Thailand is considering rules that would require foreign visitors to carry accident insurance, as public hospitals report growing volumes of unpaid medical bills linked to the country’s tourism sector and rising visitor numbers across Asia.

Authorities consider insurance requirement at the border

According to Bangkok Post’s report, health and tourism officials are reviewing options that would make accident insurance a condition of entry for international tourists, based on public statements from hospital leaders and policymakers. The issue has been driven by cases where uninsured foreign patients receive emergency treatment in destinations such as Phuket and Chiang Mai but are unable to pay. Under existing practice, hospitals provide urgent care regardless of a patient’s financial capacity, leaving facilities to absorb the cost when visitors lack coverage.

“Each year, we absorb about 10 million baht in treatment costs for foreign patients without insurance,” the director of Vachira Phuket Hospital said. He described common risk factors in resort areas. “Many visitors come to Phuket and try riding motorcycles for the first time, which increases accident risks,” he said, adding that alcohol and drug use can also contribute to serious injuries. The Ministry of Public Health estimates that unpaid hospital bills from foreign patients amount to at least 100 million baht annually. A compulsory insurance regime would transfer a greater share of this financial exposure to private insurers, including international and regional carriers active in Asian travel markets.

Tourism rebound sharpens focus on medical risk

The policy discussion is taking place as Thailand’s inbound tourism continues to expand. According to The Nation’s report, the Tourism and Sports Ministry reported that the country received 32,974,321 foreign visitors in 2025, generating 1.53 trillion baht in revenue from international spending. Malaysia and China were the largest source markets, with 4,520,856 and 4,473,992 visitors respectively, followed by India, Russia, and South Korea. Officials project that short-haul markets in Asia and the South Pacific will account for more than 70% of foreign arrivals in 2026.

Tourism Authority of Thailand (TAT) governor Thapanee Kiatphaibool said the agency is targeting 36.7 million foreign arrivals in 2026. She said 2025 performance was “not bad” given prevailing challenges and noted that Bangkok remained the world’s most-visited city, with more than 30.3 million foreign visitors. She added that the capital continues to attract a range of “quality tourists.” TAT is also aiming for more than 205 million domestic trips in 2026, with a combined revenue target of about 2.78 trillion baht from both international and domestic tourism.

Insurance gap shapes exposure for hospitals and insurers

Despite the volume of inbound travel, many visitors still enter Thailand without any form of travel or accident cover. Industry figures cited by Thai officials indicate that a two-week travel insurance policy typically costs around 1,100 baht and offers medical limits in the range of 3.6 million to 9 million baht. The divergence between available coverage and actual take-up has left hospitals exposed to bad debt and influenced how insurers assess medical and liability risk linked to Thailand’s role as a major tourism destination.

Earlier proposals included a 300 baht entry fee for air passengers, which remains under cabinet consideration. Recent discussions, however, have shifted toward directly requiring insurance, which authorities see as more closely tied to health and accident risk. Mandatory travel insurance frameworks already exist in the Schengen Area, the United Arab Emirates, Russia, and Cuba, where cover is commonly embedded in visa processes or bundled with travel purchases. A Thai model could involve integrating accident or health insurance into airline ticketing, online travel platforms, border formalities, or e-visa systems widely used across Asia.

Implications for Asia-based insurers and distributors

A formal requirement for accident cover in Thailand would likely increase use of short-term medical and accident products among inbound travellers, particularly from regional markets such as Malaysia, China, and India. Global and regional carriers may need to align benefit structures with Thai hospital costs and regulatory conditions, and consider distribution through airlines, online travel agencies, fintechs, and insurtech platforms. Brokers and managing general agents focused on travel, health, and assistance lines may also need to adjust program design, pricing, and cross-border claims handling if new rules are introduced. As Thailand seeks to grow tourism volumes and revenue, its consideration of compulsory accident cover illustrates a broader regional trend: governments using insurance as a tool to manage the fiscal and operational impact of medical treatment for foreign visitors. Thailand’s approach may signal how other high-volume destinations in Asia could seek to balance tourism development with the financial pressures on public health systems and local providers.