DAN EUROPE PROCEDURES FOR THE MANAGEMENT OF DIVING ACCIDENTS AND PAYMENT OF CLAIMS CONCERNING MEMBERS OF DAN EUROPE

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Gwenda Moore
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1 DAN EUROPE PROCEDURES FOR THE MANAGEMENT OF DIVING ACCIDENTS AND PAYMENT OF CLAIMS CONCERNING MEMBERS OF DAN EUROPE GUIDELINES FOR LOCAL HEALTH CARE PROVIDERS These procedures must be followed in the event that a DAN Europe Member is involved in a diving related emergency and requires hospital, medical or hyperbaric care at your facility. 1) Immediately alert by phone the DAN Europe Hotline Network (either the National Hotline or DAN International Hotline at IPAS on ) 2) Send the attached Form A- Diving Accident Report, which should be completed and signed by the injured member, to DAN Europe Central Office by fax ( ) or at claims@daneurope.org. This document will be considered as the initial diving accident and insurance claim document regarding this case. The DAN Europe Diving Accident Claim Administration form will be faxed /mailed/ ed back by DAN Europe Claims Office to you, the treating Health Care Facility. Such document will confirm or not the coverage benefits and will indicate the documents necessary to proceed with the claim. 3) The DAN Europe Diving Accident Report Form C must be faxed / mailed or ed as soon as sections A, B, C and D are completed and then again after completion of section E at the end of all treatments to: DAN Claims Office (fax: +39/ , claims@daneurope.org, address PO BOX DAN ROSETO TE - ITALY) DAN Hotline (fax +39/ Gestione.Servizi@ip-assistance.com or emergency@daneurope.org). This will serve as the initial diving accident medical report on this case until a final and comprehensive medical report is received. 4) On receiving notice of a diving accident involving a DAN Europe member and requiring medical / hospital / hyperbaric treatment and/or possible medical evacuation, DAN Europe Hot Line and DAN Medical Division will contact the local health care provider to: a) monitor the victim s status and progress b) co-operate with the treating medical team to jointly define the optimal treatment and/or medical evacuation procedures required Any treatment plan requiring more than 5 hyperbaric treatment sessions must be discussed with and approved by DAN Europe Medical Officers. Provided the above procedures and guidelines are followed, DAN Europe will directly pay the health care provider following receipt by DAN Europe of an invoice specifically indicating the name of the involved member and his/her DAN Europe membership number. Should the costs exceed the insured limits, DAN Europe will only accept a direct invoice up to these limits and the payment of any amount exceeding the insured limits will be responsibility of the treated individual.

2 In the event that DAN Europe is not alerted and directly involved in the management of the diving accident as outlined above, DAN Europe will reimburse the DAN Europe Member upon presentation of a Claim, including a detailed description of the diving accident signed by the insured DAN Europe member (or his/her representative if the member is incapacitated), a full medical report and the original invoices or receipts of all the sustained costs relating to the case. In these cases the DAN Europe member will be personally responsible for the payment of the treatment and/or transportation costs as well as for the eventual transfer of the related amounts to the health care provider, following reimbursement by the insurance company. For cases involving members of other DAN organizations (DAN America, DAN South East Asia Pacific, DAN Japan, DAN Southern Africa), if DAN Europe is alerted, DAN Europe will initially assist and liaise with the other involved DAN organization, so that the appropriate contacts are immediately made and information on any relevant procedures are sent to the health care provider by the involved International DAN organization on a case-by-case basis. DAN Europe Headquarters Phone Fax

3 DAN Europe Divers Accident Report Form Fax To DAN Europe to:+39(0) or to: or mail to: DAN EUROPE Claims Office P.O.BOX DAN ROSETO TE ITALY Name of Dan Europe Member: DAN Europe Membership No: Date of Diving Accident: Site of Diving Accident: Diving partner or accident witness ( name, address, tel., fax, ): Who did you call first? DAN Hotline/other (please specify) Who was your first examining doctor? (address, fax, phone, e- mail) Treating facility (address, fax, phone, ) Other treatment centres /doctors (address, fax, phone, ) Your family doctor (address, fax, phone, e- mail)

4 Describe your incident/accident and all following events: Your primary insurance in case it covers also diving related accidents Other private insurances offering a secondary cover for medical treatment/emergency transport, etc. Insurance Information: It is specified that, if the Insured enjoys benefits similar to those provided for in the policy stipulated between DAN Europe and the Insurance Company in favour of its members, with the exception of cover for death and permanent disability, this insurance cover will become supplementary and the Company is therefore only obliged to reimburse any excess up to the amount of the maximum sum insured. For details about the insurance provider, please refer to the insurance certificate enclosed in your membership packet. Signature of the DAN Europe Member:

5 DAN Europe Diving Accident Report Form C Section A Date: Time: Week Day: Patient's Name Age Gender DAN Europe Membership Card No: Site, date and time of last dive and diving accident: Name & Telephone No of Contact person: Treatment Facility Name and Address: DAN Membership Expires: Time Facility alerted: Facility Phone: Name of Physician in charge: Facility Fax: Section B INITIAL SIGNS & SYMPTOMS, CONDITIONS & EVOLUTION Itching Fatigue / Malaise Extreme Fatigue Respiratory troubles Muscular weakness Paraesthesia Up. Limbs Paraesthesia Lo. Limbs Paralysis Upper Limbs Paralysis Lower Limbs Sphincter troubles Cerebral signs Vertigo Visual troubles Auditory troubles Pain Cutaneous signs Cardio-respiratory arrest Breath Hold Accident Near Drowning Cardiovascular signs Metabolic signs Trauma Marine Life Injury Other (specify) Conscious Semi-Conscious Confused Unconscious Stable Improving Worsening Spontaneous Healing Any necessary detail on reverse or on final medical report please. Section C DETAILS OF DIVE Max. depth: Total Dive Time: First dive of Day Repetitive Dive Multiday diving Rapid Ascent Deco Stops omitted Panic Pre/Post dive stress Pre dive Alcohol Computer Diving Table Diving Equipment Failure Flying after Diving Air Diving Nitrox Diving Technical Diving Novice Diver Experienced Diver Instructor / Guide Section D TRANSPORT AND TREATMENT Oxygen First Aid Yes 100% No Oxygen during transport Yes 100% No Time left accident site: Distance from site of accident Km. Time arrived to Treatment Facility: Transport by: State of patient upon arrival to Treatment Facility: Initial Hyperbaric Therapy Protocol: USNT5 USNT6 USNT6Ext CX30N CX30He Other: Clinical Result after Initial Hyperbaric Treatment: Section E FOLLOW-UP HYPERBARIC TREATMENT? No Yes Number of HBTx & Protocol: Clinical Result after completion of all Hyperbaric Therapy: Name & Signature of treating physician: Official Stamp

1 out of every 5,555 of drivers dies in car accidents 1 out of every 7692 pregnant women die from complications 1 out of every 116,666 skydives ended

1 out of every 5,555 of drivers dies in car accidents 1 out of every 7692 pregnant women die from complications 1 out of every 116,666 skydives ended in a fatality in 2000 1 out of every 126,626 marathon