Emergency Medical Claims Overtake Trip Cancellation as Top Travel Insurance Risk

Emergency medical claims became the most common travel insurance payout in 2024, edging ahead of trip cancellation for the first time in more than 10 years. Squaremouth's annual claims report, based on Tin Leg claims data, shows emergency medical at 27% of paid claims in 2024 compared with 26% for trip cancellation and 15% for travel delay.

The average emergency medical payout reached $1,654 in 2024, a 117% increase from $764 in 2022. Squaremouth also reports that the overall average payout across all claim types rose 37% in a single year, from $1,900 in 2023 to $2,609 in 2024.

The mismatch between what most travelers buy and what a medical emergency abroad costs is large. A basic plan with $25,000 in medical coverage would not have fully covered Squaremouth's highest 2024 emergency medical claim of $61,976, and a serious medical evacuation can easily push total claim costs well past basic plan limits.

Emergency medical claims climbed from second place in 2022 to the top of Squaremouth's travel insurance claims breakdown in 2024. Travel delay claims dropped over that period, and emergency medical payouts grew faster than any other category.

In 2022, travel delay was the most common claim type at 24.69% of paid claims, while emergency medical accounted for 21.73% with an average payout of $764. By 2023, trip cancellation had moved to first at 25%, and emergency medical climbed to second at 24% with an average payout of $1,456. The 2024 data completed the reversal: emergency medical reached 27% of paid claims, edging out trip cancellation at 26%.

Squaremouth's 2022 to 2024 Tin Leg data shows emergency medical, trip cancellation and travel delay account for the largest share of paid claims, with emergency medical and trip cancellation also driving the highest average payouts among common claim types.

The 2024 trip cancellation average of $1,456 is roughly 70% below the $4,854 average in 2023.  Trip cancellation payouts vary widely year over year based on the mix of cancellation reasons and the size of the trips being canceled; a year with more partial cancellations or lower-cost trips in the claims pool will produce a lower average even as the share of claims rises.

Because evacuation claims make up less than 1% of all cases, a small number of high-cost air ambulance transports can shift the average from year to year. The 2022 evacuation average of $82,896 was pulled up by several large evacuations, including one exceeding $223,000.

Trip cancellation's share rose from 18.99% in 2022 to 26% in 2024 but increased only from 25% to 26% between 2023 and 2024. Travel delay fell from 24.69% to 15% as airline disruptions eased after 2022. Squaremouth reported that total paid claims volume grew 18% in 2024, and that growth came disproportionately from medical-related categories.

Three forces are pushing travel insurance payouts higher: trip values are growing, more travelers are buying medical coverage, and the mix of claims has shifted from flight disruptions toward medical events.

A 30-year-old pays an average of $201 for travel insurance on a $5,000 trip. A 65-year-old pays $394, roughly double. MoneyGeek gathered more than 1,500 quotes from 13 insurers using September 2025 premiums to build these estimates.

MoneyGeek's data shows pricing stays relatively flat from age 20 to 50, with increases of only 2% to 8%. At 65, premiums double, and by 75, a traveler pays $552, a 180% increase over the baseline, reflecting the higher probability and cost of medical claims for older travelers.

Coverage limits and pricing vary by plan tier. Tin Leg Basic offers $50,000 in emergency medical coverage for $65 for travelers aged 20 to 50. Tin Leg Gold offers $500,000 for $229 in the same age range, so the $164 difference buys 10 times more medical coverage.

World Nomads Standard charges a flat $167 regardless of age, one of the more cost-efficient options for travelers over 60. Nationwide Prime pairs $150,000 in medical coverage with $1,000,000 in evacuation coverage for $152, one of the strongest evacuation coverage values relative to price in MoneyGeek's analysis.

MoneyGeek's guide to comprehensive vs. basic travel insurance explains how these plan tiers differ in more detail.

Travel insurance for a $5,000 trip to Morocco costs about $290, 45% more than the same coverage for Canada at $200. MoneyGeek priced travel insurance across 15 countries using the same trip profile and found that Western Europe sits near the Canada baseline, while premiums rise 22% to 45% in countries with more limited medical infrastructure or higher expected evacuation costs.

India, Brazil and Morocco carry the highest premiums in this sample. Travelers to these countries pay $75 to $90 more per trip than those going to Canada, reflecting higher expected costs including medical evacuation coverage and healthcare expenses in those regions. Medical evacuation alone can cost $50,000 to $150,000 without coverage.

Western European destinations like France and Italy stay within 5% of the Canada baseline. Japan and Australia cost 10% to 12.5% more and remain in the low-risk tier, while Greece, Turkey and Mexico fall into a middle range where premiums are 22% to 28% higher than baseline.

Travelers who want country-specific guidance can compare options in MoneyGeek's regional guides, such as the best travel insurance for Canada or the best travel insurance for Mexico.

Basic travel insurance plans often cap emergency medical coverage at $15,000 to $50,000, while comprehensive plans offer $100,000 to $150,000. According to Squaremouth's 2024 data, the average emergency medical claim was $1,654, an amount covered by virtually all plans, but the highest emergency medical claim paid in 2024 was $61,976, which exceeds the limit on many basic plans.

Medical evacuation is where the shortfall gets most serious. Squaremouth's average medical evacuation payout in 2024 was $17,086, and the highest evacuation claim in the 2022 to 2024 Squaremouth data was $223,101, recorded in 2022. A basic plan with $200,000 in evacuation coverage would not fully cover that highest evacuation claim, and plans with $150,000 in evacuation would leave more than $73,000 uncovered.

The shortfall is largest for travelers over 65 going to high-risk destinations. A 65-year-old traveling to Canada already pays about $394 for coverage, and a higher-risk destination like India adds roughly 38% to that cost, pushing the estimated premium to around $550. Basic plans at that price point may offer only $25,000 in medical benefits and $200,000 in evacuation coverage. Upgrading from a basic plan at about $89 on average for travelers under 50 to a comprehensive plan at about $156 costs $67 more and can increase medical coverage limits from $25,000 to $150,000, roughly two to six times more protection.

Travelers buying medical coverage often have the same handful of questions: what's most common, what claims cost without insurance, what their regular health plan covers and how much a policy runs. Here are MoneyGeek's data-backed answers.

MoneyGeek analyzed more than 1,500 quotes from 13 travel insurance providers using September 2025 premiums, gathering quotes for a standard $5,000 trip across multiple age groups, destinations and coverage tiers. Average plan-tier prices ($89 basic, $156 comprehensive) and overall trip averages ($204 for a $5,000 trip, $362 for an annual plan) are weighted averages across all 13 insurers in the dataset, not just the seven representative plans shown in the comparison table.

Claims data comes from Squaremouth's annual claims reports for 2022, 2023 and 2024, which are based on claims processed through Tin Leg, its affiliated travel insurance provider. Market-level data comes from USTIA's 2022 to 2024 study conducted by Willis Towers Watson, consumer behavior data comes from Battleface's 2025 U.S. trends report comparing April through June 2025 with the same period in 2024, and flight disruption data comes from the DOT Air Travel Consumer Report covering full year 2024.

Claims data reflects what was filed and paid through Tin Leg, not the total number of medical events among all insured travelers, and Tin Leg is one provider within the Squaremouth Group, so these figures represent a subset of the broader travel insurance market. All pricing reflects the information available at time of analysis; actual premiums depend on trip cost, destination, age, coverage level and purchase timing.