The only cure for hiccups on holiday

IF YOUR digital camera is stolen on holiday in the US you are likely to be down pounds 500, and if you weren't insured, your holiday is probably ruined. If you have a heart attack and require surgery it could cost pounds 50,000, and without cover, you could be ruined.

While many people take out travel insurance primarily to cover their valuables, the medical section of the policy is by far the most important. The Association of British Insurers says only one in four claims made under a travel policy are for medical expenses but they account for half of travel insurers' total claims costs.

Columbus, a travel insurer, recently had a claim from a policyholder who suffered appendicitis in the US. The treatment involved consultations with a doctor and more than a week in hospital; a new air ticket also had to be bought as the man was forced to miss his return flight to the UK. The total cost was pounds 8,900.

This sort of claim is fairly common, but medical treatment abroad can become far more complicated and expensive. Options Travel Insurance services dealt with an emergency call this summer from a man who who broke his neck while in the jungle. Inter Group Claims, Options' assistance firm, despatched an air ambulance which made a night landing in a jungle clearing, and the injured man was airlifted back to a hospital in Glasgow. The claims bill came to pounds 35, 000.

Most travel policies, however, could cope with far larger claims. The minimum amount of medical cover you should look for is pounds 2m, though no claim has gone over pounds 1m. Most policies will also require you to pay the first pounds 35 on a medical claim and will have a strict list of exclusions, notably pre-existing conditions, and pregnancy after 28 weeks.

Some of the most crucial things need to be considered before you travel. First, if you have a pre-existing condition, such as coronary heart disease, you must be honest when taking out the cover. Insurers will not think twice about turning down a claim if you have been selective with the truth.

If you do have a serious pre-existing condition, you may be refused cover. However, some insurers have developed sophisticated fact-finding procedures that enable them to be more flexible, although premiums can be expensive.

Dr Jo Slesenger, a GP and medical claims expert, lists some of the precautions that people with medical conditions should take before travelling: make a list of the generic names of all the drugs you are on; take details of any operations you have had; and get your medical history translated into the appropriate foreign language.

Nearly all policies provide a 24-hour helpline that will go through to the insurer's medical assistance company in the UK. In the case of an emergency, it is usually the hospital that will call the helpline to confirm the patient is insured. The assistance company will then liaise with the doctors to make sure the treatment is suitable. If not, the patient may be moved to another hospital, or repatriated. Hospitalisation and travel costs are usually paid directly by the insurer.

In the case of less serious conditions, such as a sore throat or sickness, the policyholder can call the helpline to get basic medical advice and details of the nearest outpatient clinic. The policyholder would usually be expected to pay for both drugs and treatment and then claim when back in the UK. It is vital to keep all receipts and doctors' notes, and to present them with the claim.

Tim Collison is editor of `Professional Broking' magazine.