USA Follows Spain and Global Tourism Hubs as Medical Claims Abroad Expose Costly Tourist Risks

Written By: Ankita Neogi Khan

Ankita Neogi Khan

With over 15 years of experience in digital media, I bring a strong foundation in language, journalism, and storytelling to travel reporting. A graduate in English (Honours) from Presidency College with a Master's in Journalism and Mass Communication from the University of Calcutta, I began my career as a content curator before transitioning into travel journalism. I specialise in aviation, tourism trends, destination news, and industry insights, combining meticulous research, accuracy, and compelling storytelling to deliver credible, engaging, and insightful content for a global audience.

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September 13, 2026 12:04 GMT+5:30

International holidays can carry an unexpected financial risk when illness or injury requires treatment overseas. New travel-insurance data shows that medical incidents account for most travel-insurance assistance, with the United States standing out for unusually expensive claims.

UNESPA analysed 172,654 travel-insurance incidents during 2025. More than half, or 51%, involved illness or hospitalisation, while accidents accounted for another 22.1%. Overall, roughly three in four incidents were health-related.

Spain generated the largest share of incidents at 29.3%, followed by Thailand at 6.2%, the US at 6% and Indonesia at 5.4%. However, frequency tells only part of the story. North America produced just 12% of incidents but 24.3% of insurance payments, largely because of the United States.

That contrast changes how travellers should read the data. Some destinations generate more claims because millions visit them. Others produce fewer claims but far higher bills when something goes wrong.

Six Destinations Reveal Different Risks

Share of incidents in UNESPA’s 2025 dataset. Turkey and Egypt appear in other official travel-health datasets but are not among the leading destinations in this particular insurance ranking.

USA Brings The Highest Financial Exposure

The United States presents the clearest warning about the cost of medical treatment abroad. It generated 6% of travel-insurance incidents in the UNESPA analysis. Yet US-related claims accounted for 14.7% of total payments.

That gap is significant. The US therefore produces a much greater financial burden than its incident share alone suggests.

The wider regional data reinforces the point. North America represented 12% of insurance incidents but 24.3% of payments. UNESPA attributes much of that disparity to incidents occurring in the US.

Individual claims can become enormous. Recent travel-insurance data recorded a £391,221 claim in the US after a traveller suffered injuries to both knees. Another fractured-leg case reached £280,288, including surgery and repatriation.

These are exceptional claims rather than typical bills. Nevertheless, they demonstrate the potential severity of a serious medical emergency.

The US also has a major private-healthcare component. Travellers cannot assume their domestic health policy will cover every overseas expense.

Consequently, visitors should prioritise a high medical-cover limit, emergency assistance and medical-repatriation protection before travelling.

Thailand Combines Road And Tropical Risks

Thailand creates a very different claims profile. Its 6.2% share of travel-insurance incidents placed it second in UNESPA’s 2025 destination analysis.

Road accidents are a particularly important concern. The CDC says Thailand records approximately 20,000 motor-vehicle deaths every year. Around three in four motor-vehicle deaths involve motorcycles or scooters.

That matters for international visitors because motorbikes are widely used by tourists. The combination of unfamiliar roads, limited riding experience and high motorcycle exposure can produce serious injuries.

A recent insurance example illustrates the potential financial impact. A motorcycle accident in Thailand generated a £101,374 claim, according to Multitrip data.

Thailand also presents infectious-disease risks. UK government surveillance recorded 96 imported dengue cases linked to Thailand in 2024, the highest figure among Southeast Asian destinations in that dataset.

The CDC also identifies dengue, chikungunya and Zika among relevant mosquito-borne diseases for travellers.

Thailand therefore requires travellers to think beyond conventional hospital cover. Motorbike use, adventure activities, infectious diseases and evacuation all deserve attention.

Spain Generates The Largest Claim Volume

Spain is the biggest outlier in terms of claim frequency. UNESPA found that 29.3% of travel-insurance incidents occurred in Spain during 2025. Spain also represented 20.9% of total insurance payments.

However, the figure should not be interpreted as evidence that Spain is unusually dangerous.

Spain welcomed 96.8 million international tourists during 2025, according to the country’s National Statistics Institute. International arrivals increased 3.2% from the previous year.

The sheer scale of tourism helps explain why Spain generates such a high number of insurance incidents.

Health problems are often relatively ordinary. Gastrointestinal illness, dehydration, falls and existing medical conditions can all result in treatment.

Recent insurance data recorded a £17,450 appendicitis claim in Spain and a £7,267 dehydration claim.

UK surveillance provides another useful indicator. Spain accounted for 268 travel-associated gastrointestinal infections in 2024, representing 10.4% of cases where travel information was available.

Importantly, the UK Health Security Agency warns that these figures are not adjusted for the number of travellers visiting each country. They should therefore not be treated as a direct measure of individual travel risk.

For Spain, the central story is therefore tourism scale rather than exceptional danger.

Turkey Shows The Weight Of Everyday Illness

Turkey provides an important counterpoint because gastrointestinal illness features strongly in official travel-associated infection data.

UKHSA recorded 417 travel-associated gastrointestinal infections linked to Turkey in 2024. That represented 16.2% of cases with known travel information, the highest proportion among the countries listed.

Spain followed with 268 cases, while Egypt recorded 175. Thailand accounted for 77 and Indonesia for 50.

These figures need careful interpretation. They are surveillance figures rather than insurance claims. They also do not account for the number of travellers visiting each destination.

Nevertheless, they demonstrate an important travel-health reality. Medical claims are not always caused by dramatic accidents.

Foodborne illness, dehydration and infections can also require doctors, diagnostic tests, medication or hospital observation.

Turkey’s large resort sector makes this especially relevant during the warmer months. Visitors can spend long periods outdoors while coping with heat, unfamiliar food and changes in routine.

Travellers should therefore ensure their insurance covers outpatient treatment as well as hospitalisation.

Indonesia Adds Remote Medical Challenges

Indonesia recorded 5.4% of travel-insurance incidents in UNESPA’s 2025 analysis. That placed it fourth among the leading destinations in the dataset.

Bali provides important context for the country’s exposure. The island welcomed 6,948,754 international visitors during 2025, up 9.72% from 2024.

A large tourism base naturally creates a sizeable pool of potential medical incidents. However, Indonesia also presents a distinctive geographical challenge.

The archipelago’s islands have very different levels of healthcare access. A serious injury in a major tourism centre may be easier to manage than one occurring in a remote area.

Dengue adds another concern. UKHSA recorded 73 imported dengue cases associated with Indonesia in 2024.

Scooter accidents and water-sport injuries can further increase exposure for leisure travellers.

The insurance priority is therefore broader than basic hospital treatment. Travellers should examine medical evacuation, motorbike conditions and adventure-sport exclusions.

Egypt Highlights Food And Heat Risks

Egypt does not appear among the leading destinations in the UNESPA 2025 insurance ranking. However, it features prominently in official travel-health surveillance.

UKHSA recorded 175 travel-associated gastrointestinal infections linked to Egypt in 2024, representing 6.8% of reported cases with travel information.

That placed Egypt behind Turkey, Spain and India in the dataset.

Again, the figures do not measure individual traveller risk. They also do not represent insurance claims.

They do, however, underline the importance of gastrointestinal illness as a practical travel-health issue.

Egypt’s climate creates another consideration. Tourists visiting archaeological sites can spend several hours outdoors in intense heat. Dehydration can become particularly problematic when combined with physical exertion.

Resort holidays bring a different exposure profile. Swimming, water activities and extended sun exposure can create additional medical needs.

Travellers should consequently consider heat management, food and water precautions and adequate medical cover.

Medical Problems Usually Drive Claims

The destination data become more meaningful when viewed alongside the wider claims picture.

UNESPA found that illness and hospitalisation represented 51% of all travel-insurance incidents in 2025. Accidents represented another 22.1%. Delayed journeys accounted for 7.9%, while cancellations represented 6%.

The figures demonstrate why travellers should not focus exclusively on spectacular accidents.

Routine illness remains the dominant source of assistance.

Multitrip’s separate 2025 claims analysis reached a similar conclusion. Medical expenses represented 43% of all claims among its UK customers. Fractures and broken bones accounted for 34% of medical assistance cases, while internal illnesses represented 33%.

The two datasets use different methodologies and should not be directly combined. However, both point towards the same broad industry pattern.

Medical treatment is the central travel-insurance exposure.

Claim Frequency Does Not Equal Risk

The numbers also reveal why destination rankings need context.

This distinction is essential for responsible travel journalism.

A destination with 50 million visitors will naturally generate more absolute incidents than one receiving two million visitors.

Conversely, a country with expensive healthcare can generate fewer claims but much higher payouts.

The US versus Spain comparison demonstrates this particularly well. Spain accounted for nearly five times the incident share of the US. Yet the US represented 14.7% of payments, compared with Spain’s 20.9%.

The financial severity of individual incidents therefore matters as much as their frequency.

Insurance Needs To Match The Holiday

Travellers should choose cover according to the itinerary rather than simply selecting the cheapest policy.

Driving conditions deserve particular attention.

A policy may cover motorcycle injuries only when the traveller holds the required licence, wears appropriate protective equipment and complies with local laws.

Adventure activities can carry similar restrictions.

Travellers should therefore read exclusions before departure rather than after an accident.

Evacuation Can Become The Biggest Bill

Medical evacuation remains one of the most overlooked parts of travel protection.

UNESPA found that repatriation represented only 1.9% of incidents, yet individual cases could involve substantial expenditure. One repatriation from Tanzania cost €25,750, while another from Malta cost €19,600.

The low frequency can therefore disguise the potential severity.

Remote destinations create particular exposure. Indonesia’s island geography and Thailand’s dispersed tourist areas can make specialist treatment more complicated.

Travellers should check whether their policy covers air ambulance transport, emergency relocation and medically supervised repatriation.

Official Advice Still Matters Most

Insurance cannot replace sensible preparation.

Travellers should check government health advice before departure and understand the healthcare environment at their destination.

The CDC recommends appropriate precautions for Thailand, including avoiding unsafe motorcycle use and using helmets where motorbike travel cannot be avoided.

UK government guidance also stresses the importance of suitable insurance for overseas treatment and repatriation.

Travellers should keep their insurer’s emergency number accessible. They should also retain medical receipts, prescriptions and hospital documentation.

Where possible, the insurer’s assistance team should be contacted before non-emergency treatment.

The Data Point To A Clear Travel Lesson

The latest evidence does not show that travellers should avoid the United States, Thailand, Spain, Turkey, Indonesia or Egypt.

Instead, it reveals that medical risk changes dramatically between destinations.

Spain generates the greatest volume of insurance incidents in the latest UNESPA dataset. The US creates a disproportionate financial burden. Thailand combines road trauma with infectious-disease exposure, while Indonesia adds geographical challenges around medical access. Turkey and Egypt demonstrate how gastrointestinal illness can become a significant travel-health issue.

The broader data are equally revealing. More than half of travel-insurance incidents in the UNESPA study involved illness or hospitalisation, while another 22.1% involved accidents.

For travellers, the smartest response is not to avoid popular destinations. It is to prepare for the risks that actually accompany the trip.

That means checking medical limits, evacuation protection, activity exclusions and driving conditions before departure. It also means using official health guidance and taking practical precautions during the holiday.

The destination may change, but the principle remains constant: a well-prepared traveller is far better positioned when an unexpected medical bill arrives.