Do travellers really need £1 million of travel medical insurance cover?

Most UK travel insurance policies now set a minimum of about £1 million for emergency medical expenses, with ceilings running as high as £25 million on some products. That sounds like far more cover than any holiday could ever need — until a real medical evacuation, or a serious hospital admission abroad, pushes a single claim past six figures.

What a decade of quotes has looked like

Back in 2016, a comparison of UK travel insurance quotes on Compare the Market — covering standard and winter-sports policies for both US and EU trips — found that medical cover of £10-15 million was already the norm across most policies, regardless of Defaqto star rating, and one policy on the market offered unlimited medical cover. Set against that, per-incident treatment costs compared at the time (sourced from AXA data, as reported in 2016) averaged roughly £15,900 in the US, £7,300 in Singapore and £5,900 in Greece for common claims such as an ear infection, gastroenteritis or a straightforward broken bone. Even a serious fall requiring emergency surgery in the US was estimated at the time to cost in the region of £150,000 — a fraction of the tens of millions on offer.

Why the ceiling has kept rising anyway

If routine claims were so far below the headline limits, the obvious question is why insurers haven't quietly scaled cover back since. Real claims data explains it. The Association of British Insurers (ABI) reports that medical expenses are among the most common travel insurance claims, and its records include a fractured leg treated in the US that cost £280,288, and a knee tendon injury requiring surgery and repatriation from the US that reached £391,221. The ABI has also recorded at least one settled claim that broke £1 million outright, for a policyholder who needed emergency hospital treatment in the US followed by repatriation home. Figures like these, not marketing headroom, are why £1 million is now treated as a floor rather than a ceiling.

The flight home is often the bigger bill

Travellers tend to assume the hospital bill is the expensive part; the flight home can cost just as much, or more. A private, medically escorted air ambulance to the UK runs to roughly £10,500 from Italy, £19,000 from Spain, £49,500 from the US, £75,000 from South Africa, £89,000 from the Philippines and £94,500 from Brazil, according to 2026 industry cost guides. More broadly, long-haul repatriations typically cost £60,000-£120,000, and complex, critical-care transfers from outside Europe can exceed £200,000. Compare that with a 2016 estimate for a helicopter lift off a ski slope — roughly £75 a minute of flying time at the time — and it is the long-haul repatriation bill, not the mountain rescue, that has grown into the bigger risk.

A serious hospital bill and a repatriation flight can each run into six figures on their own — together, they are exactly how a claim crosses £1 million.

The US hospital bill, on its own

Even without a flight home, US treatment alone can be enough to exhaust a modest policy. A broken bone requiring surgery in the US typically costs $18,000-$35,000 once emergency care, anaesthesia and follow-up are included, and a complex fracture needing multiple procedures can run past $60,000. Cover guides aimed at US visitors now recommend a minimum of $500,000, rising to $1 million for older travellers, given the higher likelihood of a cardiac or stroke event that alone can cross $200,000 — and none of that includes getting home afterwards.

So is £1 million overkill?

For most short trips, yes, in the sense that it will sit unused. Realistic per-incident costs for common ailments in Europe remain in the low thousands, much as they were in 2016, and a £1 million ceiling is not what a routine claim needs. But that figure was never really set for routine claims. It exists for the specific, if rare, combination of a serious injury, treatment in an expensive healthcare system and a medically escorted flight home — a combination that shows up repeatedly in real settled claims, and is the reason cover levels seen a decade ago have, if anything, been matched rather than scaled back today.

• Check that the medical limit explicitly includes repatriation as a separate benefit, not just hospital treatment.
• Confirm winter sports or other higher-risk activities are covered by default, or added, before travelling.
• Note the policy excess separately from the headline cover limit — it applies to every claim regardless of size.
• For US and Canada trips specifically, look for medical cover of at least $500,000-$1 million.
• Disclose any pre-existing medical condition; undisclosed conditions are the most common reason claims are refused.

Frequently asked questions