Should Airlines Rebook Sick Passengers for Free?

Sick passenger on an airplane with headache
Sick passengers may choose to fly anyway because they don’t want to pay to change to a later flight. Photo: Adobe Stock.

Last year, a Delta flight from Atlanta to Barcelona had to divert due to “passenger diarrhoea all over the aircraft”. It was so bad that the pilots declared it a “biohazard”.

This was no doubt an extremely uncomfortable and embarrassing situation for the passenger. It was also costly for the airline and inconvenienced hundreds of other passengers, who arrived at their destination many hours late.

It begs the question: Why would somebody board a plane in the first place when they’re feeling so unwell?

Although that Delta flight was an especially shitty situation, many people every day board flights despite feeling sick. Some people may even be infectious and could pass on viruses, including COVID-19.

Delta A350 soaring above the clouds
A Delta flight to Europe had to turn back to Atlanta to offload a very unwell passenger. Photo: Delta Air Lines.

Perhaps some people do this because they just really want to get home, or need to get to their destination, no matter what. And they’re prepared to put others at risk to do so.

But you have to wonder whether more sick passengers would choose to delay their travel if airlines made it easier to change their flights.

Will airlines rebook sick passengers for free?

Australian Frequent Flyer put this question to Qantas, Virgin Australia, Jetstar and Singapore Airlines.

In general, these airlines adopt a “case by case” approach rather than publishing a formal policy. All airlines require customers who booked through a travel agent to contact their agent for assistance with rebooking flights.

Qantas rebooking policy

When you check in online, Qantas specifically asks you to confirm that you’re not feeling unwell. But what happens if you say that you are unwell?

The airline told us that customers who are feeling unwell or believe they may be infectious within a week before departure should contact Qantas to discuss their options. These options could include waiving change fees or getting a flight credit for the value of the booking.

Virgin Australia rebooking policy

Virgin Australia told us they have processes in place to assist guests who are injured or unwell on the day of travel to change or cancel their bookings. The airline said it encourages affected customers to call its Guest Contact Centre on 13 67 89 for assistance.

Virgin noted that outside of these circumstances, changes and cancellations are only possible according to the fare rules on the ticket.

Jetstar rebooking policy

A Jetstar spokesperson pointed out that Jetstar offers flexible airfares allowing changes for any reason. But for the majority of Jetstar customers with tickets that don’t allow free changes or cancellation, the airline says it reviews requests on a case-by-case basis. It may waive change fees, but only on compassionate grounds.

Singapore Airlines rebooking policy

A Singapore Airlines spokesperson said that “SIA advises customers who are unwell to defer their travel plans to a later date”.

“Customers who booked directly with us and would like to reschedule or cancel their flight itineraries due to medical reasons may do so via our online Assistance Request Form. They may also contact us if they require further assistance with their bookings. All flight change and cancellation requests due to medical reasons will be assessed on a case-by-case basis.”

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Most airlines say they may rebook unwell passengers, but only on a case-by-case basis. Photo: Troy Mortier on Unsplash.

Should airlines make it easier for sick passengers to change flights?

On some airlines, you might have to forfeit your ticket if you no-show for a flight – even if it’s because you were sick and could pose a risk to other passengers.

If this is the case, the airline is effectively incentivising you to take the flight anyway. This could mean potentially infecting other passengers on board and even the airline’s own cabin crew.

If a passenger is really sick, they may even require medical attention during the flight – which is disruptive to other people on board. And if the flight needs to divert, that costs the airline tens of thousands of dollars.

For all of these reasons, it is surely in both the airline’s and the passenger’s best interests to allow free-of-charge rebooking if a passenger is genuinely sick on the day of the flight.

Airlines may lose a few hundred dollars in change fees from sick passengers that they rebook for free. But that pales in comparison to the costs of having to divert or replace sick cabin crew.

Having said that, there is a clear need for a middle-ground that balances the safety of passengers and crew with the need for airlines to protect their revenue.

For example, it would be reasonable for airlines to require a medical certificate. Otherwise, some passengers could exploit this generosity to avoid paying legitimate change or cancellation fees. If it’s too easy to avoid paying change fees, airlines might even sell fewer of the more expensive flexible airfares.

Some airlines would argue that this is what travel insurance is for. That is a reasonable argument – travel insurance is designed to protect passengers if unforeseen events disrupt their travel. But the reality is that not everyone buys travel insurance.

Ultimately, if a passenger presented for check-in looking obviously unwell, most airlines would probably just rebook them for free. But it would surely be better for everyone involved if this policy was formalised so that sick passengers didn’t feel they needed to go to the airport in the first place.

What do you think? Share your thoughts on the Australian Frequent Flyer forum!

The editor of Australian Frequent Flyer, Matt's passion for travel has taken him to over 70 countries… with the help of frequent flyer points, of course!
Matt's favourite destinations (so far) are Germany, Brazil & Kazakhstan. His interests include economics, aviation & foreign languages, and he has a soft spot for good food and red wine.

You can connect with Matt by posting on the Australian Frequent Flyer community forum and tagging @AFF Editor.
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Funnily enough, i just directed some friends on family holiday to call QF about rebooking on compassionate grounds while in Bali due to illness

Two week vacation, currently a week in; 18 y.o. son was sick after arriving and just ended up having appendix removal while there!

Now they're understandably reconsidering plans in all directions, coming home sooner and rebooking in business, and staying longer, depending on recovery progress

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Isn't that what Travel Insurance is for? Domestically? I don't think it's an airlines responsibility. I'd not expect this unless I got to the plane and the airline refused me travel for some such reason. It's a risk you take. I know having tested positive immediately after arrival from the UK, I'd travelled with Covid although at that time I mostly wore a mask, but I had no symptoms.

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Lots of people get on flights when sick eg wirh colds, flu, Covid etc. If they could change their flight for free and not fly when sick, it would be best for everyone. However, can see it being open to abuse..

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Isn't that what Travel Insurance is for?

Exactly. If free cancellations for minor illness were to be introduced the airfare cost would increase for everyone, because of the cheapskates who choose to roll the dice and not be insured.

Some countries like Cuba require all international visitors to have TI medical coverage that includes evacuation in order to enter the country. Fabulous idea, imagine if Indonesia required this, we would see less go fund me requests for drunken bogans who injure themselves riding motor bikes unlicensed without a helmet in Bali then expect the government or public to bail them out.

So internationally I have zero sympathy for the cheap skates without insurance, if you cant afford insurance, you cant afford to travel.

Domestically, in case of genuine serious illness i.e. where person is hospitalised or properly diagnosed as contagious one can usually negotiate a credit. If you cant afford to cover the change/rebooking fee then again you should get domestic TI (or consider whether you can really afford to travel).

Those who are too cheap to get TI, tend to be the price sensitive types who will stop flying when prices increase heaps to cover their lack of insurance if a free cancellation was introduced for minor illnesses, which we all know would be exploited given the ease of getting medical certificates online. So ultimately just drives prices up for the responsible travelers.

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It's also each traveller's responsibility to act in a way prior to travel which keeps them as healthy and "match fit" as possible. Especially, if you are travelling internationally and would incur large costs (relative to your funds) and/or your schedule is inflexible (e.g. important meetings or events), you avoid all reasonable risks.

For the unfortunate surprises there's the TI to cover the rest. Though, the insurance industry needs to pull their weight, as well, instead of attempting to obstruct and obfuscate claims(1). While the cheaper tickets are appealing in cost, the buyer also makes a known decision to fork up money should their situation change. As long as airlines offer also tickets with low-cost or free changes, I'd suggest they should not need to routinely offer waivers for the lower booking classes, In fact, it's great that they already have the 'compassionate grounds' process and that's worth keeping for its own purpose but for your (reasonably) avoidable illnesses, etc, it should not be necessary.

(1) Back where I grew up, insurance companies were legally mandated to settle claims within 1 month from receiving the necessary paperwork, e.g. doctor's certificates, building inspector assessments, whatever they required. The system worked well and the companies were geared up to resolve matters efficiently instead of dragging everyone's feet. I wish we had a similar approach in Australia, too.

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As far as the Bali issues, many of them are locals who move there, then a couple of years down the track, the inadequacy of the medical system comes into play and they want to get back to Australia. Completely ignoring the fact that the reason why living there is so cheap is because they don't pay the taxes needed for a good public hopital system. But others are just asking for trouble.

Well majority of the recent cases I've read in the media related to Bali (and Thailand) were idiots who were either:

1. Uninsured

2. Not adequately Insured i.e neglected to read their policy and pay the extra fee for motorcycle/moped use such as Insurance company denies Adelaide man's claim after Indonesian scooter accident

3. Insured but void said insurance because they rode a motorcycle/moped without holding an Australian motorcycle license or sustained injuries when were very drunk. Again a case of failing to understand the rules of coverage.

I do not feel everyone should incur higher prices because some people make poor decisions.

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If it was an option would be exploited by those who want their cake and eat it - the cheapest non-refundable fare then opt out with a tummy ache and want a refund when they changed their minds.

That being said, my adult daughter was suddenly admitted to hospital a few years back and I rang JQ on her behalf saying she couldn't be on the flight due to hospitalisation and no questions asked other than “refund or credit”. Was impressed/shocked.

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The work I did meant I saw a lot of genuine cases of illness that wasn’t easily predictable. Fortunately in Australia the airlines are very good with their treatment of the compassionate cases.
It is better if your doctor is involved and speaks to the airlines medical staff. That usually ensures that there are no misunderstanding on either side.

On the other side are those cases where there is no immediate need for treatment such as coughs and colds it really is up to the individual to think of the other passengers and crew. If you have a cough or cold you really should take simple precautions such as wearing a mask.

Yes people should have travel insurance but the situation is that most people who have a cold etc will travel because they can’t get a credit or get rebooked easily. And that puts other folk at risk.
Not all colds are simple. I was involved in treating a woman who had flown from LHR to SYD and who had coughed through out the flights. She had TB. There ended up being 2 people who eventually tested positive for TB on the Australian sector and another on the sector out of LHR.

So it is not always a black and white issue.

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It is naive to think that everyone with a cough will be considerate and not travel to protect others even if airline provides for refund or free rebooking.

During Covid restrictions when Qantas was offering free rebooking if you had covid or symptoms, I was on many domestic flights where people with obvious respiratory illness were flying.

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The airline [Qantas] told us that customers who are feeling unwell or believe they may be infectious within a week before departure should contact Qantas to discuss their options.

All good in theory Qantas - If anybody is feeling sick within 24hrs of my flight, I doubt anyone at Qantas will even reply, much less deal with the problem with a sensible solution in that time. More than likely they'll get the scripted step-by-step process, and end up taking the flight anyhow.

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