Book an excursion through a cruise line, and if something goes wrong, the cruise company will back you up. Arrange a shore visit on your own and, depending on circumstances, you could be on your own.

When 16 Celebrity cruise passengers were injured during a ship-arranged scenic drive in Dominica on Monday, the cruise line sent a ''care team'' to the island and paid for medical evacuations. The tour company had been vetted by Celebrity to ensure its staff was trained, equipment up to standards and insurance adequate.

But when 12 U.S. cruisers arranged their own tour in Chile in 2006, the bus driver and vehicle had not been certified to transport passengers, officials in Chile later said. The van crashed, and all 12 died. The cruise line -- again Celebrity -- sent staff to help passengers and family members. Though they weren't responsible for expenses, Celebrity picked up the tab.

Other major lines have similar practices. ''Even if it's not our excursion, if there's an accident we're going to do everything we can to take care of those guests because reality is those guests are in a foreign country,'' said Tim Gallagher, spokesman for Carnival Cruises.

But when it comes to paying for medical expenses, the passengers -- or their travel insurance policies -- technically are responsible.

Shore excursion tickets typically state that cruise lines are agents only and therefore not responsible for safety or medical expenses related to accidents.

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