Treatment overseas v Repatriation – who decides?

Insurance companies have a duty of care to help ensure you receive appropriate and necessary medical treatment if you need it whilst travelling overseas.

If you have been injured or fall sick, the insurer will first and foremost determine if the policy responds to your claim.

If the insurer accepts liability for your claim, the decision on where you will be treated ultimately rests with the insurance company.

The insurer will decide if you can be treated locally, need to be evacuated or repatriated to Australia for treatment.

Lets look at each in turn.

Local treatment

Assuming adequate healthcare facilities exist, minor conditions can usually be treated wherever you are located.

This means once you are returned to good health, you can then continue your trip.

An example of this would be a bout of food poisoning or the flu.

Generally speaking, in the case of minor conditions, your insurance provider would be reasonably confident that you can receive appropriate treatment whilst overseas.  Once they have assurance that this course of action is appropriate, the insurer would compensate you for the cost of treatment you receive whilst overseas.  This usually means that you pay for the cost of treatment and submit a claim for reimbursement.

Evacuation and Repatriation

If you are seriously hurt or sick and appropriate medical facilities don’t exist where you are at the time, the insurer may look to evacuate or repatriate you.

Many countries have excellent health care facilities which are on par with those we enjoy here in Australia.  However, third world countries often do not have high quality medical facilities and your insurer will be concerned for your welfare in this case.

Similarly, if you are in a remote location, it may not be possible for you to receive appropriate medical treatment there.  In that case, your insurer will consider whether it is feasible to evacuate you to another country / region for treatment or repatriate you to Australia.

Repatriation is usually reserved for serious medical conditions such as those which require complex surgery and/or long periods of convalescence or treatment.  Repatriation is also considered in circumstances where continuation of the pre-planned trip is impossible due to the injury or illness.

In some cases, the patient is not medically able to travel and the insurer will then do their best to ensure appropriate medical treatment is provided in situ and until such time as the medical condition has stabilised so that it is medically safe for the patient to travel.

Let’s look at some examples.


If you are trekking in a remote location in Nepal and suffer altitude sickness, your insurer will most likely consider evacuating you to Kathmandu where you can be suitably treated for altitude sickness.  Following your return to good health, you should be able to continue your journey.

Similarly, if you are bitten by a dog in Laos, consideration will be given to whether you should be given post-exposure treatment for Rabies.  If so, it may be that you cannot receive the treatment in the location where the incident occurred.  Perhaps, there is no vaccine available or there is an insufficient quantity of the vaccine to ensure you have a full course of treatment.  In that case, you will need to be relocated so that treatment can be administered.  If you have a long trip planned with many forward bookings, it may be that the insurer elects to relocate you to Singapore or Thailand where appropriate treatment can be obtained following which you can continue to your trip.


If you are bitten by a shark whilst swimming off a remote South Pacific island and suffer serious injuries requiring surgical intervention and long term convalescence / ongoing treatment, your insurer will most likely look to repatriate you to Australia (assuming you are able to travel).

Similarly, if you suffer serious illness and are likely to need extensive and long term medical care, your insurer will assess whether or not you can be repatriated so you can be cared for by your own doctors and support network.

When an insurer decides to repatriate, your medical status will determine the most appropriate travel method.

So, what’s involved in the case of repatriation?

The method of repatriation will depend on a range of factors.  Determining how repatriation will occur primarily revolves around your medical condition and requirements for safe travel.

There are two types of repatriation:

  • Commercial repatriation; and
  • Air ambulance repatriation.

As these terms suggest, commercial repatriation occurs via commercial airlines.  Air ambulances are planes that have been fully equipped with medical equipment and crew to transport seriously ill patients by air.

Commercial repatriation

If your insurer decides to repatriate you via a commercial airline, this will be on one of the following bases:

  • Unescorted
  • With non-medical escort
  • With medical escort

Depending on your condition, you may be able to travel home on your own (unescorted).

Sometimes, you require a non-medical escort to accompany you.  This person will help you with your luggage and tend to your needs during transit (eg eating and using the bathroom).  A travelling companion or relative often acts as a non-medical escort.

If you are seriously ill or injured, it may be that you require a medical escort to ensure your safe return home.  This medical escort may be a nurse, two nurses or doctor.  It may also be that your medical condition requires a combination of medical professionals (eg a nurse and a doctor).

Your condition will also dictate the travel class used to repatriate you.

If you have a leg injury (eg broken or fractured bone), it is most likely you will require transit in Business Class with a lay flat seat.  This will allow you to elevate the leg and afford a greater level of comfort.

In more serious cases, provided an airline will carry you, it may be necessary for you to travel via stretcher.  If so, the airline will remove a number of seats to make room for a stretcher and the medical escort team to care for you during your flight.

Air ambulance

Sometimes an illness or injury means that the patient cannot be carried via commercial aircraft and/or that repatriation is urgent.  In this case, repatriation will occur via air ambulance.  If this is required, an ambulance and medical team with appropriate expertise will be engaged and flight plans logged for them to travel to you.  Once the medical crew is satisfied that you are medically stable for travel, they assume responsibility for your care and facilitate your return home for treatment in Australia.

In all cases, the decision on how to repatriate will be made by the insurance company following consultation with its own medical team and also the patient’s treating doctors.

If you have any questions about travel insurance, please don’t hesitate to contact us on 1300 819 888 or email




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