Sheryl

An Ombudsman will follow the terms of the policy which is a binding contract. An Ombudsman cannot and will not make a ruling that clearly contravenes the contractual agreement between the insured and jnsurer. They can only require the insurer to adhere to the contract. Virtually all insurance policies exclude alcohol/drug related injuries in some manner. Some base it on blood alcohol level while others just state injuries where alcohol or drugs were a contributing cause. The former is at least objectively measurable. Not a veranda by the way, anyone might trip and fall off one of those (but not incur much more than a sprained or broken snkle in mist cases). We're talking high rise balcony. Not as easy to just fall off those.

It hasn't so far. Most travelers do not plan on, or engage in, drinking to the point that it is likely to cause a serious accident. And frankly no one wants to insure those that do. Investigation of possible alcohol/drugs as a factor is not done for all accidents. Just those that logically raise suspicion. Falling off balconies is certainly in that class.

Yes there is. I do it all the time. But you have to log in first. And the box to type in your search term is not well labeled.

If one's judgement and reflexes are too impaired to safely drive a car, they would also be impaired with regard to taking basic precautions (like not leaning too fsr over a low balcony railing and the like). You really don't see a space between no drinks at all, and 3 or more drinks taken within a single hour? (that being about what it would take for average man to reach legal intoxication level in US...I have no idea about Thai limits).

There quite a lot of space between between being legally too drunk to drive and tee totalling.

Some insurance policies specify the legal limit for being considered too drunk to drive in the country where the accident occurred as what they consider evidence of alcohol being a factor. Makes sense to me. Those limits by the way vary greatly from place to place. I don't happen to know what they are in Thailand.

Not sure what you mean, the Medtide site still works. But you have to log in first. An additional option is https://medisafepharma.com/ On that site, use the Messenger function, the web site search function doesn't work. Medtide and Medisafe both have large selection, more than Bangkokdrugstore. Which one is cheaper varies depending on what brands they happen to have on hand at the time. If you are located in Bangkok there are some good large pharmacies which sell gabapentin local brands.

Sending this through the mail could get one in seriously legal trouble.

Coronary bypass at a private hospital is more like 20 - 30k. And this is not including pre-op tests etc, discharge meds, rehabilitation. In this man's case, at least a week in hospital recuperation would be needed after. My best case, from recent hospitalizations more or less comparable, is would end up costing another 25-35 K on top of his existing bill. still less than repatriation but nto by too much and . have to also consider things like hotel and lodging costs for family to be with him etc. In any event their funding age makes clear they are looking to do the surgery in Thailand. The Daily Mirror article is very misleading. They are trying to raise 100k for care in Thailand.

A post with video link in very poor taste has been removed. Please remember we do nto know the circumstances of this man's fall. Maybe he was reckless/drunk but maybe not. Let's give him the benefit of the doubt. And have some compassion. If (IF) he was reckless he is certainly paying a very heavy price, and not just financially, for it. No cause for gloating or mockery.

More like 35-40K in my experience. (Remember have to pay business class fee for all the removed seats as well as cost of the removal etc). But yes, obviously much less than a chartered plane. But perhaps still more than the most of having the surgery done in Thailand.

No, but WorldMed on Phi Phi (which is where the accident occurs) has a speedboat ambulance service. With medical staff on board and ambulance waiting at the dock in Phuket on arrival. "We choose the safest means possible, from arrangement of a medically equip speed boat to a medical transport on a civilian ferry boat. A doctor or a nurse or both who are experienced in emergency medicine will escort you and attend to your condition the entire way." https://worldmed.center/portfolio/emergency-services/ Pricey of course but in this instance, it saved his life. He might not have survived a DIY boat transport to Phuket. Good likelihood Worldmed has an arrangement with Bangkok Phuket for the Phuket end of things.

The visa exempt entry and wide range and number of direct flights are surely the 2 biggest factors.

He absolutely cannot stand or sit at this time. He has an "open book pelvic fracture". What they did so far was emergency life saving surgery to control extensive internal bleeding and apply external fixation (metallic device outside the body with pins inserted into bone as a temporary measure to hold the pelvis together). He needs to have a second surgery to repair the fractures with internal screws etc to hold all the bones together Preferrably soon as there is a risk of infection with the external devices. If transported back to UK he would have to be lying on a stretcher the whole time. Which is possible to do but costly as have to pay for a whole row of seats to be removed to accommodate it (if on a commercial flight, the most affordable option). And airline would insist on a nurse or doctor accompanying.

Tabloids have a way of distorting things. If you go to the actual fundraising site they are asking for 100k to cover cost of the surgery in Thailand. The cost of evac is mentioned only in terms of "this is why that's not an option".

Thrre are certainly balcony railings in Thailand so flimsy that they give readily way when pressed against, or so low that one can easily trip or fall over them. And even, as mentioned above, sometimes rooms rented out with balconies that have no railing at all. it is also true that most often when people come off balconies here (or elsewhere) it is either connected to intoxication or not an accidrnt. Most often -- but not always. None of us know what applied in this specific case.

It is a travel policy thst covers emergency medical care. They aren't using the term"private" to mean they do not cover care in private hospitals. There is no restriction on type of hospital that can be used provided other terms of the policy are followed. What they are saying is that this is not comprehensive health insurance and only covers emergencies. It is an odd choice of terms but it is clearly what they mean.

I think what he means is that he declared a pre-existing condition at application and was given a choice of either an exclusion or a higher premium and initially chose the latter. Now, in order to reduce his premium, he opted to take the exclusion instead. I was given a similiar choice by April when I applied and opted for the exclusion.

To my understanding it will only cover care in government hospitals. He's in a private hospital. Which raises a real issue with the new scheme. Often when foreigners are injured the rescue van (sic) automatically takes them to a private hospital. Anyone who can;t get to a hospital on their own, may have little or no say in where they go. And if unconscious or in a weakened state it may be quite a while (and a lot of accumulated bill) before transfer to a government hospital can be insisted on -- at which point it can't be effected until the bill at the private hospital is first paid. That will greatly reduce the helpfulness of this scheme for foreigners. However, it's stated purpose was to reduce financial losses for government hospitals.

People often are not in a position to chose where they are taken. May be unconscious, and even if not, emergency personnel (or what passes for them here) often do as they want.

A number of flaming/trolling/unhelpful posts have been removed along with replies to them

No reason to hire a private jet. This sort of medical evacuation is done on commercial aircraft all the time. While still not cheap, it is far, far less than a private plane charter. There may well be a medivac company trying to sell the family on chartering a plane, but if so they should look elsewhere (including DIY by contacting airlines). Contact airlines, explain the requorements (i.e. stretcher as he cannot sit up) and overall condition etc (e.g: conscious, not on a ventilar, etc etc. Will likely be told have to pay for a full row of seats (and costs of their removal to accomodate a stretcher) and medical personnel accompaniment.

The alcohol exclusion is often worded with reference to the legal blood level limit under local laws . Or else, it is worded in terms of the accident having been due to intoxication. Not the case that simply having had a "few drinks" invalidates a claim. It would have no effect at all on a claim for illness. For accidents, would depend on how high your blood alcohol level was (i.e. if you met the legal definition for intoxication) or if the accident can be considered due to intoxication. In practice, insurers tend to check for this only for injuries of a type where alcohol is often to blame.

Actually we don't know if their insurance is from a UK company, could have been from elsewhere. But regardless, this "fine print" business is a myth. Every insurance policy I have ever seen lists its exclusions in clear lay language in normal print. From Nomad Insurance list of Exclusions (Safety wings) - a very popular policy because low cost and easily bought online: 13. Intentional self-inflicted injury or illness and/or suicide or attempted suicide whether sane or insane. 14. Injury sustained that is due wholly or partially to the effects of intoxication or drugs other than drugs taken in accordance with treatment prescribed by a physician and except drugs prescribed for the treatment of substance abuse. https://safetywing.com/nomad-insurance Now I am not saying either of those 2 exclusions - which are common to most policies, both travel and general insurance - apply in this case. But I can certainly see why injuries due to a fall from a balcony would immediately lead an insurer to question (and investigate) whether they might.

"it´s very hard to believe that a person who is in the prime of their life just falls from a balcony" is exactly what the insurer would be thinking. (though they may not be familiar with Thai balcony construction!). They cannot however get away with not paying just based on statistics. They would have to have some basis for saying he was intoxicated or jumped -- or, possibly, that he did something reckless (many policies also have a clause about extremely reckless behavior e.g. balancing on top of balcony railing or at edge of a steep cliff to take a selfie - anything a reasonably prudent person would not do). They have probably asked for all hospital records and also for a police report of the incident and are trying to make sense of them which knowing Thai hospital record-keeping and Thai police reporting will be no easy task. The latter would all be in Thai...if a report exists at all.