Who pays for medical treatment if my family member is injured at sea?

Under MLC 2006 Standard A4.1, the shipowner is responsible for the cost of medical care for seafarers who become sick or injured during the period of employment. This includes onboard treatment, shore-side hospital care, and the cost of repatriation if medically necessary. These costs are covered by the shipowner's P&I (Protection and Indemnity) club insurance. The seafarer or their family should not be asked to pay upfront for treatment arising from a work-related illness or injury. If you are asked to pay, refuse and contact the ITF immediately.

What is TMAS and does my family member have access to it?

TMAS stands for Telemedical Assistance Service — it is a 24/7 remote medical consultation service provided by shore-side physicians, required under SOLAS Chapter IV and MLC. Every ship is required to have access to a TMAS provider. The master or ship's medical officer contacts TMAS for advice on diagnosis and treatment for any crew member. The service is free to the seafarer — it is part of the ship's mandatory safety equipment. Major providers include the Italian CIRM, the French CCMM, and the UK's Aberdeen TMAS.

Do I have the right to know what is happening to my family member medically?

The seafarer has a right to information about their own condition and treatment. They can consent to sharing that information with a named next-of-kin, and most companies will communicate with the family as a matter of course in serious cases. Under GDPR and equivalent privacy laws, the company cannot share confidential medical information about an adult seafarer without that person's consent — unless the seafarer is incapacitated. If you are struggling to get information, ISWAN SeafarerHelp can help you navigate the right contacts and, if necessary, escalate through the ITF.

What if there is a language barrier between my family and the company?

ISWAN SeafarerHelp operates in multiple languages — they can help a non-English-speaking family communicate with an English-language shipping company or P&I club. The ITF inspector network also covers many languages. If the company provides documents only in English and your family does not read English, ISWAN can help facilitate translation of key correspondence. P&I clubs deal with multinational families routinely and usually have multilingual case officers or access to translation services.

Injury or illness onboard

Receiving news that a family member has been injured or fallen seriously ill at sea is frightening, particularly when the ship is far from port and communication is limited. The international maritime system has established legal obligations and support structures that apply in exactly this situation — but families often do not know they exist. This page explains what to expect, who pays for what, and how to get information when communication with the ship is difficult.

How medical care works at sea — TMAS

Ships are not hospitals, but they are not without medical support. Two systems operate in parallel:

Onboard medical officer or trained first-aider. STCW requires all ships to carry crew trained in medical first aid. Ships carrying 100 or more persons must carry a medical doctor. Larger vessels have a ship's hospital; most vessels have a medical kit and a trained designated person. Under MLC Standard A4.1, ships must carry medicines, equipment, and a medical guide sufficient to care for the sick and injured until they reach a port with medical facilities.
TMAS — Telemedical Assistance Service. Required under SOLAS Chapter IV, TMAS is a 24/7 shore-side medical consultation service available to any ship at sea. The master or trained medical officer contacts TMAS by radio or satellite telephone; a shore-based physician advises on diagnosis, treatment, and whether evacuation is necessary. The service is free to the crew and covered as part of the shipowner's obligations. Major providers include CIRM (Italy), CCMM (France), and Aberdeen TMAS (UK).

Medical evacuation and repatriation

If a seafarer's condition requires shore-side hospital care, the master and TMAS coordinate evacuation. Options depending on position and severity:

Diversion to the nearest suitable port — the most common route for serious but stable cases.
Helicopter evacuation (MEDEVAC) — used for life-threatening conditions where the ship is within helicopter range of a coast guard or military base.
Transfer to a passing vessel — rare, used when a vessel with better facilities is nearby.

Under MLC 2006 Standard A4.1, all costs — evacuation, hospitalisation, treatment, and repatriation back to the seafarer's home country once medically fit — are the shipowner's responsibility, covered by the P&I club. The coverage extends for a period after the end of the employment contract (minimum 16 weeks for illness, 12 weeks post-disembarkation for some conditions — the SEA and P&I club terms apply). See medical care rights and injury and death compensation.

P&I cover — what it means for families

The P&I (Protection and Indemnity) club is the shipowner's liability insurer. For families, the P&I club is the entity that authorises and pays for:

Medical treatment — hospital, surgery, specialist care.
Repatriation — cost of transport home when the seafarer is fit to travel.
Continued wages during incapacity (as required by MLC and the SEA).
Death benefits and outstanding wages if the seafarer does not survive (see injury and death compensation).

The P&I club details — which club, which policy — should appear in the DMLC Part II document. Ask the manning agency for this document before the contract starts, or check the documents families should keep page for a full list of what to collect.

Your rights to information

In a serious medical situation, the seafarer can consent to the company sharing information with a named next-of-kin. If the seafarer is incapacitated, the company has a welfare obligation to communicate with the family and should do so as a matter of course. If you are not receiving information:

Contact the manning agency directly and ask for a welfare update in writing.
Contact the P&I club if the agency is unresponsive — the club has its own case officer assigned to the claim.
Contact ISWAN SeafarerHelp for help navigating the system and, if necessary, escalating through the ITF.

Frequently asked questions

Who pays for medical treatment if my family member is injured at sea?
Under MLC 2006 Standard A4.1, the shipowner is responsible for the cost of medical care for seafarers who become sick or injured during the period of employment. This includes onboard treatment, shore-side hospital care, and the cost of repatriation if medically necessary. These costs are covered by the shipowner's P&I (Protection and Indemnity) club insurance. The seafarer or their family should not be asked to pay upfront for treatment arising from a work-related illness or injury. If you are asked to pay, refuse and contact the ITF immediately.
What is TMAS and does my family member have access to it?
TMAS stands for Telemedical Assistance Service — it is a 24/7 remote medical consultation service provided by shore-side physicians, required under SOLAS Chapter IV and MLC. Every ship is required to have access to a TMAS provider. The master or ship's medical officer contacts TMAS for advice on diagnosis and treatment for any crew member. The service is free to the seafarer — it is part of the ship's mandatory safety equipment. Major providers include the Italian CIRM, the French CCMM, and the UK's Aberdeen TMAS.
Do I have the right to know what is happening to my family member medically?
The seafarer has a right to information about their own condition and treatment. They can consent to sharing that information with a named next-of-kin, and most companies will communicate with the family as a matter of course in serious cases. Under GDPR and equivalent privacy laws, the company cannot share confidential medical information about an adult seafarer without that person's consent — unless the seafarer is incapacitated. If you are struggling to get information, ISWAN SeafarerHelp can help you navigate the right contacts and, if necessary, escalate through the ITF.
What if there is a language barrier between my family and the company?
ISWAN SeafarerHelp operates in multiple languages — they can help a non-English-speaking family communicate with an English-language shipping company or P&I club. The ITF inspector network also covers many languages. If the company provides documents only in English and your family does not read English, ISWAN can help facilitate translation of key correspondence. P&I clubs deal with multinational families routinely and usually have multilingual case officers or access to translation services.