Following on from Broken in Bansko (Bulgaria 2017)
What is this post/article? – a recounting of a snowboard holiday in Bulgaria where I broke my collarbone into 3 pieces, and how I dealt with the practical side of seeking medical attention in a foreign country and getting home using my travel insurance.
What you’ll need to know to begin with – the About me and Travel Insurance Guru sections of this website will help to give you some context; basically I have 7 years experience working in the emergency travel insurance industry.
What you’ll know at the end – a fair amount about how travel insurance works in the context of ski/snowboard holidays and what you can expect in terms of their assistance in these situations.
Why it’s relevant to you – if you are unfortunate enough to require medical attention whilst on a ski/snowboard holiday then this article may provide guidance and/or reassurance. Please feel free to contact me if you have any questions about what your travel insurance provider should be helping you with.
I hope this article comes in useful for some of you:
…that panicked feeling as you suddenly realise that half of your left collarbone is sticking out at a weird angle, and it moves when you touch it…so what the hell happens now?
Getting down off the mountain:
Thankfully for me, my good friends Aaron and Mystery Dan came skiing around the corner to witness the aftermath of my collision and Aaron was able to diagnose me on the spot (he’d broken his collarbone during a season in Utah after deciding that backflips should be executed at every possible opportunity; unfortunately it was only a matter of time before he did one backflip too many). Mystery Dan looked on with the appropriate ‘oh bugger’ face and kindly escorted my slowly limping carcass down the hill as Aaron set off to alert ski patrol.
I used my right arm to hold my injured left arm tight to my chest as best I could. Bansko ski patrol were very good and the skidoo met me just a short while later. Even though the patroller spoke very limited English he quickly secured my injured arm in a makeshift sling and sped me down to the medical centre at the base area. At least me and Aaron got a free skidoo ride.
At the medical centre:
Judging by the queue of sorry-looking individuals waiting to be triaged at the medical centre, it seems that this particular Friday 13th was unlucky for quite a few other people in Bansko too.
Theo, James and Jack rocked up half-way through my 45 min wait to hear the crash story, offer their condolences, and once they realised I wasn’t bleeding to death, take the piss a little bit (see video below). The medical centre secretary spoke pretty good English and was happily chatting away to us, explaining that the previous patient had suffered a deep laceration right down to the bone, so I should consider myself lucky; I guess she had a point really.
Practical travel insurance advice: Medical centre staff will ask if you have travel insurance, but unless there is need for serious inpatient treatment then it’s much simpler to just pay the costs on a credit/debit card and claim them back later (my costs for a consultation, X-rays, medications and a sling were about £90 GBP). Involving your travel insurance assistance company will normally just cause extra stress even if they act quickly and efficiently (which may not always be the case). Be aware that you’ll generally be speaking to an ‘assistance company’ who specialise in providing medical and logistical assistance and who act on behalf of your actual insurance company.
You’ll spend a minimum of 15-20 mins on the phone just getting through to them and setting up a case. They’ll be checking:
all your personal details/trip dates/hotel info/flight details/home address etc
if any drugs or alcohol were involved (obvious tip: say “NO”)
if you were on or off piste (and if you were off piste then were you with a qualified instructor; say “YES”, but be aware they will then want that person’s name and proof of qualification)
if you were wearing protective gear (not always mandatory but depends on your terms and conditions)
if another person was involved in the accident (referred to as a ‘3rd party’; if so then they will want that person’s insurance details to try and ‘recover’ costs from them)
Once the call is finished they’ll still need to confirm with your insurer that your policy is active and that you have valid winter sports cover, they’ll also need to check your policy’s specific winter sports terms and conditions since they do vary from policy to policy.
Even if all this happens relatively quickly (and the person you spoke to hasn’t been sidetracked by another emergency call) then a Guarantee of Payment will need to be sent to the medical centre. Be aware that some medical centres will simply refuse to accept your assistance/insurance company’s guarantee and will demand direct payment from you, so you might as well not have bothered going through all of that in the first place!
In my case the X-rays confirmed the obvious, a badly broken and dislocated collarbone; they strapped my shoulders to keep them straight, gave me a receipt, a printed medical report, a prescription for Diclofenac, and advised me to see a doctor when I returned to the UK. And that was that, all done in about an hour and 20 mins after I’d hobbled through the door.
Dealing with the travel insurance company:
I called my travel insurance company later that evening to let them know about the incident, but since I know how the process works it was quite a straightforward call. Essentially:
They take details (as listed above), open a case on their system and request that you email them a picture of your medical report and receipt from the medical centre (easily done with your smartphone).
Their medical team (aviation medicine specialists) will review the report and advise what needs to happen next. In my case it was simply that an extra seat be organised for me on my original flight so that no one could sit next to me and accidentally bash my injured arm. They agreed with the Bulgarian doctor that I could wait to be reviewed in the UK to determine if surgical repair was necessary.
NOTE: doctors aren’t all saints, especially ones who practice in ski resorts and are clued up on how travel insurance works. I’ve dealt with plenty of private doctors (in Austria and France) who swear blind that immediate surgery is critical to prevent long term neurological damage…and guess what; they can operate on you tomorrow in their private clinic just around the corner because the public hospital 2 hours away won’t operate. Why won’t the public hospital operate? Normally because the public hospital medics don’t think the injury needs immediate surgery, and that it can wait for you to return to your home country for surgical review. In these instances try and remain calm and listen to what the assistance company medical team have to say about it; they aren’t just trying to save the insurance company’s money, they can get in serious trouble if they don’t put your medical well-being first, so they won’t put your health at risk to cut costs.
You also need to be aware that the call centre staff are simultaneously dealing with hundreds of other emergencies from all over the globe. So whilst your broken collarbone has ruined your holiday and is a pretty major event in your life, remember that there are plenty of other people in much worse situations, and in way more remote locations. The screaming mother of a 10-year-old suffering from acute appendicitis somewhere in the middle of a jungle in Borneo is going to be higher on the medical team’s agenda; just accept it and roll with any minor delays. That being said, this shouldn’t prevent you from being given the assistance you require.
The assistance company will then begin organising the extra seat for you on your original flight, but you need to be aware that:
There may not be any seats left on your original flight; in which case you can discuss with the assistance company whether you’re happy to risk a few bumps on your original flight home, or whether you want them to book you two seats on a new flight. This could mean delaying your return home until seats are available though.
The assistance company will normally have to fill in a special medical information report (MEDIF) and apply for medical clearance with the airline. Each airline has its own set of medical clearance rules/guidelines and the assistance company can do nothing to change/avoid these. More well-known airlines tend to (and I use this term very loosely) have more efficient medical clearance departments, British Airways for example will normally grant medical clearance within 2 to 4 hours of the MEDIF being submitted, unless it’s a hugely complicated medical scenario. Other airlines however can take anywhere from 72 hours to 7 days!
It can also be difficult to actually book the extra seat(s) needed until medical clearance has been officially granted, so that one remaining seat might just get snapped up whilst the medical clearance element is being processed. Although seats can sometimes be held awaiting medical clearance, this again depends on the airline and how their online booking system works. The Emirates system for example is notorious for freeing up seats just one hour after they have been put on hold; which has caused more than one complete customer meltdown in my experience.
Included in this process should also be a request for luggage assistance to be offered to you at check-in. It would have been a huge pain in the arse to deal with both my carry-on bag and a big, heavy snowboard bag with just one arm at the airport; since the normal process is for you to take your snowboard bag to an oversize luggage area once you have finished checking in. (Getting the bags from the taxi to the check-in desk is another matter however).
Thankfully I flew with BA and my medical clearance was granted relatively swiftly:
The assistance company should then offer to organise your transfers both abroad and in the UK. Mine did but I already had pre-booked transfers, so it seemed pointless for new ones to be organised. Whilst I did consider how nice it would be to have my own private taxi for the 3-hour road trip from Bansko to Sofia airport, I also knew that I ran the risk of the assistance company not managing to organise it appropriately and thus me missing my flight altogether. In my situation it really wasn’t worth the hassle when all I wanted to do was get home ASAP and be assessed for possible surgery.
So that was that, an extra seat and luggage assistance had been organised on my original flight back home, all sorted right? Well, almost.
The day of the flight:
I’d originally asked Aaron if he wouldn’t mind taking my board bag back with him since he’d rented his skis in Bansko and didn’t have any gear to take home. But since I’d already paid extra for the baggage on my flight it seemed better just to try and deal with it, even if I did only have one good working arm. It turned out to be a very simple matter in the end; getting the hotel concierge to explain to the transfer driver that I’d be very grateful if he could take my board bag to check-in at Sofia airport. He was cool with that, top bloke.
Having checked-in and been given great assistance by the BA staff to get my board bag to the oversize area, I had just two final hurdles before boarding the flight:
My bloody snowboard jacket; bright sunshine streaming into Sofia airport that day was great, but it was also bloody warm and so I now found myself trying to juggle both my carry-on bag and a large snowboard jacket with just one arm. The solution seemed simple, grab a small plastic bag from somewhere and stuff the jacket into it, easy. Well…whilst I found most Bulgarians to be pleasant enough folks, the people working in the airport that day were pretty damn moody to say the least (whether they were bonafide Bulgarians I’m not sure). I went to the clothes store, the newsagent and the pharmacy (Sofia airport is small, so there is only one of each) and very politely asked for a small plastic bag. The response from all three individuals was an emotionless stare combined with a grunted one-syllable refusal and minimal eye-contact. Even when I made sad-eyed gestures towards my incapacitated limb hoping for a sign of pity, their reactions remained unchanged. This might help to explain why Bulgaria isn’t on my list of places to visit again any time soon. Accidental injuries I can cope with, but rudeness should not be tolerated! I am English after all (even if our long history as blood-stained imperialist genocidal maniacs does cause me a fair amount of mental anguish now and then).
Airport security; did I mention that putting on shoes and tying up your laces with a badly broken collarbone is like a combination of yoga mixed with a wickedly tricky game of Twister? Well it is, and that’s fine when you have the time and space in a hotel room to work it out. But when you’re being herded through airport security and ‘the big thug-looking one’ glares at you holding a stick with a swab on it, you just ram your feet back into your shoes as best you can and work it out later, laces be damned. I can imagine my dishevelled appearance must have drawn more than one or two raised eyebrows as I shuffled off to the departure lounge that day; just waiting for someone to ask me, “Is there someone who looks after you?”
Have you had a similar experience? Are you laid up in a foreign country right now and not sure how your travel insurance should be helping you?
Please feel free to ask me any questions about the general travel insurance process and what your expectations should be. Even if I can simply offer you peace of mind that you are being treated appropriately.