as member states have an agreement on health insurance.
The example of a diving emergency in France
From an international perspective, I know France’s health system is often looked at as one of the best in the world, and many fantasise about it as totally free. Well, hum, not really. For my non-French resident readers, please be aware that for every 1,000€ I earn, I pay 220€ of charges to benefit from the “Sécurité Sociale” in France, which by the way doesn’t cover 100% of my medical expenses and doesn’t even include income tax.
This being said, when I researched the potential costs of a diving emergency in France, especially a DCI when hyperbaric treatment is needed, I was positively shocked by how well I was covered and how affordable the whole thing would be.
In case of a diving emergency at sea in France, we need to call the CROSS (VHS channel 16 or phone number 196) to coordinate the evacuation by boat/helicopter/ambulance to the nearest hospital equipped with a hyperbaric chamber (32 locations in metropolitan France).
Most of the time, the SNSM (Société Nationale des Sauveteurs en Mer), a non-profit organisation run by volunteers, will be called to send one of its intervention boats. They have 214 stations all along France coastline. The volunteers usually live within 15 minutes of their station to be ready to board as fast as possible and go through intensive training all year long. They have my greatest admiration for the work they do.
In case of complex access to the location of the emergency, the helicopters of the “gendarmerie” (military police forces), “SDIS” (firemen), “SMUR” (hospital ambulances) or even the French Navy can come to the rescue. Now, wait for it; all of this, whether you are a French citizen, a French resident, an EU citizen or even from anywhere else in the world, will be free of charge.
The CROSS Méditerranée near Toulon coordinates between 100 and 200 diving emergencies per year in the Mediterranean sea. Their objective is to manage the emergency under 3 hours. The casualties remain relatively low, with 3 for 94 coordinated diving emergencies in 2020.
Once at the hospital, whatever the treatment required, a “day hospital treatment” is 170€ even if you need to go to the hyperbaric chamber for as long as 7 hours for the most severe diving accidents. Of this, French residents get 80% paid off by social security; then, if you need to stay, hospitalisation is charged at 20€ a day (you don’t get a private room at this price, though). This is why most people in France have top-up insurance, I do, to be covered for the remaining cost (and get a private room at the hospital).
Note about the NHS in the UK
As I have lived for 2 years in Scotland, I wanted to check if what works with social security in France works with NHS too in the UK. The main difference between the two countries is that in France, we pay first and get the money back after, in the UK, as long as you remain with the public GP surgeries and hospitals, you don’t pay anything upfront.
Search and rescue in the UK works similarly; it will be free of charge. The UK also has a volunteer-run organisation to save people at sea, similar to the SNSM, the RNLI (Royal National Lifeboat Institution).
Hyperbaric chamber treatment is free of charge with the NHS for UK residents. But as I was warned by DDRC in Plymouth, non-residents would face an amount of more than £10,000. So if you live outside of the UK and dream about wreck diving in Scapa Flow, you’d better make sure you are fully insured.
Note about the European Health Insurance card
EU citizens can all request an EHIC card from their respective national health bodies. As I’m looking forward to spending some time in Spain soon, I asked for mine recently and discovered you have to renew it every 3 years.
However, if the card allows you to have your health expenses covered by your health insurance of your country of origin in the EU, the reference fare used will be the ones used in your country of residence. If there is a big difference, and this is the case for me as the reference fares are super low in France, the advantage of the EHIC card can be limited. I can’t do without travel insurance, even in the EU. But if this is the other way around for you, then make sure you have it!
Please note as the UK left the EU officially as of 2020, UK residents can’t apply to the EHIC card anymore. Make sure to have travel insurance when going to EU countries.
How am I covered for scuba diving with my collection of insurances?
This enlightening information of what a diving emergency would cost me in France motivated me to look in the fine print of all the insurance contracts I’m holding. And I got quite a few surprises. Of course, the devil is in the details.
Here are all the insurances that cover me from a health and legal point of view:
- National social security
- Top-up health insurance
- Home insurance
- 2 premium credit cards
- Scuba diving insurance (DAN Europe)
I summed up in the following table the different levels of cover I get from these insurance policies (click on the image to see it bigger). I highlighted in green which one is offering the best cover in each case.
You can download the template and do the same exercise for yourself.
It took many long reading sessions of my contracts and a couple of phone calls to pinpoint precisely how everything was working. Here are the most interesting findings I made:
- Contrary to what I initially believed, all my insurance contracts cover some of my scuba diving activities. However, there are exceptions such as my top-up insurance that covers it when I’m in France but not abroad, or my credit card insurance which want me to either use the services of a professional dive centre (make sense!) or limit my depth to 30 m (this sucks).
- While all insurances (but one of my credit card) covers 100% of the actual costs of any repatriation, the main difference is how well they cover the health expenses and hospitalisations. The maximum amount goes from 11,000€ to 155,000€ and kudos to DAN Europe for covering 100% of the actual costs. Some countries like the US and Australia are infamous for their skyrocketing healthcare costs, so don’t gamble there!
- Another big surprise was the amount covered in case of a third-party liability issue; the maximum amount covered goes from 25,000€ to 4,6 million € (you read correctly), and this is coming from my home insurance, and yes, even abroad!
- Something shocking was the cover for the search and rescue costs. Skiers are insured for this but if you are into ocean sports, forget about it? I mean, I understand in Europe, rescue at sea will be free of charge, but this is definitely not the case outside. Fortunately, I have my diving insurance for this.
- Finally, as you should be aware, the devil is in the fine print of an insurance contract. Make sure to go to the end and read the common exclusions. I found a few interesting things such as sports competitions, pregnancy, cyclones, earthquakes or volcanic eruptions (have you noticed some of the most exciting scuba diving destinations are volcanic islands?). Don’t hesitate to read twice and to call to get an explanation in doubt.
By doing this exercise, I realised my second premium credit card (that I have mainly for air miles) changed its travel insurance conditions this year. As it’s not as interesting as it used to be, I decided to downgrade to the level below. I can keep cumulating miles this way, but with a minimum of expenses per year on the card, I won’t pay for it. As a result, I save 165€ per year by doing so (hey, that’s the equivalent cost of 4 to 5 dives!).
The benefits only specialised dive insurance can bring
Beyond money, the nature of diving risks involves specialised knowledge that not all doctors have. Relying on an organisation whose medical consultants are diving medicine experts to coordinate your treatment, even remotely, can have a tremendous impact on how you will recover.
This is why I have been a member of DAN Europe for 10 years. Luckily, I have never had to use their services, but I’m happy that my money, in the meantime, is funding medical research to improve the health and safety of fellow scuba divers. I also know that even if I have a simple question related, for instance, to a new medication and the potential effect it could have when diving, I can contact them 24/7, not only in case of an emergency. This has never been easier thanks to their new app, which replaces now the former plastic cards.
My two cents? I’m just scuba diving too often, deep quite often, to let any accident that could ever happen to me being managed by generalists.
I hope this article will clarify some interrogations you might have had about subscribing to diving insurance. If you still have questions, don’t hesitate to leave a comment. Unfortunately, I can’t evaluate personal situations, but I’ll do my best to point you in the right direction. You can also share your findings for your country; it could help a fellow diver who will read this article after you.
- Dr Andreas Kauert, Hyperbaric department, Nice Hospital (CHU)
- Mr Jean-Luc Fiorina, SNSM Sanary-sur-Mer
- Mr Olivier Drevon, CROSS Méditerranée
- Dr Doug Watts, Hyperbaric chamber, DDRC Plymouth
Photo credits : Pierre Paoli & Juliette Simier – courtesy of SNSM
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