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New judgment on the foreign travel health insurance

Under certain conditions, a travel health insurance company can refuse to pay for the medical expenses of the insured person incurred abroad. A judgment of the district court Munich confirms this. In principle, however, international travel health insurance is an important basic protection for all travelers.
 
No holidays without foreign travel health insurance

The travel health insurance is not obligated to provide benefits in every case of illness of the insured person abroad. The Munich district court has ruled in a recent ruling (AZ 273 C 32/13): The tourist must bear the burden of proof that and what he is ill. Because only if the insured can prove the prerequisites for the benefit case, the travel health insurance is actually in the obligation to pay. In general, someone who falls ill abroad should inform the insurance center of their insurance according to the insurance conditions. This then accompanies the medical treatment abroad and organizes, if necessary, a return transport to Germany.

A case for the foreign health insurance?

The policyholder, who filed a lawsuit against his foreign health insurer, contracted stomach and stomach cramps on a trip to Cameroon. As a result of vomiting and diarrhea, he suffered a circulatory collapse. Relatives and acquaintances sent him to the local clinic, where he was hospitalized. The hospital charged him with discharge treatment costs of 3265.57 euros.

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Foreign travel health insurance only pays with verifiable diagnosis

The plaintiff later presented documents on the medicines and laboratory tests and the invoice. On the other hand, he was unable to provide any evidence of his illness, for example in the form of a doctor’s letter, a laboratory finding, ECG strips, ultrasound images, CT images or the like. Diagnosis is crucial for demonstrating the medical need for examinations and drug administration. Alternatively, either the relatives or the man himself – at the latest after improvement of his condition – the emergency call center of his insurance on the acute case of illness would have to put into the picture.

Important foreign travel health insurance

In principle, a travel health insurance covers an improved medical care when traveling and, for example, covers the costs of a return transport. In the EU area, the insurance coverage of the statutory health insurance applies, but even here, a foreign health insurance can be worthwhile. For example, certain treatments can be billed in the holiday country as a fee, which would have been refunded easily in Germany. In addition, vacationers in some EU countries may be treated as private patients and asked to pay. A foreign travel health insurance comes for such costs – if the acute illness can be proven.

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