Ask any newly-arrived expat what they are afraid of and you get the same list. Snakes. Spiders. Crocodiles. Something exotic and venomous.
Now look at what actually happens.
The World Health Organization estimates 18,218 road traffic deaths in Thailand in 2021 — around 50 a day. Thailand ranks ninth out of 175 WHO member states for road fatality rate, at 25.4 per 100,000 people. Motorcyclists account for 83.8% of those deaths, and the most affected group is aged 15 to 29. Vietnam sits at 17.7 per 100,000, above both the Asia-Pacific and Southeast Asian averages.
The thing that will hurt you in Asia is a rented scooter, a wet road and a driver who did not see you.
“That is the real risk. But it is not the thing that ruins you.”
What ruins you is the exclusion
Here is the sequence that plays out every week somewhere in this region.
You rent a scooter in Phuket or Bali. You hold a car licence from home. You do not hold a motorcycle entitlement, and your international driving permit does not cover two wheels. Nobody at the rental shop asks. Everybody does it.
You come off the bike. You are in a private hospital with fractures, possibly a head injury, looking at a bill in the tens of thousands.
Then your insurer reviews the claim.
Look at the general exclusions in Bupa Global's own 2026 schedule — they are typical of the market, not unusual. Among the exclusions applying across all plans: illegal activity, harmful or hazardous use of alcohol, drugs and/or medicines, and professional sports activities.
Riding a motorcycle without the legal entitlement to ride one is illegal activity. Riding after drinking engages the alcohol exclusion. Either can be enough for a declined claim.
“You were insured. You are simply not covered for what you did.”
The five that actually catch expats
- 1. No motorcycle licence — The single most common declined claim in Southeast Asia. Your home car licence does not entitle you to ride a scooter, and an IDP only covers the categories you already hold.
- 2. No helmet — Where local law requires one, riding without it can be treated as illegal activity in its own right.
- 3. Alcohol — Not "drunk driving" as a criminal matter — any involvement of alcohol in the incident can be enough to engage the exclusion. One beer at dinner, a scooter home, a crash at 10pm.
- 4. Adventure and hazardous activities — Diving beyond your certification, climbing, motorsport, martial arts, rugby. Some are excluded outright, some require a paid extension. Check before you sign up, not after.
- 5. Dengue is not exotic, it's routine — Mosquito-borne illness is a far more realistic hospitalisation risk than any animal on your list, and in the region's private hospitals a week of inpatient supportive care is a substantial bill.
The honest version of your fear
Snakebite is a genuine and serious problem in rural Asia. It overwhelmingly affects agricultural workers, not expatriates in cities. If you are reading this from an apartment in Bangkok, Singapore or Hong Kong, the traffic outside your building is a materially larger threat than anything with fangs.
Rabies is the one exotic risk worth taking seriously — a stray dog bite, anywhere in the region, means post-exposure prophylaxis promptly and without argument. Check that your plan covers it.
What to do about it
- Get the correct licence — A motorcycle entitlement at home and the matching IDP category costs very little and converts an excluded claim into a covered one. It is the highest-return administrative task available to you in Asia.
- Read your exclusions once — Not the benefits — the exclusions. Ten minutes, once, before you need them. Look specifically for illegal activity, alcohol, hazardous pursuits and sports.
- If you ride, tell your broker — There may be an extension available. If there is not, you now know something important.
- Do not assume travel insurance covers it either — The same exclusions appear there, usually more tightly drawn.
The point
Asia is not dangerous in the way people imagine. It is dangerous in an entirely ordinary way — traffic, at scale, on two wheels, with limited enforcement.
You do not need protection from crocodiles. You need protection that still pays out when you have done the thing that half the expats in this region do every single day.
The tragedy is never being uninsured. It is being insured, injured, and finding the clause.
“Ask Mira what your plan excludes — motorcycle, alcohol, adventure sports — before you need to know.”
Written and verified by Jean-Marc Herbet — Managing Director, Expat Medicare. Thirty years advising expatriates on international private medical insurance across Asia. Expat Medicare is a licensed IPMI brokerage. General information, not personal, medical or legal advice. Exclusion wording, licensing requirements and their application to a claim vary by insurer, policy, jurisdiction and the facts of each case. Refer to the general exclusions in your own policy documents and confirm your position with your insurer.
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