Crewmembers are Entitled to Free Medical Care Under Maritime Law

Information for Crew Members

Free Medical Care Under Maritime LawUnder American Maritime law, all vessel owners and operators have the legal obligation to provide free medical care for any crew member that is injured or becomes sick while he is working or is in the service of the ship. By the time of the case of Harder vs. Gordon in 1823 this was already well established law.

What does this mean for the crew member working on a cruise ship?

It means that if a crew member suffers an accident on a cruise ship and becomes injured or sick, the company he works for cannot evade the responsibility to provide him free medical care by the simple expedient of sending him home. The company cannot legally abandon an injured or sick crew member. The obligation to provide free medical care to an injured or sick crew member is so strong that it does not matter if the crew member was negligent or had any fault in causing his maritime accident or sickness. The only legal requirement to receive free medical care is that the crew member be working at the time of his medical problem or that he be in the service of the ship. For example, if a crew member is injured or becomes sick while on shore leave, he is still entitled to free medical care. If a crew member is traveling from his home to the ship or from the ship to his home, he is entitled to free medical care. American courts have been so generous in interpreting the crew member’s right to receive free medical care that in the famous case of Koistinen v. American Export Lines, a crew member was allowed to recover the medical expenses he incurred when he was injured by jumping out of the window of a house of prostitution.

What types of injuries or sickness entitle the crew member to receive free medical care?

The injury or sickness does not need to be related to the crew member’s work. It does not need to be caused by a maritime injury, or other cruise ship incidents. For example, a crew member is entitled to free medical care for a gall bladder attack, heart attack, diabetes, kidney stones, mental conditions, or any other medical treatment. Even when a pre-existing medical condition recurs, the crew member is still entitled to free medical care.
The crew member’s right to receive free medical care from the company is expected to work automatically without uncertainty or administrative delay or haggling.
American courts have imposed a duty on the employer under maritime law to pay for the crew member’s medical care irrespective of cause or fault and to resolve any doubts in favor of paying the crew member’s medical expenses.

Where am I entitled to receive my medical treatment?

The crew member is entitled to receive his emergency and non-emergency medical care aboard the ship, and at the nearest port depending upon of the severity of his injury or sickness. If the cargo or cruise ship injury or sickness renders the crew member unable to work, then, after the initial medical care is given, a doctor will determine if he is able to travel. If the crew member is able to travel, he will probably be sent home to receive his medical care. If the crew member is not able to travel, he will receive free medical care wherever he is at.

Can the company send me to a third country to receive my medical care?

In the last few years, many of the cruise companies have negotiated with doctors and hospitals in poor countries to obtain cheap and low quality medical care for their crew members. Instead of giving the medical care at the closest port or in the crew member’s home country, they try to send the crew member to a third country for his medical care. This is not an accepted practice and the crew member can and should refuse to go to a third country for medical care.

When does the company obligation to provide medical care end?

The company’s obligation to provide free medical care ends when the crew member has reached maximum medical improvement.

What does maximum medical improvement mean?

Maximum medical improvement means that, in the doctor’s opinion, any additional
medical treatment will not improve the crew member’s medical condition.

Who determines when the crew member has reached maximum medical improvement?

This is determined by the crew member’s doctor. When the crew member’s doctor writes a medical report saying that the crew member will not benefit from any additional medical care, the company’s obligation to provide it ends.

Can I challenge the doctor’s opinion that I have reached maximum medical improvement?

If the crew member disagrees with the doctor’s opinion that he has reached maximum medical improvement, he can challenge the doctor’s opinion. If the doctor who determined that the crew member has reached maximum medical improvement was selected by the company instead of the crew member, the crew member can get a different opinion from an equally qualified doctor and challenge the company doctor’s opinion. If the crew member selected his own doctor, challenging his opinion is far more difficult but it still can be accomplished in some cases.

What can I accomplish by challenging the company doctor’s opinion as to maximum medical improvement?

A successful challenge to the company doctor’s opinion will result in the company reopening the crew member’s medical file and giving him any additional treatment
that he may need such as additional medication, additional medical testing, additional therapy, additional surgery, etc.

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Cruise Ship Incidents & Engine Problems Are Surprisingly Common

Maritime Articles

Though cruise trips are one of the most reliably safe and enjoyable vacations a traveler can choose, engine mishaps, malfunctions and other cruise ship incidents are more commonplace than the cruise industry lets on. There are many reasons for this, so would-be passengers need to be aware of the facts before they make a final decision.

Cost cutting affects cruise ship incidents

In the era of cost-cutting and competitive pricing, it can be easy for cruise ship companies to cut corners on ship upgrades and repairs until it is too late. Ship repair and retrofitting can be quite costly, so it is fairly common for ships to be sailing with an outmoded engine and inadequate backup power sources.

One of the latest incidents to illustrate this bleak reality occurred on the Carnival Triumph, which suffered an engine room fire while sailing in the Gulf of Mexico. The main engine was disabled and the ship did not have a viable backup power source. The result was over 4,000 passengers left to drift at sea for 5 days without power, plumbing, or standard sanitation. The suffering finally ended when the ship was towed to Alabama on Valentine’s Day earlier this year, though the trauma experienced by the passengers continues to this day as many wait for their lawsuits to be heard in the U.S. court system.

"Engine and weather-related problems are very common", notes Ross Klein, prominent author and editor of According to the 2007 records on his site, around 5% of the ships cancelled some port calls or altered itineraries due to engine issues, accidents, or equipment failures.

Though unfortunate, weather related problems are more understandable, since the cruise industry has no say over the matter. The only point of concern is if the captain of the ship insists on sailing and sacrificing everybody’s well being in the face of extreme weather, safety be damned.

Weather problems truly become an issue when a ship’s crew members are not properly trained because the cruise ship owner has chosen to hire the cheapest available labor. There is a domino effect that is not always readily apparent – many crew members are overworked and underpaid and may not even be proficient in communicating with each other, which can compromise efficient planning and evacuation during an event of an accident or emergency.

Cruise ship incidents are related to the use of “flags of convenience”

The "flags of convenience" phenomenon has only made these safety concerns worse, because it allows ship owners to bypass strict safety and labor laws to maximize profit. For the uninitiated, flags of convenience allow ship owners to register their cruise ship under other countries in order to save on registration fees and taxes, and to be almost legally untouchable in the event of a crime or accident.

There is very little recourse for the passenger when the cruise ship’s engine breaks down or when an accident occurs during the vacation. What the cruise ship will do for recompense is outlined on the ticket, so passengers would do well to read everything, especially the fine print.

Public opinion affects cruise ship companies’ decisions

Though cruise ship companies are practically invincible under the court of law, they are not immune to the power of public opinion. In the end, the cruise ship industry is wholly dependent on the public’s trust if it wants to survive. All it takes is widespread negative publicity and a threat of a costly public boycott for a ship owner to clean up their act, knowledge is power after all, which no court of law can ever nullify.

Cruise Passengers Have Fewer Consumer Rights than Airline Travelers

Information for Passengers

Cruise ship passengers have more limited compensation rights and consumer protections than air travelers – as the Carnival Triumph passengers found to their dismay.

Cruise ship regulations and cruise industry loopholes

Cruise ship passengers contemplates cruise lawsuitThe cruising industry is regulated by the Federal Maritime Commission (FMC), which focuses on safety rather than consumer issues. The FMC is not as strict as the US Department of Transportation, which oversees the airline industry and enforces consumer-friendly regulations. In addition, many cruise lines sail under foreign flags such as the Bahamas, Panama, Liberia, or Honduras, which enables major cruise operators like Carnival Cruise Lines and Royal Caribbean to avoid paying US federal taxes and exempts them from following regulations and standards established by the US government.

These loopholes mean that cruise ships passengers can experience on-board fires, power outages, and other maritime hazards, yet they have limited legal recourse for their pain and suffering.

“Each of these issues requires urgent attention from both the industry and regulators,” said Ross Klein, a researcher at Memorial University of Newfoundland, Canada. “Because most [cruise ship] accidents are avoidable – related either to human error or to allowing ships out of port with unresolved mechanical issues – there is a need for much greater oversight of the industry and stricter enforcement of safety standards.”

Significant cruise ship accidents

According to Klein’s research, there have been at least 100 recorded cruise ship incidents worldwide in which cruise ships have gone adrift or sustained power outages since 2000. In addition, there have been 79 onboard fires and 73 collisions recorded for cruise ships since 1990.

In defense of the industry, The Cruise Lines International Association (CLIA) insists that its members “are subject to a very comprehensive body of laws, regulations and policies established at the national and international levels.”

The International Maritime Organization (IMO) also oversees the cruise industry and establishes global standards that all vessels are required to adhere to. However, its regulations specify cruise safety standards rather than passenger rights and comfort.

Notable past cruise ship incidents include: a fire on the Azamara Quest near the coast of Malaysia; the Costa Concordia accident last year; and a power outage on the Allegra, which stranded 1,000 passengers without power or water for one week. In response, CLIA adopted 10 new regulations to ensure cruise ship passenger safety, such as the number of available life jackets and revamped emergency procedures.

CLIA released an official statement regarding the new policies, stating: “Cruising is one of the safest forms of leisure transportation, thanks to our industry-wide commitment to safety, strict regulations and vigorous enforcement mechanisms. Yet the rarity of cruise ship accidents does not mitigate the pain and loss we feel if they do occur.”

Cruise passengers may have limited consumer rights and protections

However, the new regulations have done nothing to spell out and formalize consumer rights and protections for cruise passengers. Critics also charge that the new policies do nothing to mitigate lax global oversight, even when the ships dock at US ports and submit to US Coast Guard inspections.

“There is not one universal overlord” that oversees the vessels, explained Robert Jarvis, professor of maritime law at Nova Southeastern University Law Center in Fort Lauderdale, Fla. “So there is a race to the bottom for cruise lines looking for which country is the most lax and the most inexpensive. And there are countries that say to ship owners, ‘If you come here and pay an annual fee, we will leave you alone.’ “

Would-be cruise passengers need to carefully read the contract on their ticket, so they can understand what they are entitled to if anything were to happen. Standard practice usually involves full or partial refunds, or credits toward a future cruise. In response to what the 3,143 Carnival Triumph passengers endured, Carnival Cruise Lines offered $500 on top of a full refund for their ticket.

According to Carnival Cruise Lines, an engine room fire causes the power outage. The US National Transportation Safety Board will be investigating the cruise ship incident, though any impact on cruise regulations remains to be seen.

Cruise lawsuit immunity

Cruise ships are largely immune to lawsuits, since the standard of proof required of the plaintiffs are very difficult to fulfill. For a cruise ship lawsuit to have any traction, it must be proven that the cruise company knew that the vessel was not seaworthy, which is very hard to establish.

Though cruise vacations are often one of the safest travel options around, travelers need to be aware of what their rights are in case the unthinkable happens. Unfortunately, the cruise industry continues to operate in a type of legal purgatory, which means that passengers won’t be able to expect substantial changes in consumer protection anytime soon.

If you have suffered from a cruise ship accident, please contact our law office for a free evaluation. Attorney Elias Rudnikas is a maritime lawyer that provides law services free of charge until he wins each case.