The Insurer Refuses or Delays a Repatriation: What Can You Do?

Two separate problems: the emergency and the dispute

When an insurer or an assistance company refuses or delays a repatriation, the family faces two problems that need different answers. The first is the emergency: the patient is in a hospital, and care must continue. The second is the dispute: the refusal can be challenged, but this takes time. Do not mix the two. The patient's care comes first, the dispute comes after.

In the emergency: what to do now

• Ask for the decision and its reasons. Ask the assistance company to explain why the repatriation is refused or delayed, and to confirm the decision in writing, with the clause of the contract on which it relies.
• Ask the doctors to talk. Ask the assistance doctor to speak directly with the treating physician. Many disagreements come from missing information, and a direct conversation often clears them.
• Give the missing elements. A refusal or a delay is sometimes due to an incomplete file. Supply the medical reports, the imaging and the documents requested.
• Keep a logbook. Note the date, the time, the name of every person spoken to and the case number. This record is precious later.
• Do not stop the care. The treating physicians' priority is the patient. If the patient's condition requires a transfer that the insurer does not support, the family may decide to organize it, on medical advice.

If the family organizes the transfer itself

If the family decides to advance the cost of a repatriation, keep every document: the medical reports that justify the transfer, the written quote, the invoices and the proof of payment. We can provide a written quote before departure and the medical elements of the file. These documents will support a reimbursement request. Nothing guarantees a reimbursement, but without these documents it is very difficult.

The State's exceptional help, in France

In France, the consulate can inform the family and consider the measures to take, but the costs remain the patient's responsibility. The Ministry of Foreign Affairs explains that in an emergency with a proven life-threatening risk, it can exceptionally organize a repatriation even without insurance. The person is informed in advance of the budget terms, the Ministry advances the sum, and the person signs a commitment to reimburse the State. A rescheduling of the repayments, or a partial or total remission, can be requested from the tax authorities.

After the emergency: challenging the refusal

Once the patient is safe, you can challenge the decision. In France, the steps are generally these:

• 1. A written complaint. Write to the insurer's complaints department, preferably by registered letter or the channel indicated in the contract. State the facts, the contract, the guarantee you invoke and the decision you challenge, and attach the supporting documents.
• 2. Wait for the reply. You can go further after two months of the complaint, whether or not you have received a reply, or earlier if the reply does not satisfy you.
• 3. The insurance ombudsman. La Médiation de l'Assurance can be contacted free of charge once the complaint has been sent, within one year, provided no court action has been started. It generally proposes a solution within about three months. The proposal is not binding on the consumer.
• 4. The court. If the dispute continues, the matter can be brought before a court. Insurance claims are generally subject to a limitation period of two years from the event, so do not wait too long.

The rules differ from one country to another. Many countries have an insurance ombudsman or a consumer authority, and your insurer's reply should indicate the recourse available.

How we can help

We cannot replace a lawyer, but we can help you build a solid file: the medical reports, the written quote, the timeline of the case and the justification of the means of transport chosen. If you do not know whether the insurer's decision is justified, call us: our coordinating physician can tell you whether the medical situation called for a transfer.

To go further, read whether your travel insurance covers an air ambulance, what a bank card really covers and who decides on a medical repatriation.

General information only — not personalized medical, legal or insurance advice. Your insurance contract and the treating physician's opinion prevail in your situation.