Lessons, Advice from a Physician – THISDAYLIVE

Nkechi Ilodibia

“Do you have insurance… or are you paying this bill yourself?”

The question hung in the air of a busy emergency ward in the United States of America, a simple routine question, especially necessary for visitors from other countries. The fluorescent lights were harsh, the lobby was busy and cold, and at the registration desk, clerks moved quickly as patients waited to be checked in and directed for care.

Mr Tayo looked away in silence, while Belama brought out his phone to give them his insurance details.

Both men arrived four days ago. Tayo, an Assistant Director with a Federal Parastatal, was on a business trip, while Belema was on a leisure trip. Both were experienced international travellers, so the logistics felt routine. Nothing could go wrong.

Unfortunately, on the fourth day, an inebriated driver crashed into their vehicle, leaving them at the mercy of fate. The impact left Tayo with rib injuries and Belema with a fractured shoulder, which required monitoring for possible surgery. They were rushed to the nearest hospital, and were both stabilised and admitted for further care and evaluation.

As discharge planning began, a patient financial counsellor visited each of them separately.

The question still remained the same: “Do you have health or travel insurance?”

Tayo’s conversation was straightforward and uncomfortable. With no insurance and insufficient personal funds to cover the bill which had already climbed into the tens of thousands of dollars, he was offered a formal repayment plan and asked to sign an undertaking before he could be cleared for discharge. This was supposed to be a simple trip as usual. He had never bothered about insurance before and never saw the need to.

Until this accident. Now, he was in debt and there was no way out.

But Belema?

That was a different form of complication.

Feeling some sense of relief, he reached out for his phone and pulled up his policy document. Every time he travelled to the U.S., he would purchase an insurance package that didn’t cost much but made him feel like he had ticked off all the right boxes. Belema prided himself on being a careful and responsible traveller. Insurances were for unforeseen situations such as this and he was adequately prepared.

So he thought.

He dialled the 24-hour emergency contact number, explained the accident, the hospital, and the shoulder fracture, and then asked how the insurer would assist. The response was brisk and procedural: pay out of pocket, retain all receipts, and submit a claims request upon return to Nigeria.

Belema was in a bind. He never anticipated thousands of dollars in emergency medical costs. He had assumed travel insurance would shield him from such burdens. That was the whole point of getting it in the first place. Yet, after a frustrating series of back-and-forth, nothing changed. Disheartened, he ended the call and returned to the financial counsellor, who presented the same repayment options offered to Tayo.

Both men were now trapped in the same hole, but at different entry point.

What neither of them fully understood before travelling is a reality many Nigerian travellers overlook: travel insurance is not always what it seems.

Tayo had not purchased a policy. He failed to take into cognizance the unpredictability of life’s accidents.

Belema, on the other hand, purchased a policy but did not ask the most important question: how does this policy actually work in an emergency?

Some policies require upfront payment with later reimbursement. Others offer direct hospital billing. Some have strict coverage ceilings that are rarely highlighted at the point of purchase.

Belema would only discover this later—while recuperating—that his policy had a reimbursement limit far below his actual medical expenses. He didn’t think it was necessary to inquire and get clarity about the policy he purchased before leaving Nigeria, hence, the insurance company never mentioned it.

Tayo, on the other hand, missed his official assignment and returned home with something heavier than pain: a hospital bill submitted to his office for settlement since the accident occurred while he was on official duty.

But it wasn’t all good news because during the last management meeting, a clear decision was made by the board that every business traveller was to get travel insurance or consult a Travel Physician before traveling. He had even looked up the price. Now, lying there, it felt painfully ironic that such a small expense could have spared him this crushing financial burden.

The Protection That Exists and the Gap That Persists

These stories may be fictional, but the reality it reflects is not. From Nigerian offices to emergency wards abroad, these situations happen more often than people realize; travellers without insurance, others who thought they were covered until reality proved otherwise, families left to face crushing hospital bills far from home because of the illness or death of a loved one, employers being overwhelmed to cover unexpected costs, and even visa statuses threatened because of unpaid debts.

What a lot of people don’t know is that travel insurance exists for moments like these. It’s a safety net for the unexpected medical emergencies, cancelled trips, lost luggage, delayed flights and many more of life’s unpredictabilities.

Travel insurance often costs just a fraction of the entire trip. Depending on the coverage, it can either pay hospitals directly or refund what you’ve already spent. Unfortunately, most people overlook it and ignore it until they are faced with situations similar to Belama and Tayo.

As Nigerians, we cannot claim to be intentional about our health while treating travel as an exception. Every journey, whether for business, leisure, or family, carries health risks. Firstly, you’re changing environments and cannot accurately predict how the climatic conditions or environmental hazards in the country would affect the body. Secondly, while nobody wishes for emergencies and tragedies in foreign countries like the one Tayo and Belema faced, it is often better to be prepared than sorry.

Leading insurance providers in Nigeria offer packages that cover medical and hospitalisation expenses, emergency medical evacuation, and, in the worst cases, repatriation of mortal remains. If Tayo had purchased a policy for less than ₦50,000, his hospital bills wouldn’t be weighing on him today, they would have been handled by the insurer.

When Insurance Becomes a Second Emergency

It is also often not enough to just purchase travel insurance without understanding the full benefits as well as its limitations. Some travellers get caught in situations like Belema experienced when his travel insurance failed to deliver as expected. Some policies require the travellers to pay for their treatments upfront, hold on to the receipts even in discomfort, and hope to be reimbursed later.

This reimbursement model characterises many travel insurance products available to Nigerian travellers today. There’s often an assumption that insurers will step in immediately and settle hospital bills. Instead, the process can place the burden on the traveller: pay first, document everything, recover, file a claim, and then wait.

Some policies, however, operate differently, with insurers directly guaranteeing payment to hospitals so the traveller can focus solely on recovery.

The second lesson can hit harder when travellers, in trying to process their claim, discover that the reimbursement cap on the policy purchased can sometimes be nowhere near enough to cover the cost of the emergency treatment received abroad. The information is always there in the fine print, but travellers often don’t read it closely, and so never think to question it. A lot of travellers fall into this category.

Every Nigerian traveller needs to pause and ask a few key questions before buying travel insurance: Will this policy pay hospitals directly, or will I have to pay first and seek reimbursement? What is the coverage limit, and will it realistically cover costs in my destination country? Is there a 24-hour emergency line, and do I know exactly where to find it?

And beyond insurance, there’s a bigger issue, which is the pre-travel health preparation. It shouldn’t stop at taking preventive drugs such as antimalarial or prophylactic antibiotics. It should include a full assessment of personal health risks, destination-specific concerns, and proper guidance on choosing the right travel health advisory that includes proper guidance on travel insurance.

If Belema had attended a pre-travel medical consultation, he would have left Nigeria far better prepared, both medically and in handling the administrative realities of travel insurance. The challenges we see in Nigeria’s travel space are not unsolvable. They simply demand more awareness from travellers and clearer guidance from health professionals who understand both sides.

This is exactly where the Nigerian Society of Travel Medicine (NSTM) comes in. It sits right at the point where health advice meets travel preparation. They are the professional body for certified travel medicine experts in Nigeria, and they make it easy to find travel physicians across different parts of the country who can properly guide you before you travel. A proper consultation means you don’t just pack your bags, you leave with real clarity, including what your travel insurance actually covers. These consultations ensure that every Nigerian who boards an international flight receives tailored travel advisories, including clear information on travel insurance options and coverage.

If you’re a Nigerian planning to travel, here’s the truth: buying insurance isn’t enough. You need to understand what you’ve actually bought. Know how it works before anything goes wrong. Save the emergency number on your phone ahead of time so you’re not searching for it when it matters most. And if you’re not sure what questions to ask, find a travel medicine physician who does and they will help you make sense of it.

Travel safe and stay healthy.

If you’re serious about doing things properly, start with the NSTM. You can avoid being a victim like Tayo and Belema with the right information from the right source.

Dr. Ilodibia is a Family Physician with a special interest in Travel Medicine and Public Health. She serves as President of the NSTM and is a Board Member of the Pan African Travel Medicine Federation. She can be reached via president@nstm.org.ng.