New Zealand's biggest online travel insurer has just released last year's top 10 claims and for the first time, not all are attributable to kiwis travelling overseas.
Craig Morrison, Southern Cross Travel Insurance chief executive, said some of the top claims have for the first time come from foreigners - including students - visiting New Zealand but unable to get treatment costs covered here because they are not residents.
Medical emergencies were responsible for the most expensive payouts and the biggest was for a kiwi travelling overseas who needed $405,000 for surgery required for cancer while in the United States.
The fourth largest - $236,000 - was for a foreigner who needed treatment while here and is an example of the new trend for foreigners in New Zealand to make big claims.
Morrison said international students and foreigners living here also bough the insurance and had made big claims.
"They are all medically related but for the first time they are not all attributed to New Zealanders travelling overseas," Morrison said of the list of top 10 list.
"SCTI's other travel insurance policies which cater for international students, those visiting New Zealand and those living but not a resident make up three of the large claims.
"Not everyone qualifies for free treatment on the New Zealand public health system and those that don't, have to pay out of their own pocket for medical care, which is why insurance is so important.
"New Zealand District Health Boards are forced to write off millions in debt from patients, mostly overseas visitors who had been treated in the region's hospitals," he said.
As well as New Zealand's "cash-strapped health system being out of pocket," Morrison says that the unpaid bills are sent to debt collectors and Immigration NZ was notified to make sure visas to re-enter the country were not granted until the debts were paid.
"This can have long term ramifications for those that want to return or have extended family in New Zealand", Morrison said.
"Medical incidents can happen to anyone, at any time, regardless of age and the trip duration.
"The cost of travel insurance is really just a tiny fraction of the costs that can result from these incidents," he said.
Highest value travel insurance claims for 2014:
1. $405,000 - surgery required for cancer in the USA.
2. $365,000 - air evacuation after a brain bleed and heart attack in North America.
3. $285,000 - blood clot while travelling caused a cardiac arrest on a plane, admitted to hospital in the US.
4. $236,000 - a tourist visiting New Zealand suffered a stroke requiring extensive hospitalisation and rehabilitation and transport to home country by air ambulance.
5. $193,000 - suffered a stroke in Europe, required air ambulance.
6. $177,000 - fell from a roof and fractured several leg bones in the USA.
7. $122,000 - family member of an international student diagnosed with cancer.
8. $120,000 - hit by a motorcycle in South East Asia.
9. $112,000 - heart attack while visiting New Zealand, required surgery and rehabilitation.
10. $105,000 - accidental fall resulting in broken bones in Europe
Source: Southern Cross Travel Insurance.