The short version
Call the insurer 24-hour line before the helicopter flies, then collect an itemised invoice, an English diagnosis and every receipt.
If something has gone wrong on a Nepal trek, do this in order. Call your insurer’s 24-hour emergency number before the helicopter lifts, because most policies pay for an evacuation only if they authorised it. Then, before you leave Nepal, collect four documents: an itemised invoice, a written diagnosis in English, every receipt, and the helicopter operator’s invoice. Photograph all of it while you are still in Kathmandu. Almost every Nepal claim that fails, fails on one of those two steps.
This is the walkthrough we give our own clients, and it is deliberately practical rather than reassuring. We are a trekking operator, not an insurer, and we earn nothing from any policy — what we have is the part nobody writes down, which is what happens in a Nepali valley when a decision has to be made in twenty minutes.
- Who arranges the rescue differs by policy, and it is the single biggest variable. Some insurers arrange it and pay directly; some expect you to arrange it and claim it back. Both still want the phone call.
- An itemised invoice is not the same as a receipt for a total. A lump sum with no line items is the most common reason a Nepal medical claim stalls.
- The clock can start at the incident, not at your return. One wording gives 60 days from the incident; another gives 28 days from getting home. Do not assume you have a month.
- Nobody covers search. Insurers cover medical evacuation of a located patient. Those are different products.
- Since the 2026 fraud charges, Nepal rescue paperwork is read harder. That is a reason to keep clean records — never a reason to hesitate over a real evacuation.
What to do in the first hour
Get the patient down, then get the call made. Descent treats altitude illness and no phone call does, so nothing here outranks losing height. But the moment the situation is stable enough to use a phone or a satellite device, someone needs to ring the insurer’s 24-hour assistance line, and that call is what turns a rescue into a paid claim rather than a bill.
The reason is written into the wordings. True Traveller covers helicopter rescue only “if needed and approved by the 24-hour Emergency Medical Assistance Service”, and states the consequence of skipping it: “Failure to contact the 24-hour Emergency Medical Assistance Service may mean that we are not able to provide cover, or we may reduce the amount we pay for your medical treatment.” It runs a dedicated Nepal helicopter line separate from its main number. Staysure requires that a cut-short or repatriation “must be authorised in advance”. Global Rescue puts the same rule the other way round and far more bluntly: “If you arrange for your own rescue, we are unable to reimburse members.”
Have four things ready before you dial: the policy number, the patient’s full name and date of birth, the location with an altitude, and a plain description of symptoms and when they started. Write the name of the person you speak to and the reference they give you into your phone. That reference number is the cheapest piece of evidence you will ever collect.
The two models, and which one you are on
Find out which of these your policy is before you leave home, because they behave completely differently on the ground.
| Model | Example wording | Who arranges the flight | What you must do |
|---|---|---|---|
| Insurer authorises and pays | True Traveller — rescue covered when “approved by the 24-hour Emergency Medical Assistance Service” | Insurer, via its assistance service | Call before the flight; notify within 48 hours if admitted by emergency service |
| Provider arranges everything | Global Rescue — a membership, not insurance; “all transport arrangements and costs would be covered by us” | Global Rescue deploys it | Call their one number. Self-arranged rescues are not reimbursed |
| You arrange, then claim back | British Mountaineering Council — “It is Your responsibility to make all arrangements with the relevant mountain rescue organisation” | You and your party, on the ground | Still contact their assistance line “as soon as possible”, and obtain a written statement from the rescue authorities |
Two corrections to things people repeat about this. First, the BMC model is not a no-phone-call model. Its wording requires you to contact the 24-hour assistance service as soon as possible and lists that requirement twice; what differs is who makes the arrangements, not whether you notify. Second, its headline £100,000 search and rescue limit carries an aggregate cap of £250,000 for any one event, with each person’s payment “proportionately reduced” if a group incident exceeds it — a detail the marketing page does not carry.
The Kathmandu Post, reporting on the 2026 fraud investigation, described the structural problem exactly: “Most travel insurance policies require the insurer to be contacted before an evacuation takes place. In the Himalayas, in altitudes where communication is a challenge and many areas are without proper cellphone signals, this almost never happens.” Plan for it. Carry a satellite messenger or know which lodges have a working phone, give your guide the insurer’s number before you start walking, and if the call genuinely cannot be made, have someone make it at the first signal and document why it was impossible. Smartraveller also warns that people arranging evacuations “sometimes falsely claim to have checked with a trekker’s insurance company” — so confirm it yourself where you can.
The documents a Kathmandu clinic or hospital must give you
Ask for these at the desk before you are discharged, in writing and in English. Nepali hospitals will produce all of it, but usually only if you ask, and chasing paperwork from Australia or the UK six weeks later is where claims die. Insurers’ own checklists are explicit about the categories: Travel Guard requires “medical, treatment, ER, and admit/discharge records” plus “copies of all bills, invoices, receipts”; the BMC requires “receipts (including itemised bills)” and warns that failure to obtain them “could prejudice Your claim”; True Traveller asks for all receipts “together with any other documents you were given by the Clinic or Hospital”.
| Document | What it must show | Get it from |
|---|---|---|
| Itemised invoice | Line-by-line charges, not a single total. Bed, oxygen, drugs, imaging, consultation, each priced | Hospital billing desk |
| Written diagnosis in English | The condition named, the date of onset, treatment given, doctor’s name, stamp and signature | Treating doctor |
| Discharge summary | Admission and discharge dates, course of treatment, fitness to fly home | Ward or reception on discharge |
| Every payment receipt | Amount, currency, date, what it paid for — including the card or bank statement line | Cashier; keep the card slips |
| Helicopter operator’s invoice | Operator name, route flown, date, and the amount charged | The operator or their Kathmandu office |
| Rescue statement (if claimed) | A written statement from the rescue authority involved | Required in the BMC wording; useful for any insurer |
| Assistance reference | Case number, the name of who you spoke to, times and dates of each call | Your own notes |
One practical note on the helicopter invoice: ask for it to show the flying time as well as the fee, because a bill that reconciles to the flight is easier for an assessor to accept than a round number. To be straight with you, that is our advice rather than a published requirement — we could not find an insurer that formally demands flight hours. It sits inside the “all bills, invoices, receipts” wording, and it costs nothing to ask.
Every page, in daylight, on a flat surface, before you leave Nepal. Then email the photographs to yourself so they exist somewhere other than the phone. Nepali hospital paperwork is frequently carbon-copy or thermal print, and a thermal receipt in a rucksack in the monsoon is unreadable within weeks. If a document is only in Nepali, ask for the English version at the same desk while you are standing there — not by email later.
The filing window is shorter than you think, and it varies wildly
There is no industry standard, and the clock does not always start when you get home. These are the published windows from four wordings we checked in August 2026.
| Insurer | Deadline | Clock starts |
|---|---|---|
| True Traveller | Claims submitted within 60 days; notify within 48 hours if taken to hospital by emergency service | Date of the incident |
| Staysure | Written notice within 28 days | Your return home |
| World Nomads (US wording) | Notify within 20 days, documents within 90 | Date of loss |
| British Mountaineering Council | “As soon as possible” — no day count published | — |
Look at the first two rows together. Sixty days from the incident can expire while a seriously ill trekker is still being treated; twenty-eight days from returning home is generous by comparison but starts later. An article that told you “you have about a month” would be wrong for both. Open your own wording, find the sentence, and put the date in your calendar on the day it happens.
What actually gets a Nepal claim refused
Five things, and four of them are decided before you ever leave home.
- An undeclared medical condition. The most common refusal of all. True Traveller warns that “failure to declare any medical conditions could leave you with no right to make a claim”; the BMC states that “any additional Medical Conditions not declared to Us will not be covered” and excludes trips taken while awaiting an operation, consultation or test results. Citizens Advice lists non-disclosure first among the reasons an insurer refuses.
- Altitude above the policy ceiling. A trekking grant is capped at a stated height, and above it you are in an activity exclusion regardless of what caused the injury. If you are unsure where yours stops, our Nepal trekking insurance guide works through the published ceilings, and Australians should start with the Australian market page because none of the specialist European insurers will sell to you.
- Missing pre-authorisation. Covered above, and it is the failure most specific to Nepal.
- The wrong tier or a missing endorsement. Some wordings require more than a high enough number. True Traveller, for instance, requires that the endorsement “Trekking in Nepal” appears on your validation certificate. Check your certificate, not the brochure.
- Paperwork that cannot be assessed. A total with no line items, a diagnosis only in Nepali, a receipt that has faded. True Traveller says a claim without the required documentation “will be put on hold until the documentation can be supplied” — which, if the hold outlasts the filing window, is a refusal wearing a politer word.
One more that is worth knowing about even though it is not a refusal: several insurers apply an extra excess specifically for Nepal. Both True Traveller’s 2026 UK wording and the BMC’s wording increase the excess by £500 for helicopter or air ambulance services in Nepal, and True Traveller states that this increase is not waived even if you bought the excess waiver.
Why your paperwork is being read harder in 2026
Because of a live court case, and it is fair that you know the shape of it. Nepal’s Central Investigation Bureau laid charges against 32 people on 12 March 2026 over an alleged fake-rescue scheme, and the case was filed at the Kathmandu District Court on 23 March 2026. Reported estimates of the sum allegedly defrauded from international insurers run to around USD 19.6–19.7 million — the Himalayan Times and the Kathmandu Post report US$19.65m, while OnlineKhabar reports US$19.69m for three companies specifically. Investigators reviewed 4,782 foreign patients treated at the implicated hospitals between 2022 and 2025 and confirmed 171 fake rescues. We covered the case in our report on the charges.
You will have seen the poisoning headlines. Here is the accurate position. The chargesheet contains an allegation that in at least one case baking soda was mixed into a trekker’s food to make them ill. Nepal’s Central Investigation Bureau has publicly rejected the wider narrative, stating that “during the course of investigations till date, no evidence has been found to substantiate these claims”. These are untested allegations before the Kathmandu District Court and nobody has been convicted. Report it that way, and treat anyone repeating it as settled fact with caution.
The consequence for an honest trekker is small but real: assessors now read Nepal rescue documentation harder, and OnlineKhabar reports that at least three insurance companies have halted premium payments over fraudulent claims. That is an argument for clean, itemised, contemporaneous records. It is not an argument for hesitating over a genuine evacuation. If a doctor or your guide says you are going down, you go down and sort the paperwork afterwards.
The bottom line
Make the call, keep the itemised invoice, photograph it in Kathmandu, and diarise the filing deadline the day the incident happens. Those four habits cover the overwhelming majority of Nepal claims that go wrong. And the unprofitable part: the cheapest claim is the one you never file, which is why a slower itinerary with a real acclimatisation day beats a bigger policy every time — the illness insurance pays for is the one our altitude sickness guide exists to stop you getting. If a company offers to shorten your trek to fit your leave, that is the moment to push back, not the moment to upgrade your cover.
On our treks the guide carries the insurer’s number and the office knows how to get a letter of guarantee issued at 6am, because in Nepal the aircraft usually does not lift without one. Our 14-day Everest Base Camp trek is from $1,350pp ($1,850 solo) and the 14-day Annapurna Circuit from $1,150pp, permits, licensed guide and porter included. Send us your policy wording before you book and we will tell you what it is missing — whoever you end up walking with.
See dates & price →Do I have to call my insurer before a helicopter rescue in Nepal?
If your policy requires authorisation, yes, and most do. True Traveller covers helicopter rescue only where it is approved by its emergency assistance service and warns that failing to contact them may mean it cannot provide cover or will reduce what it pays. Global Rescue does not reimburse self-arranged rescues at all. If the call is physically impossible from where you are, get it made at the first signal and record why it could not be made sooner.
What is the difference between medical evacuation and search and rescue?
Search and rescue is the cost of finding and reaching someone who is missing or stranded. Medical evacuation is moving an already-located patient to hospital. Many policies cover the second generously and exclude the first entirely, and the two are frequently confused in marketing copy. Check which words appear in your benefit schedule.
What does an itemised invoice have to show?
Each charge separately — bed, oxygen, medication, imaging, consultation, procedures — with dates and amounts, rather than a single total. The BMC wording specifically asks for “itemised bills” and tells members that failing to obtain the evidence could prejudice the claim. Ask the billing desk to reissue it if what you are handed is a lump sum.
How long do I have to file a Nepal trekking claim?
It depends entirely on the wording and the range is wide. True Traveller requires submission within 60 days of the incident, Staysure within 28 days of returning home, World Nomads’ US wording requires notification within 20 days and documents within 90, and the BMC says only “as soon as possible”. Find the sentence in your own policy on day one, because for some insurers the clock starts on the mountain.
My documents are in Nepali. Is that a problem?
It slows a claim and can stall it. Ask the treating hospital for the diagnosis and discharge summary in English before you are discharged — Kathmandu’s international-facing hospitals produce them routinely. Getting it after you have flown home means a request by email to a busy ward, and that is exactly the delay that runs into a filing deadline.
Will the 2026 fraud case affect my genuine claim?
It means more scrutiny of the documents, not a presumption against you. Keep the itemised bill, the English diagnosis, the operator invoice and your assistance case reference, and a real claim looks like a real claim. Nothing about the case is a reason to delay a medically necessary evacuation.
Who pays the helicopter operator, me or the insurer?
Ask your insurer that question in writing before you travel, because the answer decides whether you need funds available on the day. Some insurers authorise and settle directly with the operator; others reimburse you afterwards, which means the cost lands on your card first. In Nepal an aircraft generally does not launch without a guarantee of payment, so knowing which model you are on is not academic.
Can my guide or operator make the claim for me?
No — the claim is between you and your insurer, and only the policyholder can submit it. What a good operator does is help you get the documents while you are still in the country, put you in touch with the hospital billing desk, and provide a written account of what happened on the trail. Ask for that account before you fly home.
Keep reading
The altitude ceilings, the rescue benefit and what voids a policy.
What it costs, who calls it, and how the flight actually happens.
Why the specialist insurers will not sell to you, and what will.
The altitude cap that quietly voids an EBC policy.
Dealing with a claim now, or want it set up properly before you go? Contact us — we will tell you what your policy needs to say and what to ask the hospital for.
Written by
Bishnu AdhikariPokhara-based, NMA-certified trekking guides. We’ve led 5,000+ treks across the Annapurna and Everest regions since 1998 — every word here comes from the trail. More from this author →
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