Following last week’s State Department warning on allegations of tainted alcohol being served at Mexico resorts, there are a few steps travel agents can take when speaking with clients who are concerned about the situation. Travel Agent spoke with several insurance carriers and a medical expert to learn more.
“[This situation] is not something that would allow someone with a typical insurance policy to cancel their trip, unless you have ‘cancel for any reason’ coverage,” says Jason Schreier, CEO of travel insurance provider April USA. Schreier says that April has received some ‘cancel for any reason’ cancellations for Mexico recently, although because those policies do not require travelers to state a reason for their cancellation, the company cannot definitely say whether or not the tainted alcohol allegations were a factor.
Schreier recommends learning the definition between primary and secondary insurance, noting that primary insurance can often be superior in situations where a traveler is hit with a sudden medical crisis on the road.
“Primary coverage will step up before and above any other possible people out there who may pay for the incident as it’s happening,” Schreier says. That’s important because, depending on the exact details of the policy, primary coverage can prevent a traveler from having to lay out tens of thousands of dollars in medical expenses in advance and ask for reimbursement later. If the insurance company is able to work with a traveler on payment immediately, it can also help the traveler know where they stand in terms of how much they’ll end up needing to pay.
Many hospitals require proof of payment before they will even being treatment.
“There are some hospital chains that are fairly notorious for that,” says Bob Chambers, head of operations for Generali Global Assistance Travel. “If they see a foreigner come in they may see an opportunity to get more money…Some hospitals will almost hold a person hostage. They may take their passport and say, ‘We’re not going to let you go [unless you pay].’”
A travel insurance company can work with a medical provider to get a guarantee of payment and get the traveler released an on their way, Chambers says, while many U.S.-based medical insurance companies will tell travelers to pay out of pocket and submit a claim for reimbursement when they get home. Additionally, travel insurance companies can help connect travelers with trusted medical providers in the destination.
There is one key exception to keep in mind, however: travel insurance policies exclude coverage for losses due to alcohol or drugs, Chambers says.
“If you’ve had an incident as a result of alcohol consumption, and you’re found to be over the legal [intoxication] limit, that’s something that could preclude coverage,” Schreier agrees. “Travelers should try to drink alcohol at appropriate levels, and if you start to feel weirder than alcohol typically makes you feel, as long as you haven’t drunk excessively, the insurance policy will step up and help make sure you aren’t a victim.”
What Is Tainted Alcohol?
It’s also important to keep in mind exactly what the term “tainted alcohol” can mean. Travel Agent reached out to Rade Vukmir, a fellow of the American College of Emergency Physicians and chairman, education and risk management at ECI Healthcare, for details.
“The most common ingestion is regular ethanol,” says Vukmir. The average distilled liquor has an alcohol proof of 80, meaning that it’s 40 percent alcohol by content, with the rest being distilled or natural water. Common types of liquor, like whiskey or gin, also typically have something to give the liquor taste and flavor, like juniper berries for gin, or barrel charring for aging.
Grain alcohol, on the other hand, is distilled down to 180 proof – twice to two and a quarter times the alcohol by content, Vukmir says.
“The concern is it has no taste or odor, so that’s how people get into trouble, because you can’t taste it and can’t smell it,” Vukmir says. “It might burn a little going down, but sloshed around in a mixed drink it might get lost. Just by increasing the alcohol content proper with a product like grain alcohol, you can over-imbibe and have no way of knowing.”
Alternative alcohols, on the other hand, are more dangerous. The two most common types are methanol and isopropyl alcohol.
“No one drinks methanol by design, because it’s known to be poisonous,” says Vukmir. “You can go blind from drinking methanol, because it concentrates in the retinal cells as one of its side effects …It will make you intoxicated, but the adverse side effects are so extensive that it can be a lethal ingestion.”
Isopropyl alcohol, on the other hand, is a “little less dangerous type of poison,” Vukmir says, that can still produce a state of intoxication. Typically companies that package isopropyl alcohol as rubbing alcohol will give it an accompanying aromatic, like a wintergreen scent.
Telling the difference between a patient who is intoxicated on ethanol and methanol or isopropyl alcohol requires a special test in the emergency room.
“If a patient presents as intoxicated we would measure a serum alcohol and standard electrolytes,” says Vukmir. “If we were suspicious we would measure something called serum osmolality, which would help us calculate indirectly the presence of one of these poison alcohols.” If the patient’s blood alcohol level is normal and they have a history of ingesting alcohol, then an emergency room physician would back calculate the presence of this alcohol from the present measured serum osmolality to the osmolality that would be predicted.
The patient’s history with alcohol, as well as the environment of a resort vacation, can also be a factor in how they react to drinking.
“Oftentimes there are patients that have never had an alcoholic drink before, and somehow end up imbibing a lot of alcohol,” says Vukmir. “If you have a younger patient with a blood alcohol level of .8 or .1, that can be devastating for a patient who hasn’t had an alcoholic drink before. With that amount of alcohol they can appear like they’re in a coma.”
Patients who drink every day, on the other hand, may seem fine with an alcohol level of two to three times the legal level of intoxication, Vukmir says.
Dehydration and being in an unfamiliar environment can also play a part.
“If you ingest a particular amount of fluid as part of your routine, then you know your [drinking] capability,” Vukmir says. “Then you fly or take a cruise, and if you’ve been on the cruise for 10 or 12 hours, you have had a change in the amount of liquid that you ingest. If you pour the same amount of alcohol into a smaller container, then you have a higher concentration of alcohol.”
The sun can cause additional stress on the body, causing it to dilate and lose more fluid, Vukmir says.
“Additionally, at home, there would be some particular expectation that you have about what you buy, where you buy it, what bar you go to, versus when you’re in a completely unknown situation, it may be a different product, and it may be in a different concentration,” says Vukmir. “Remember, this is a leisure culture, and there’s a difference between stopping for a drink after work, and then expectation where you’re in a resort community, you’re on vacation, maybe they are thinking, ‘Let’s liven it up a little bit.’”
Vukmir says, “But there can be changes in your routine that can accompany leisure travel that affect your day to day ability to tolerate alcohol.”