The Amazing Race 34, Episode 7

Domme (France) - Toulouse (France)

A case study in COVID-19, travel, and insurance

Master of ceremonies Phil Keoghan sends off the racers at the start of each season of The Amazing Race with the line, “Travel safe!” But what does that mean? And is it even possible?

My previous couple of columns prompted the e-mail message below from an online acquaintance. With their permission, I am sharing their story, not as a conclusionary parable but as food for thought:

I got COVID-19 in early September 2022, from a family member, when we arrived the same evening for a holiday together in Stockholm from two different directions — me from our home in Spain, and them from a week of hiking with a group in Norway.

I knew better. I shouldn’t have agreed to meet them right after they’d been with a group. That’s on me. I know that not all members of my family take the same precautions that I take.

I’d avoided the virus for two and a half years. I’d kept distance from some family members, so that they could continue their less-careful-than-mine social lives. I’d eaten inside a restaurant exactly three times, two of which were forced by conditions, and the third to allow a close friend to see their elderly parents, which had become a very rare occurrence since 2020, in a restaurant with very high ceilings, and a half-empty dining room with very widely spaced tables — all things that we knew in advance.

Thinking about real experiences like this with all their tensions, including especially within family and close-friend groups, may help prompt some of the uncomfortable conversations we need to have to avoid decisions we might regret. In my case it was a combination of wanting to schedule holiday time with my family and the practical logistics being such that doing it just then (despite knowing that they would be coming back from ten days traveling in a group) was much more economical than trying to do it in the other order. I knew the risk, and I chose it. I’ve forgiven them, and largely forgiven myself.

The rest of this story is about the travel insurance industry, which is probably responsible for a lot of avoidable cases of COVID-19 transmission.

We landed on September 7th in Stockholm. My family member already had minor symptoms. They knew that at least one person in their group had clearly been ill “with something” throughout the hiking trip.

A day or two into this trip, they heard from their close friend, with whom they had stayed throughout the trip, that their friend had received a positive COVID-19 diagnosis. We took my family member the following morning to a testing center in Stockholm (PCR results within eight hours, for the equivalent of about US$60) and confirmed their illness as well.

We had been sleeping in separate parts of the rented apartment in Stockholm, keeping windows open despite the cold outside temperatures, etc., but I had already been exposed in spite of that.

We were scheduled to fly out from Stockholm to our next destinations on September 13th, me to Germany, them back home to Spain. Starting on September 10th, I contacted American Express, from which I have a platinum “international currency card” which includes rather extraordinarily good insurance coverage. I also contacted my private medical insurance company (DKV) based in Spain.

I was in touch with two insurance companies. AmEx contracts with AXA for travel insurance; DKV contracts with something called ERGO or Euro Centre. It’s not clear to the traveller trying to get information or make a claim whether “ERGO” and “Euro Centre” are separate companies, or which does what. Both names occur, the traveller deals with both, and it’s a further part of the lack of clarity in dealing with travel insurance as to who, if anyone, might actually give binding answers in a timely fashion to allow the traveller to make sound risk management decisions about maybe-insurable events.

Neither AXA nor ERGO/Euro Centre could promptly confirm to me that, based on the situation, extending my hotel stay (which would be extremely expensive right at the end of high-season or just into shoulder season in Stockholm, when little lodging was available at short notice at any price) would be covered by either of their policies.

A very bright spot in all this is that the host of the AirBnB apartment we had rented in Stockholm was unbelievably flexible and responsive with us about enabling an extended stay - although of course we would have had to pay for it - if that’s what we would have decided, despite that it required her to find alternate lodging for a guest who was reserved for right after our stay. A truly great human being.

I spent the bulk of the next two days on the phone between AmEx, AXA, and ERGO/Euro Centre. I finally decided to fly as planned on September 13th, because I didn’t want to absorb the uncertainty of a potentially uncovered €3000 [approximately US$3000] travel extension expense.

I made this decision because neither insurance company gave me an answer to the straightforward question: “Given these facts, would the cost of extending my trip be covered?”

It should have been covered, but in typical insurance policy language (which gives immense wiggle room to these companies, who have sadly earned their negative reputations) it might not be covered if it wasn’t the case that I couldn’t travel.

In your most recent column, you suggested that travellers should “Consider travel insurance if you can find a plan that explicitly covers COVID-19 quarantine expenses if a self-test is positive.”

The AmEx/AXA insurance does explicitly cover “inability” to continue with travel plans “caused” by COVID-19. But “inability” and “caused” are left undefined in the text, and the customer service/support agents couldn’t/wouldn’t give a clear answer.

Back when the public law was that “you must not travel if you have COVID-19”, it would have been easy. I would have been officially prohibited from traveling. And these insurance policies would have covered the cost of extending my trip.

But that’s not what the law was in Stockholm or in Germany in mid-September 2022. I was absolutely permitted by both countries to travel, by ground and by air, to leave Sweden and to enter Germany.

I hated making that decision. It goes against some of my most basic programming: Do The Right Thing. But I also must take into account my own needs and resources. And to risk a €3000 loss, against governments being perfectly happy for us to travel sick, and insurance policies deliberately playing games with our health and sanity, I chose what I chose.

I wear FFP3 masks (a step above FFP2/N95 masks) everywhere when I’m around people, and all the more while travelling on that day. I hope that kept others safe from me. Certainly I saw a number of other people sniffling, coughing, etc, and not wearing masks that day.

So, I wasn’t happy about it, but I chose to travel while knowing I had this virus and was contagious.

With some effort, I arranged a hotel in Bremen, Germany where I could isolate myself until I tested negative, to avoid surely infecting the friend with whom I had planned to stay in Bremen, whose apartment just isn’t adequate for isolation.

The first hotel I called in Bremen, I told that I had the virus and I needed to isolate. They said they wouldn’t accept a guest who was infected.

To the next hotel I simply didn’t mention this fact, and they didn’t ask. I stayed there for nine nights, not allowing any service into my room, keeping to myself, masking any time I left the room, always leaving the window open, until I finally tested negative, then checked out. (It was possible to open the windows in my room, but only by asking the front desk for a key to unlock them, and promising not to fall out! Too many hotels, for perceived liability reasons, don’t allow opening windows at all. That’s not a good assessment of risk during this pandemic.)

One of the two insurance policies — the one through ERGO/Euro Centre (via DKV) — fairly promptly paid out their limit of €80/night for an isolation hotel. From the other, AmEx-AXA, I’m still awaiting any reply to the claim. (That claim was for the rest of the hotel balance, the PCR tests and stack of self-tests, and the other expenses that I wouldn’t have had if I hadn’t needed to isolate.)

To add insult to these injuries, I got a letter from AXA asking me to sign — on paper (though in the end they accepted a scan of a signature instead; that took three go-rounds to clarify) — a letter allowing them to coordinate benefits. AXA also sent a benefits coordination request to ERGO/Euro Centre.

ERGO/Euro Centre sent me a request to sign either that I had received (or was expecting to receive) benefits from another insurance policy, or that I had not received (and that I was not expecting to receive) such benefits. Being that I Didn’t Know, because None Of Them Would Give Me A Clear Answer, I responded asking them to clarify the question, re-stating the facts, and explaining the doubt that this caused me in attempting to fulfill their paperwork requirement. They only responded with another copy of the same useless document.

I complained to both companies, and I eventually received a note saying that the two insurance companies would coordinate with each other, and that the form wasn’t needed.

Which is of course how it should have been from the start. (But, as I said, I haven’t heard squat since then from AXA).

All the pre-trip planning you might try to do is pretty useless against lack of clarity in government rules around travel during the endemic phase of COVID-19, and the poor regulation of the insurance industry globally.

In my case, when I would get reimbursed was of little importance to me, just that I would eventually get reimbursed mattered. The insurance companies were unwilling to get me an answer soon enough to avoid me having to make the decision to travel while contagious. And throughout the whole experience I was in bureaucratic runaround nightmare hell, adding tremendous stress to what otherwise should have been merely an annoying, disappointing, physically unpleasant time.

The actual virus (the acute phase) was a minor event for me, but for at least three weeks afterwards it left me with very limited capacity to exert myself. Walking up stairs at faster than “slow” would leave me with a pounding headache. Even two full months later, the first time I got on my bicycle and actually pushed myself, a rather short steep bit which I didn’t take super-easy left me wrecked for the rest of the day, with my lungs feeling like I’d gone for a half-marathon run in sub-freezing temperature. (It was 20°C [68°F] and sunny that day.)

All the best, and I hope that my experience is helpful to others!

You might be tired of talk of COVID-19, and even more tired of having to think about it. I am too. But the unfortunate reality is that, as I’ve said before, if the COVID-19 pandemic is over, that’s only because COVID-19 has become endemic.

Travelling in a world in which COVID-19 is endemic doesn’t mean acting as though it didn’t exist, any more than travelling in places where malaria is endemic means ignoring it. I don’t want to get malaria or COVID-19. I have travelled in places where malaria was endemic, and when I did I thought about risks and took precautions to mitigate them. I’m travelling again despite endemic COVID-19, but not without thinking about risks and how to mitigate them.

It’s also unfortunate that, while we all might prefer a simple crib sheet of categorical do’s and don’ts, that doesn’t exist for COVID-19 any more than it does for malaria. There is no perfect prophylaxis against either. Travel where any such disease is endemic, which in the case of COVID-19 is now worldwide, carries inherent risks that can only partially be mitigated. Each of us has to make our own individual and ongoing choices about which risks to take.

I’m not a doctor, and even if I were, I couldn’t tell you what to do. What I can do, in my role as a travel advisor, is suggest issues and scenarios that you might want to consider in your travel planning, especially ones that you might not otherwise have thought about.

What I find so helpful in the case study above is that it exposes so many of these issues:

1. Family and friends, even intimates, may have different risk assessments and responses than we do. It’s natural to assume (or to hope) that family members and close friends will be following the same COVID-19 protocols that we have developed for ourselves, and that people we know pose less risk than strangers. But family and household experiences with COVID-19 have shown us that this is wishful thinking. Cohabitation is one of the most common routes of COVID-19 transmission, and family members are among the most common sources of infection. Like the narrator of the story above, I’ve taken greater risks for family gatherings in the last year, including travelling to an indoor funeral service, than I would have for other types of travel. But if we make that choice, we should be honest with ourselves and fair to others about the risks we choose to take.
   
   
2. “Self-quarantine” is easier said than done. Even at home, unless we live alone or have a very big house, it may be difficult to isolate ourselves from our housemates. On the road, it can be much harder. Few countries other than China have public quarantine facilities available, and having talked with people who have been living through the pandemic in China, I’m not sure I want to follow the Chinese government’s example of COVID-control measures. Before you leave on a trip, think about what you would do if, at any point on your planned journey, you or one of your travelling companions develops symptoms or tests positive for COVID-19.
   
   
3. Most people are kind, and most accommodation providers will try to help, up to a point. But (a) you can’t count on it, and (b) quarantine could be quite expensive even if it’s possible. If you don’t have insurance you are certain will cover that cost if it proves necessary (and you can almost never be sure of that), estimate and include the cost of quarantine self-insurance in your contingency budget. If you can’t afford to isolate yourself if you get infected and infectious, maybe you can’t afford to risk the trip.
   
   
4. Insurance companies are not your friends. They make money by denying claims, not by granting them. They make money by averaging out predictable risks, and they hate providing coverage for uncertain risks like COVID-19. You cannot expect that they will interpret ambiguous policy terms in your favor. As in this story, if quarantine is legally optional, it probably won’t be covered by insurance, even if it is recommended and your personal preference as The Right Thing To Do to protect others.
   
   
5. Overlapping insurance coverage is hard to avoid and harder to cope with if you have a claim. This is a case in which “belt and suspenders” is generally counterproductive, and at a minimum likely to delay payment. “Travel insurance”, including the insurance required or recommended by a tour operator or cruise line, may duplicate your existing medical insurance or national health coverage. You may have insurance you haven’t even thought about (until you have a claim) through your credit card or an organizational membership. This story of neither insurer being willing to pay in such a situation is quite typical. Once when my partner was injured and needed emergency surgery while studying abroad, neither the provider of the insurance the language school required, nor her HMO, was willing to pay until she complained about both companies to the office of the state insurance commissioner.

Have you gotten COVID-19 while travelling? What did you do? Please share your story in the comments or by e-mail.