Divers Alert Network, which is probably the most well known dive membership (and insurance) org out there is registered in Malta in Europe.

Absolutely horrible according to DIVE TALK

https://www.youtube.com/watch?v=O7NsjpiPK7o

Insurance company would not cover a decompression chamber for someone who has severe decompression sickness, it is a life-threatening condition that requires immediate remediation.

The idea that you possible neurological DCS and you must argue on the phone with an insurance rep about if you need to be life-flighted to the nearest chamber is just.... Mind blowing

It is probably among the standard forms required to participate in a diving class/excursion for travelers from other countries; and, Malta was probably chosen as the official HQ for legal or liability shelter reasons.