Helicopter transport on vacation: Does health insurance pay in the event of an accident?

Verdict

Health insurance does not have to pay for rescue operations

A woman fell on vacation and the emergency doctor finally called the rescue helicopter. But the woman now has to pay the cost of the flight out of her own pocket.

A health insurance company does not have to pay for helicopter transport on vacation – unless it is absolutely medically necessary. This is what the Hessian State Social Court found.

The lawsuit was filed by a woman suffering from osteoporosis who broke a lumbar vertebra while on vacation in Austria while pushing her vehicle. After an ambulance with a doctor arrived at the scene of the accident, a helicopter was called in to take the woman to a hospital. The woman had to pay 6,200 euros for the transport. She then asked for this back from her health insurance company. She stated that the helicopter transport was medically necessary. If she had been transported by ambulance in impassable terrain, she would have risked paraplegia.

But the Hessian State Social Court denied the woman’s claim to reimbursement of costs. This only exists if the law of the country of residence – in this case Austria – provides for a corresponding claim or the requirements under German law are met.

According to Austrian law, rescue costs and transport to the valley are not reimbursed in the event of accidents occurring during sport or tourism. Only in the case of life-threatening injuries is there a right to a small flat rate. However, according to the court, there was no life-threatening situation.

According to the court, the eligibility requirements under German law were also not met. The German health insurance company only pays for transport abroad if it is medically necessary. However, the court was not convinced that the helicopter transport was medically necessary. It was of the opinion that transport by ambulance with appropriate safety measures would have been possible and sufficient. The health insurance company therefore does not have to reimburse the woman for the rescue costs.

The judgment is not final. However, the Hessian State Social Court did not allow an appeal.

Coverage in such cases is often provided by international travel health insurance that covers rescue and rescue costs – although this depends heavily on the respective tariff and the circumstances of the accident.

Most private accident insurance policies also cover the costs of search, rescue and recovery operations.