An injured skier who flew home from Japan against his insurer’s advice has won his bid for a payout to cover an air ambulance and unused hotel costs.

The man travelled home for surgery, acting on medical advice that insurer AIG disagreed with.

Now, the Australian Financial Complaints Authority has ruled it was fair to return and AIG should pay $310,502.

The complainant broke his leg while skiing in regional Japan in February last year.

He said a doctor there initially recommended surgery in Japan and recovery in Australia, but the medic later reconsidered because he did not think he could safely perform the operation.

The complainant asked AIG to repatriate him. When it declined, he hired an air ambulance, costing $282,000. He said he could not fly commercially and his surgeon in Australia confirmed this, saying it was a “very complicated injury that requires a specialist trauma knee surgeon’s input”.

AIG argued repatriation was unnecessary and offered to cover reasonable costs if the insured had surgery in Japan and flew home business class.

The ombudsman notes the claimant paid a higher premium after selecting the “snow sports” option of his travel insurance policy.

AIG offered a settlement of $135,418 based on what it may have cost to have the surgery in Japan.

The insurer’s medical expert said the Japanese health system could have managed the injury, but the ombudsman accepts the complainant had genuine concerns about staying in Japan for surgery, and the flight home appeared the only reasonable option.

Read the determination here.