Brit Undergoes Brain Surgery After Songkran Stroke

Bet they were queuing up to look at a functioning brain?😉

Just now, Liverpool Lou said:

More nonsense. Insurers pay claims because they have contracted with the client to do so if the claim is legitimate.

"if claim is legitimate" being the entire question, which only can be finally decided in court.

Again, not honest arguing, seeming to disagree while covering back with empty tautology, et cetere...

9 minutes ago, Jim Waldron said:

While the focus of other contributors has been on the insurance issue, I think the message here is that if you have persistent headache, confusion, or sudden weakness, you should always seek urgent medical attention.

Or get a divorce

12 minutes ago, scubascuba3 said:

29 minutes ago, Liverpool Lou said:

Why? Is his insurer a Thai company?

But easy for anyone to check...

"While there is no single published statistic for all claims across the entire market, data from the Office of Insurance Commission (OIC) indicates that major life and non-life insurance companies in Thailand generally maintain claim settlement ratios (CSR) between 95% and 99% for standard, valid policies. [1, 2, 3]

The remaining few percentage points do not mean these are simply "stolen" from policyholders. Here is how the claims and payout process actually breaks down:

1. Life Insurance Payouts

For life insurance—which covers death, maturity benefits, and riders—the settlement ratio is usually above 98%. [1]

• Top Performers: Major companies in Thailand (like Thai Life Insurance) operate with high efficiency and typically pay out almost all valid death and maturity claims without contest. [1, 2]

2. Health & Medical Insurance

Health policies face the highest rate of claims disputes, though the vast majority are still resolved in the customer's favor.

fake news, you focused on life insurance, we are talking about travel insurance

No, I did not focus on life insurance but just for you....

"While there is no specific national statistic for Thailand alone, industry data shows that travel insurance claim payout rates typically range from 75% to 90%, depending on the insurer and the policy".

If you're going to continue to dispute it perhaps you have some evidence to justify your disagreement?

12 minutes ago, Dont confuse me said:

Bet they were queuing up to look at a functioning brain?😉

Ironically, their functioning brains gave them the ability to do that.

"Major companies in Thailand (like Thai Life Insurance) operate with high efficiency and typically pay out almost all valid death and maturity claims without contest. [1, 2]"

Which again meaningless, as it excludes "not valid" claim, and if company declines to pay claim it will almost always state claim is not valid... perhaps not correctly. Almost all case in which a claim is found to be valid, it is because there is no contest on either side. So statement could be re-written as "typically pay out almost all uncontested death and maturity claims without contest". Which is more meaningless than "Liverpool Lou" argument.

In fact, implication is these companies do not pay 2-5% of claims that even they agree are valid, which is ludicrous.

Also for clarity, I did not and do not claim Thai insurance companies are worse than those of other countries. Disputing some(!) claims is simply aspect of this industry worldwide.

1 hour ago, klaikangwon said:

It is a bit more complicated. Some private hospitals do accept SSO, but only up to SSO rate, not to their "real" private rate, and many private hospitals will not do work for such "low" rate, so do not participate, etc.

SSO covered me for near on 6 million in 2023 in a private hospital.... but yeah low SSO rate.

Off topic bickering posts removed. Discuss the topic not other posters.

What a lot of folks are missing here is....medical negligence. Good luck with that in Thailand.

Any western country he's in for a huge payout.

5 hours ago, damo1967 said:

Thank you... I was waiting with bated breath for this news. I can now sleep easier at night. [He should pay the $16k - and wait his Insurance to cover it, but only if he has 'disclosed' everything on his Insurance Application]. Afterall - it is only around 700,000 thb FFS.

What happens if his Insurance comes to the party and pays all his medicals costs? Is he going to track every GFM donation and refund it back to people? Of course not! The UK grub... and for the record, I donated NOTHING for this pathetic non-man who can not handle or take care of his own life.... PATHETIC excuse for a MAN! Grow a pair, and stop acting like a little child that needs a blanket from others covering him.

There's a new dick in town. You don't know the guy so spare us the character assassination.

5 hours ago, damo1967 said:

Yep! The GoFundMe that I did not contribute to. Insurance company has not denied his claim.. they are investigating it. No need for a GoFundMe... He is a MAN isn't he? Let him look after himself... and stop being a little pussy.

Yes, a real dick.

5 hours ago, damo1967 said:

It is called 'Non-Disclosure'. When applying for Insurance you need to be 100% accurate in what you divulge about your past health conditions.

Insurance companies base their 'premiums' on the 'risk' of future treatment for illnesses. IF this guy was hiding information on his original Application that could have increased the risk for claims in the future, (and the Insurance premium was not adjusted) the Insurance company is well within their right to 'refuse' a claim based on previous health conditions not disclosed.

The guy is only 36, which is not a lot of mileage to accrue a pre-existing condition and chances are the insurance company didn't require a medical. His father recently suffered a fatal stroke, but most insurance applications ask for any family history of strokes, hypertension, diabetes, etc..

Health insurance is a minefield and typically very challenging for seniors when it comes to pre-existing conditions, exclusions and claims challenges. However, there are insurance companies and there are insurance companies so it's still a lottery.

Insurance companies base their premiums on their making profit. Bugger all to do with the best financial outcomes for their customers.

Thanks for trying out.

3 hours ago, Patong2021 said:

Where do you get this conclusion? A policy pays what the contract says it will pay. If the high blood pressure was declared to the insurer and the condition was stable for the required period of time, a stroke would most likely not be excluded because of the condition. Claims are denied when people are caught trying to deceive or have not declared their health conditions.

3 hours ago, Patong2021 said:

Where do you get this conclusion? A policy pays what the contract says it will pay. If the high blood pressure was declared to the insurer and the condition was stable for the required period of time, a stroke would most likely not be excluded because of the condition. Claims are denied when people are caught trying to deceive or have not declared their health conditions.

3 hours ago, Patong2021 said:

Where do you get this conclusion? A policy pays what the contract says it will pay. If the high blood pressure was declared to the insurer and the condition was stable for the required period of time, a stroke would most likely not be excluded because of the condition. Claims are denied when people are caught trying to deceive or have not declared their health conditions.

I just had that issue and due to not having any issues for the past few years they added it back on to be covered or anything related at all Discounted rate. I also had to push them hard for a couple years because I had no BP issues. Glad they finally cover Part of it, but not in full. I’m sure every policy has different requirements for it to become covered again and how much they will pay. Definitely ask about it and start pushing after the exemption period. I made the mistake of assuming that it was listed back under coverage that it would pay in full.

Yet another instance where mandatory insurance would have still left the victim in the hospital with no money to pay bills.

24 minutes ago, John Drake said:

Yet another instance where mandatory insurance would have still left the victim in the hospital with no money to pay bills.

Curious why you think that ?

People have mentioned 'travel insurance' as Micheal was living here, surely his insurance would be a different type - i.e. Health Insurance which is different.

It seems - there was no direct settlement option - which is odd.

It's also odd that they hospital have held his passport - surely thats illegal.

I wonder if the insurance company are 'digging' through the 'small print' to find something they can use to avoid paying out.

The mention of alcohol could be a factor - particularly as it was reported the hospital suggested he was drunk - is that enough wiggle room for the insurance to avoid pay out ? again - it depends whats mentioned in the 'small print'.

6 hours ago, stevenl said:

Which insurance? If working legally as a teacher, he probably was on social, therefor government hospital. The operation was done at a private hospital.
If working illegally, he may have had travel insurance or some other form of health insurance, he may even have had the latter while working legally. But without details, nobody can tell whether his insurance was valid for the procedure.

The Government hospital sent him home with their usual prescription, Paracetamol.

I don't understand, all of the personal attacks on this man, even questioning his manliness for not taking care of himself.

Well a stroke can happen to anyone at anytime, so all you supermen, think about that, the next time you have a headache.

The first hospital didn’t even get named in the article. Tells you all you need to know about medical malpractice, administrative and government oversight, and patient rights in Thailand.

You probably simply pay them. Either you are long established patient, or you pay deposit, or... but TheThaiger carries stories regularly of this happening, often tourist (not long stayer) who unexpectedly got large bill, and hospital won't release until he pays.

I myself never had passport stolen by hospital, but did in fact get "detained" in bed pending demand to pay final bill. Which was bizarre as had alreayd paid 90% of cost of that admission, and had no money problem, and had never refused to pay any bill, and had never been given final bill in "friendly" way first. I stated to detaining staff, taht this is a crime and I do not accept to do this way, even if I do not reject bill itself (which was completely valid), but they clearly believed they acted with impunity. As in Thaiger stories...

Now granting that hospital is indeed "unfairly treated" if patient can "flee into exile" abroad, this is typical risk in all forms of business, and vigilante violence is not acceptable response... except Tony Soprano...

Rushed into emergency, one month after Songkran when he had his stroke?

11 minutes ago, Caldera said:

Rushed into emergency, one month after Songkran when he had his stroke?

Maybe try reading the article.

9 hours ago, shackleton said:

The same moaners come up with comments on the Gofundme

Its up to the individuals who want to donate their money they are not forced to

End of

No,

That's only one side of the medal.

It's brazen to beg for money, just wait for the insurance company to pay or pay up-front by yourself.

I criticize the cheeky brazen Brit, not the donators

12 hours ago, Patong2021 said:

Travel insurance is structured as a reimbursement format.

This is generally not true.

A decent insurance may not have a direct billing agreement with every hospital, but they will work with an assistance company who takes care of it for them. Big assistance companies in Thailand are e.g. Eurocenter or April Assistance, but there are others, too.

2 hours ago, newbee2022 said:

No,

That's only one side of the medal.

It's brazen to beg for money, just wait for the insurance company to pay or pay up-front by yourself.

I criticize the cheeky brazen Brit, not the donators

As said in article he has been kidnapped by hospital. So really it more like "bail money" than just debt. Insurance company kicks decision down road because it wants to deny claim; if it knew it would approve would just approve. I am not going to donate to him, but asking for money (him or friend or colleageue etc.) not totally unsympathetic.

12 hours ago, Rams86 said:

It was possibly heat stroke, I used to be a plumber and I remember working on a roof and the temperature was 40C + After work I became dizzy and appeared to be heavily intoxicated I couldn't walk straight or even drive my car. So I laid down in the shade and drank as much water as I could and I slowly recovered. UK people like many Europeans aren't used to the heat or humidity that we get in Thailand. Always wear a hat if you're in the sun for prolonged periods.

Heat Stroke?

Haha....interesting diagnosis.

If he is a teacher, then should his school not cover his medical expenses?

This is strange.

I also think he might have been confused about his diagnosis.

I think the problem is actually an ANEURYSM.

A sudden swelling of an artery in the brain can cause pain and be immediately life-threatening.

So, I think the patient is confused about what was actually wrong with him.

Still: I really like RAM Hospital. Also, as far as I know, the prices there are still not extremely high, considering the level of care one gets. I also suppose that many of the doctors and staff are coming out of CMU, which is good. It's good to have one good hospital in Chiang Mai (and Chiang Mai has more than one).

18 hours ago, OldHand2541 said:

Or maybe his insurance company don't have a "direct billing" agreement with the hospital.

Neither does Europe A and others.

10 hours ago, richard_smith237 said:

People have mentioned 'travel insurance' as Micheal was living here, surely his insurance would be a different type - i.e. Health Insurance which is different.

It seems - there was no direct settlement option - which is odd.

It's also odd that they hospital have held his passport - surely thats illegal.

I wonder if the insurance company are 'digging' through the 'small print' to find something they can use to avoid paying out.

The mention of alcohol could be a factor - particularly as it was reported the hospital suggested he was drunk - is that enough wiggle room for the insurance to avoid pay out ? again - it depends whats mentioned in the 'small print'.

A lot of teachers living in Thailand actually have precarious situations, namely insurance-wise. They often choose cheap policies such as those offered by Kasikorn and the likes: a 600 THB per month policy might be worthwhile if you break a leg but they are often capped at 100,000 and riddled with small print.

10 hours ago, richard_smith237 said:

It's also odd that they hospital have held his passport - surely thats illegal.

This has happened to me twice before, so I would say it is probably standard practice. A French expat insurance I had, which worked in partnership with Allianz Thailand, covered me for emergencies, but the two times I used it, the hospital (Pattaya Memorial Hospital) kept the passport until the payment was 100% confirmed as cleared (it typically took 2-3 days), following which they called us and we went back to pick up the passport. It was either that (and go home early) or stay at the hospital until the payment was confirmed.

Troll posts about covid vaccines removed. @rattlesnake @flaming dragon this is the news section, which require verified facts, not just an opinion from social media. If you want to post your conspiracy theories, stay in the “off the beaten track”.

8 hours ago, klaikangwon said:

As said in article he has been kidnapped by hospital. So really it more like "bail money" than just debt. Insurance company kicks decision down road because it wants to deny claim; if it knew it would approve would just approve. I am not going to donate to him, but asking for money (him or friend or colleageue etc.) not totally unsympathetic.

Asking other people for money though you can pay the bill by yourself?

I think in this tale are many flaws.

It's not clear about payment by the insurance. Why they wouldn't deny to pay??

Why he doesn't have his passport?

Unusual.

Did he pay no deposit?

The whole tale is missing something: the truth

4 hours ago, newbee2022 said:

Asking other people for money though you can pay the bill by yourself?

I think in this tale are many flaws.

It's not clear about payment by the insurance. Why they wouldn't deny to pay??

Why he doesn't have his passport?

Unusual.

Did he pay no deposit?

The whole tale is missing something: the truth

I do not know man personally. But seems easy "truth" would be he does not have money already, and hospital either took passport by force or refused to treat further without it.