Travel Insurance: What It Actually Covers When Things Go Wrong

The four things travel insurance is actually for

Strip away the marketing and most policies pay out under four headings. Everything else is either bundled or borderline.

1. Medical treatment abroad. The point of travel insurance. A broken leg in Spain that needs an X-ray, a cast, and two follow-up appointments costs perhaps €800. A serious motorbike accident in Thailand can run to £40,000 by the time it's done. Insurance pays the hospital direct in most cases (sometimes after a deposit) and the cost-cap on a comprehensive policy is usually £5–10 million.
2. Medical evacuation. The expensive one. Flying a stabilised patient on a commercial flight with a medical escort costs £5,000–£20,000 depending on the route. An air ambulance with full life support and a critical-care nurse runs £25,000–£250,000+, with Antarctica and remote Africa at the high end. The Warnely medical evacuation cost dataset covers the band-by-band breakdown for the countries British and American travellers visit most.
3. Repatriation of remains. The least cheerful coverage line but a real one. A coffin and the documentation to fly a body home from overseas costs £5,000–£15,000 in 2026. No family wants to be making those arrangements in the middle of a crisis.
4. Cancellation and curtailment. The trip is cancelled because of a covered reason (illness, bereavement, jury service, redundancy in some policies, FCDO advisory changes in better policies). Insurance refunds the non-refundable portion of flights and accommodation.

Theft, lost baggage, delayed flights, and rental-car excess are bundled into most comprehensive policies but the limits are low: typically £1,500–£3,000 for lost baggage and £200–£500 per item. They are the parts of a policy that pay out small amounts often, rather than the parts that exist to keep you solvent.

What 'comprehensive' actually buys you

A comprehensive single-trip policy from a mainstream UK insurer in mid-2026 typically buys:

• Medical cover up to £5–10 million, including emergency dental.
• Repatriation, including medical escort.
• Cancellation up to £5,000.
• Baggage up to £2,500, single-item limit £300.
• Personal liability up to £2 million (mainly relevant if you injure someone or damage property).
• Sometimes: gadget cover, ski cover, golf cover, adventure-sports cover, missed-departure cover.

Annual multi-trip policies are about 30–50% cheaper if you take more than two trips a year and don't mind the trip-length limit (typically 31 or 45 days per trip).

US travellers buying through Travel Guard, Allianz, or World Nomads see equivalents in dollars, often with explicit air-ambulance and stateside-repatriation lines that UK policies bundle into 'medical evacuation'.

The exclusions that catch people out

Insurance pays out predictably; the unhappy cases are almost always exclusions. The ones we see most:

• Drugs and alcohol. Almost no policy covers an injury sustained while the policyholder was 'under the influence', and the definition is the insurer's, not the bar's. A motorbike accident after two beers has been disputed by every major insurer at some point. Sober up before you ride.
• Adventure activities. Standard cover includes hiking and snorkelling. It usually excludes paragliding, motorbike riding above 125cc, scuba diving below 30 metres, and white-water rafting above grade 3 unless you pay the adventure-sports upgrade. Check the schedule before, not after.
• Undeclared medical conditions. Insurance is voided if you didn't declare a relevant pre-existing condition. The big traps are blood-pressure medication, diabetes type 2, and any specialist appointment in the last two years. Declaring usually adds £15–£50 to the premium and protects everything.
• Travel against FCDO/State advice. UK insurers will not pay out for trips where the FCDO advises against all travel to the destination. US equivalents tie to State Department Level 4. Some insurers also exclude Level 3 ('reconsider travel'). Worth checking before you book a trip to a borderline country.
• Valuables left in checked baggage. Most policies explicitly exclude jewellery, laptops, cameras, and phones that go in the hold. Carry them on, or expect zero recovery if they vanish.
• Documents and money beyond a small float. Policies usually pay £200–£500 for emergency cash and a small documents allowance for the replacement passport. They do not cover the full value of crypto, watches, or anything held in physical form beyond the named limits.

What to do at the moment of the incident

Three steps decide whether a claim pays cleanly or grinds through dispute:

1. Call the 24-hour emergency line first. Every comprehensive policy has one, and they handle real-time triage. Going to A&E without ringing the insurer is the most common reason for a claim to be challenged.
2. File a police report for theft, regardless of how small. Most policies require a police reference number for any theft claim above £50–£100. The Warnely country guides at /guides carry the local police and tourist-police lines for every country.
3. Photograph everything and keep every receipt. Wreckage, scene, hospital paperwork, taxi to the hospital, every drug bought at the pharmacy. The insurer reimburses what is documented.

The piece travel insurance won't fix

A few risks travel insurance is genuinely not the right product for:

• Long-stay chronic medical care. If you become resident abroad or stay longer than the trip length, you need expat health insurance, which is a different product.
• Mental health crises. Most policies have hard caps on mental-health-related care, and many exclude pre-existing mental-health conditions outright. Check the schedule.
• Acts of war. Standard war exclusions apply in active conflict zones. The Warnely conflict-zone country guides flag these.
• Pandemic-related trip disruption beyond what is now contractually covered. Most insurers have settled coverage at 'medical care for a confirmed COVID infection' but exclude cancellation triggered solely by travel restrictions. Worth re-checking each year as policies tighten.

The single highest-leverage decision

Buy the policy the day you book the trip, not the day before you fly. Insurance bought between booking and departure covers cancellation events that happen in the intervening weeks (illness, bereavement, broken legs at home) which is often when claims actually arise. The premium is identical.

Then read the schedule. Twenty minutes spent before the trip is the difference between a paid claim and an argument.