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Car Rental Personal Accident Insurance in the UK

I often travel to the UK with a group. Last year when I looked into car rental, I was surprised to find that only Hertz offered personal accident insurance (insurance that would cover medical expenses if something happened to anyone inside my car in an accident). Most of the same companies offer that insurance option in the US, but not in the UK. Enterprise, for example, told me that I should look into travel insurance to have that covered. I couldn't find any travel insurance that would cover rental car accidents. My car insurance won't cover personal accident insurance in another country.

What's the deal? Is it because the NHS covers UK citizens for that sort of thing, so they don't bother offering it for visitors? Would the NHS cover any of us in the event of an accident? (My initial research says they shouldn't, but please correct me, if I'm wrong.)

Thanks for any help you can give! I really would prefer to have more options than Hertz - I had a bad experience with them last year.

Posted by
6810 posts

I’m surprised Avis doesn’t offer it since it’s always been an option when I’ve rented through it going to Europe. When I get travel insurance through Allianz, medical insurance is part of it. PAI and liability are nice to cover damage to others’ vehicles, property, or persons.

Posted by
13 posts

If you will be charging the rental car rates to a major credit card, call them to see what protections they provide. Ours will cover a rental car without the added expense of the CDW. It may well be that the personal accident insurance can be covered also.

Posted by
7906 posts

AmEx provides and option that we exercise for insurance that is very inexpensive. Also, AmEx has excellent choices for Medical with Medical Evacuation.

Posted by
5383 posts

The PAI sold in the UK on car hire tends very much to be the '£X if you lose a leg' variety. There is usually a small amount for medical costs, but more of an incidental kind.

The NHS does provide accident and emergency treatment for visitors without charging, but any consequential care is chargeable if from a country without reciprocal heath arrangements.

Note that a registered outstanding debt to the NHS of £500 or over is an automatic bar on re-entry to the UK until cleared.

Posted by
3122 posts

Marco, thank you for mentioning reciprocal health agreements. I for one wasn't aware of this. I just Googled it and found the following document, which seems to state that the UK has a reciprocal agreement with the United States. "The UK has agreements about National Insurance and benefit entitlement with the following Non‐EEA countries:" [list follows]

Posted by
5383 posts

There is a reciprocal agreement on social security, so for example the short period I worked in the USA will qualify me in due course for a small pension from the US Social Security, as the years I have paid in the UK count as qualifying years. There is no reciprocal agreement on medical costs.

The reverse is true for Australia - no social security agreement, but there is one on heath costs between the UK NHS and Australian Medicare.

Posted by
495 posts

Isn't that covered by other insurance policies though?
If a passenger is ingured in the car they sue the at fault driver (in this case either you or the other guy) and their third party insurance pays. In the case of the driver (IE you) then your normal medical insurance covers it.

Posted by
2 posts

jaimeelsabio - I had somehow overlooked Avis before (I think they were too expensive for me last year), so that’s good to know! I wish Allianz was cheaper; I might as well pay for PAI through the rental company at their rates. But it’s good to know about that option.

RG - My card covers CDW, but not personal accident. Good thought, though.

Marco - Your info is exactly what I’d like to know more about. I have travel insurance for the group, but it won’t cover us in rental car accidents. Am I understanding correctly that the NHS would cover initial treatment from an accident, just not the care to get to complete recovery? I’m just curious why a company like Enterprise wouldn’t even bother offering insurance to cover that, which made me think that most UK citizens and perhaps even visitors don’t need it.

Peter - Many health insurance plans won’t cover people on international trips. Depends on the health insurance. (At least that's the case in the US.)

Posted by
1013 posts


Thanks for that information about social security - I had no idea about the agreement. Having worked in both countries and looking forward to retiring in a couple of years - this was very good information! Thanks again.

Posted by
4630 posts

Repeating what was said above, the $20 Amex premium policy covers PAI and theft from vehicle, as well as damage to the car.