in this case
- A case of Covid on a Holland America cruise leaves David Aronstein with a $750 medical bill and a desperate need for paperwork.
- His insurance company refuses to pay without official records, but the cruise line ignores his requests for nearly a year.
- Stuck between a silent cruise line and a strict insurer, he asks the advocacy team to intervene.
David Aronstein needs his medical records from Holland America. Without them, he can’t file an insurance claim for the treatment he received on a cruise. What’s the holdup?
Question
I was on a one-week cruise from Seattle to Alaska on the Holland America MS Westerdam last year.
I came down with Covid two days before the cruise ended. I received excellent care from the medical team on board.
When I got home, I saw that I had been charged $750 for the Paxlovid treatment I received. I contacted my insurance company and a representative said I needed to submit my medical records from the cruise.
Holland America told me that I needed to fill out a release form and send it to mrecordsrequests@carnival.com, which I did. I have sent it multiple times and never gotten a response. Therefore, I can’t collect the $750 from my insurance company.
Can you help me get my medical records from Holland America? — David Aronstein, Jamaica Plain, Mass.
Answer
I’m sorry your cruise ended with you confined to quarters with Covid. That’s no fun. But I’m happy to hear the Holland America crew took care of you. That care should have extended to your follow-up when you asked for your medical records.
But wait a minute. Holland America should have provided you with medical records at the time of your treatment — and if not then, when you paid for the medical service. (Related: What happens when Holland America changes my port?)
Your case is an important reminder to collect all medical records immediately after you’ve seen a doctor on board. You’ll need them to file an insurance claim. Insurance companies have to see your medical records and a bill in writing if you have any hope of getting refunded. I’ve seen too many travel insurance claims that went nowhere because of insufficient records. Don’t let that happen to you (but don’t worry, you’re in good hands with my advocacy team).
The delay matters more than people realize. Medical records are time-sensitive. Without them, patients cannot file insurance claims or get proper follow-up care.
Read more insightful reader feedback. See all comments.
Do you have a legal right to your medical records on a cruise ship?
You might have a legal right to your medical records on a ship. Maritime law, which governs cruise ships at sea, doesn’t specifically address patient access to medical records at sea. However, the ship’s flag state may specify your access to that information. (Related: “A cruise from hell”: Raw sewage in my cabin on Holland America!)
The Westerdam, which is flying under the flag of the Netherlands, says a patient has the right to view their medical records and receive an electronic copy of their record via the internet at no extra charge. (The EU’s General Data Protection Regulation requires it.)
But what if you’re on a ship that’s registered under a flag of convenience, like Liberia or Panama, and is less regulated? You still have some leverage.
Ask the cruise line
Even if it isn’t legally required to provide your medical record, it may, as a customer service gesture, provide your record. Pro tip: It’s better to ask for a copy while you’re still on board. Take a picture with your phone in case you lose the paper copy. (Related: Is this enough compensation? My wife broke her neck, but my cruise line will only give me a 25 percent refund.)
Cite any relevant laws
The Maritime Labour Convention (MLC) of 2006 requires ships to carry medical records, but doesn’t specify patient access rights. Also, the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers (STCW) mandates medical fitness standards but doesn’t address record access. You can throw these around to see if that shakes anything loose with the cruise line. It might.
Enlist your doctor or travel insurance company
Sometimes, your MD or travel insurance provider will have a direct line to the cruise line’s medical records and can help you find the right person. Note: Your cruise line won’t send your records without a release signature, so that may add a level of red tape. It’s probably easier for you to get the records yourself. (Here’s our guide to taking a cruise.)
Remember, while maritime law doesn’t explicitly guarantee access to your medical records at sea, you can usually get your medical records without much of a problem. It should only take a few days to receive your records at most.
Will you ever get your medical records?
It appears all record requests are handled through Holland America’s parent company, Carnival. Carnival also has a page on its site that allows you to submit questions after your cruise, although it’s unclear if that applies to Holland America customers. It looks like you also tried to call Holland America. Calling would be less helpful; you were right to keep everything in writing.
I think you were more than patient with Holland America. You waited 10 months before contacting my advocacy team and me, which is about 9 months longer than I would have waited. You could have enlisted the help of your travel advisor to get the documents. If that didn’t work, you could have also reached out to one of the Holland America executives I list on this site.
I contacted Holland America on your behalf. Within a few hours, it sent the records you had requested.
How to access your medical records at sea
Don’t let your insurance claim get stuck in international waters
The problem: Maritime law gaps
The solution: Get it before you leave
The backup: If you forgot
Your voice matters
Holland America held onto David Aronstein’s medical records for nearly a year, preventing him from filing a simple insurance claim. The delay raises questions about patient rights at sea.
- Should maritime law be updated to mandate that cruise lines provide patients with their medical records immediately upon disembarkation?
- Have you ever been stuck in the middle between an insurer demanding paperwork and a provider refusing to supply it?
- Is 10 months too long to wait for a company to respond before contacting a consumer advocate?
Executive contacts
If standard Holland America customer service has not addressed your issue, you may consider escalating your complaint to the executives below.
What you’re saying
Readers criticized the cruise line’s sluggish response, noting that medical records are property, not a privilege. Many offered practical advice on how to secure documents before leaving the ship to avoid the administrative black hole.
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Records are time-sensitive
Jennifer emphasized that delays prevent patients from filing claims or getting follow-up care. The Brown Crusader agreed, arguing that medical records should never be negotiable and that the company’s silence seemed intentional.
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Why did it take an advocate?
7cats mom asked why Holland America could solve the issue in hours for an advocate but ignored the passenger for months. jonesnori suspected understaffing, noting that non-revenue tasks like record retrieval often fall to the bottom of the priority list.
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Don’t leave the ship without them
Mark Bergman and Tim advised passengers to sign releases and demand printed records at the time of care. Tim suggested holding payment until the receipts and records are in hand to force the issue while you still have leverage.
