Thaivisa exclusive: Hua Hin shark attack victim said insurance gave him the green light to go to expensive hospital

[snoop1130]

Thaivisa exclusive: Hua Hin shark attack victim said insurance gave him the green light to go to expensive hospital

 

Werner Danielsen pictured in Bangkok Hospital Hua Hin earlier this month

 

Thaivisa have contacted the Norwegian man who was attacked by a bull shark off Sai Noi Beach, Hua Hin last month.

 

Werner Danielsen, 54, told how he was assured by his insurance company that they would pay only for them to change their minds four days later after he racked up a 300,000 baht bill. 

 

That was for just four days at Hua Hin Bangkok Hospital.

 

But he had nothing but praise for the Thai people who helped him, the doctors and the reaction of the authorities.

 

Werner was speaking Thursday evening from Khon Kaen where he is still recovering from his ordeal after the bite on his left leg on April 15th. 

 

He left hospital in Khon Kaen three days ago but still needs to have the wound cleaned every few days to safeguard against the possibility of infection.

 

He said that he was with some children at the beach and went out to some rocks. He then jumped in and was swimming about 100 meters offshore when he felt something go for his leg three times.

 

He didn't see what attacked him in the murky water but he managed to get to the shore where Thai people rushed him to hospital.

 

He said that he was mindful that an expensive hospital in Hua Hin would cost him a lot of money and was prepared to go to a cheaper hospital if necessary.

 

But after his insurance company assured him over the phone that everything was okay he decided to go to Hua Hin Bangkok Hospital.

 

He described the treatment and the doctors and nurses as excellent but four days later his insurance company made contact and said they could not cover the bill. 

 

It was reported in the Thai media that he had been away too long and the policy had expired.

 

"I wouldn't have gone to that hospital if I had known," he said resignedly.

 

Now he hopes that representations made on his behalf by the deputy governor of Prajuab Khirikhan might give him some financial assistance.

 

Kindhearted Werner, who runs a home for runaway and problem children back in Norway, is not bitter about his experience and is ambivalent about getting financial help. 

 

If he does that is good, if not never mind.

 

He praised the Thai people who helped him at the beach and the Thai authorities for their actions adding:

 

"I am not the kind of person that bashes Thailand".

 

He said that his girlfriend Amonrat Phaengnga, 43, had been a tower of strength and has sorted out everything for him.

 

The couple are not actually married as has been reported in the media but Werner said that he considers himself married in his heart.

 

Amonrat lives in Khon Kaen, where she looks after family members, preferring not to live with Werner in Norway. But he makes visits to Thailand as regularly as he can.

 

He said that his visa has been extended and he is due to leave before the 16th of June giving him plenty of time to recover from his ordeal that has been top of the news in Thailand for several weeks.  

 

Signs have now been erected at Sai Noi Beach as the authorities mull what further action should be taken.

 

-- © Copyright Thai Visa News 2018-5-3

[darksidedog]

33 minutes ago, snoop1130 said:

But after his insurance company assured him over the phone that everything was okay he decided to go to Hua Hin Bangkok Hospital.

 

He described the treatment and the doctors and nurses as excellent but four days later his insurance company made contact and said they could not cover the bill. 

Reneging on a promised bill payment after four days of treatment is a nasty thing to do. I am a little surprised the hospital didn't get written confirmation of the insurance cover, which they normally like to do when expensive treatment is needed. I am glad he is recovering well. He sounds like a nice guy, who I am sure will be using a different insurance company in the future.

[GuiseppeD]

Seems like a nice guy and very positive.  Though would appear that his insurance was invalid on this occasion, hence the insurance company not paying out.  It is what it is.

[hellstens]

42 minutes ago, GuiseppeD said:

Seems like a nice guy and very positive.  Though would appear that his insurance was invalid on this occasion, hence the insurance company not paying out.  It is what it is.

 

How come the insurance company gives the green light for him to go to Bangkok hospital then?

I smell something rotten here.lol

[GuiseppeD]

4 minutes ago, hellstens said:

How come the insurance company gives the green light for him to go to Bangkok hospital then?

I smell something rotten here.lol

Who knows? Clerical error, maybe.  But if you read the story, this guy's insurance was definitely invalid. 

 

Anyway, would it make much difference if the insurance company had not given the green light in the first place?

[darksidedog]

45 minutes ago, GuiseppeD said:

Who knows? Clerical error, maybe.  But if you read the story, this guy's insurance was definitely invalid. 

 

Anyway, would it make much difference if the insurance company had not given the green light in the first place?

I believe it would have made a considerable difference. After all, he is quoted in the story as saying, "that he was mindful that an expensive hospital in Hua Hin would cost him a lot of money and was prepared to go to a cheaper hospital if necessary." So if your insurance company says you are all good and to go for it, and then turn around when you are 300K down already which could have been 10-20% of that, to say sorry, we aren't paying, I personally would be more than a little pissed off.

[GuiseppeD]

Just now, darksidedog said:

I believe it would have made a considerable difference. After all, he is quoted in the story as saying, "that he was mindful that an expensive hospital in Hua Hin would cost him a lot of money and was prepared to go to a cheaper hospital if necessary." So if your insurance company says you are all good and to go for it, and then turn around when you are 300K down already which could have been 10-20% of that, to say sorry, we aren't paying, I personally would be more than a little pissed off.

Call me cynical, but surely the onus is on the policy holder to know whether their insurance is valid [out of date] or not.  I certainly do.

[Just Weird]

54 minutes ago, hellstens said:

How come the insurance company gives the green light for him to go to Bangkok hospital then?

I smell something rotten here.lol

Maybe he didn't get the green light specifically, so far there's only his word for that.  You could be right about something rotten going on.

[Just Weird]

1 hour ago, hellstens said:

How come the insurance company gives the green light for him to go to Bangkok hospital then?

I smell something rotten here.lol

Maybe he didn't tell them exactly how long he had been in Thailand?

[darksidedog]

20 minutes ago, GuiseppeD said:

Call me cynical, but surely the onus is on the policy holder to know whether their insurance is valid [out of date] or not.  I certainly do.

Again I reiterate that when an insurance company gives you the green light, as it is alleged they did, you should consider yourself approved to get good treatment. If you make a mistake, you should suffer a consequence when that causes another a financial loss. If the Insurance company originally said you are covered and to go get the treatment, it should not be able to pull out from the financial commitment it has made,especially after a nasty bill has already accrued. Regardless of if they made a mistake with the policy's expiry date, or later found a sub clause exclusion about being away from your home country more than X days. I question again though, why the hospital didn't get it confirmed before allowing such a bill?

[Get Real]

6 hours ago, darksidedog said:

Again I reiterate that when an insurance company gives you the green light, as it is alleged they did, you should consider yourself approved to get good treatment. If you make a mistake, you should suffer a consequence when that causes another a financial loss. If the Insurance company originally said you are covered and to go get the treatment, it should not be able to pull out from the financial commitment it has made,especially after a nasty bill has already accrued. Regardless of if they made a mistake with the policy's expiry date, or later found a sub clause exclusion about being away from your home country more than X days. I question again though, why the hospital didn't get it confirmed before allowing such a bill?

Why do you think the insurance company made a mistake. It can be so simple that he called in quickly and just said what insurance he had and if thaat kind of insurance covered what he wanted. Maybe never asked for dates, if the insurance still was active, or even gave his name to the company. Just saying that it´s a possibility. Sure it´s also a possibility that the insurance company gave the wrong information, without checking on their side. I guess I will go with Just Wierd in this case. It seems like the most sensible action to make.

 

6 hours ago, Just Weird said:

Perhaps Thaivisa in all it's journalistic wonderfulness should also be contacting the insurance company for it's side of the story instead of publishing a one-sided report based only on what the "kindhearted" (what?...geez) Norwegian said!

 

[petedk]

Again I reiterate that when an insurance company gives you the green light, as it is alleged they did, you should consider yourself approved to get good treatment. If you make a mistake, you should suffer a consequence when that causes another a financial loss. If the Insurance company originally said you are covered and to go get the treatment, it should not be able to pull out from the financial commitment it has made,especially after a nasty bill has already accrued. Regardless of if they made a mistake with the policy's expiry date, or later found a sub clause exclusion about being away from your home country more than X days. I question again though, why the hospital didn't get it confirmed before allowing such a bill?

Maybe they won't renew his policy next time.

That happened to me recently. I was insured for up to 1.5 million baht for surgery.
The insurance company gave the go-ahead for laparoscopic surgery for 650K.
The final amount was 600K and they paid without any problems.
When my policy was due for renewal, they threw me out.

Hope he is ok

Sent from my SM-C710F using Thailand Forum - Thaivisa mobile app

[happy chappie]

Maybe if he had read his policy conditions first then he wouldn't be stuck with this over inflated bill.

[BwindiBoy]

11 hours ago, darksidedog said:

Reneging on a promised bill payment after four days of treatment is a nasty thing to do. I am a little surprised the hospital didn't get written confirmation of the insurance cover, which they normally like to do when expensive treatment is needed. I am glad he is recovering well. He sounds like a nice guy, who I am sure will be using a different insurance company in the future.

 

It looks, to me, like he failed to disclose the material fact that he had been holidaying for longer than his policy allowed, and that the initial OK from the insurance company was on the basis that he had stayed within the terms of the policy.  I suspect that once it came to light that he had holidayed too long, they advised that they wouldn't pay.  Seems fair enough to me.

[BwindiBoy]

11 hours ago, hellstens said:

How come the insurance company gives the green light for him to go to Bangkok hospital then?

I smell something rotten here.lol

It looks, to me, like he failed to disclose the material fact that he had been holidaying for longer than his policy allowed, and that the initial OK from the insurance company was on the basis that he had stayed within the terms of the policy.  I suspect that once it came to light that he had holidayed too long, they advised that they wouldn't pay.  Seems fair enough to me.

[wvavin]

It is hard to believe that the person insured did not know that the insurance had expired.

[mstevens]

19 minutes ago, BwindiBoy said:

 

It looks, to me, like he failed to disclose the material fact that he had been holidaying for longer than his policy allowed, and that the initial OK from the insurance company was on the basis that he had stayed within the terms of the policy.  I suspect that once it came to light that he had holidayed too long, they advised that they wouldn't pay.  Seems fair enough to me.

Surely the insurance company would have gone in to the computer, checked his policy and then given the green light, or not?  You would think their computer system would show immediately whether the policy was valid or not and even if it didn't, that they would make the requisite checks before giving him the green light to get treated.

[Xonax]

10 hours ago, Just Weird said:

Maybe he didn't tell them exactly how long he had been in Thailand?

They should definitely have asked him about that.

[zyphodb]

I am quite surprised to see all these members above defending the insurance company when it's common knowledge that these "human sharks" will do anything that they can to get out of paying up on a claim.....

 Looks like a large lack of empathy to me...

But then again, this is Thaivisa so I shouldn't be surprised I suppose,

 It does make me grieve for the "human condition" these days....

[HLover]

5 minutes ago, zyphodb said:

I am quite surprised to see all these members above defending the insurance company when it's common knowledge that these "human sharks" will do anything that they can to get out of paying up on a claim.....

 Looks like a large lack of empathy to me...

But then again, this is Thaivisa so I shouldn't be surprised I suppose,

 It does make me grieve for the "human condition" these days....

what insurance do you recommend? 

[Jonmarleesco]

13 hours ago, snoop1130 said:

It was reported in the Thai media that he had been away too long and the policy had expired.

So, the insurance company didn't actually check the validity of the policy before assuring him he was covered. 

 

Then again, if only a travel insurance, it pays to read the T&Cs.

[madmitch]

If the insurance company had given the go-ahead for its client to be treated at Bangkok Hospital then they have made an error. They should have checked that coverage is valid before making a recommendation of this nature. Assuming this is the case, the insurance company should at least consider a partial settlement (ex gratia and/or without prejudice if anyone in the business is reading) as their client has been saddled with a much larger bill than he should have paid, though he probably got better, faster and more comfortable treatment as a result. 

 

I'd recommend the victim should take this to the management level of the insurance company as a decision of this nature is most likely beyond the remit of the claims handlers.

 

If, however, the insured did not supply any policy details when requesting the recommendation, then I'm afraid he won't have a leg to stand on (sorry!!).

[zyphodb]

10 minutes ago, HLover said:

what insurance do you recommend? 

Do I sound like an insurance broker to you HLover?

[NextStationBangkok]

Well done!

 

Sounds like finally they found the shark at large!

 

[4MyEgo]

11 hours ago, Just Weird said:

Maybe he didn't get the green light specifically, so far there's only his word for that.  You could be right about something rotten going on.

To add to that, most insurance policies state that they will provide specific instructions for the treating hospital to proceed.

 

Personally, as much as this is all sounding like a sympathy card with what he does back home, looks after kids, but is spending 3 months and more often to see his girlfriend as often as he can, I don't buy it and the focus should be focusing on the event and what occurred, i.e. Norwegian gets attached by shark, insurance company "allegedly" gives the go ahead "over the phone", but why not to the hospital staff, 1st thing they would want is confirmation with the hospital, i.e. what is the diagnoses of our insured Mr Norway, what treatment will he require, how long will he be in the hospital and a rough guide to the cost.

 

Giving him the go ahead over the phone I do not buy one bit, that said, as much as I feel for his bad luck with the shark and the expired insurance policy, I could also feel for a lot of people in Thailand that go hungry everyday from no fault of their own.

 

We all know its up to us to be insured and check our expiry dates, he sounds not only like a nice guy, but has caught the yellow fever and has become too relaxed, time to pay up chump 

[theguyfromanotherforum]

His insurance expired.

 

Why is this a story? Are we getting ready for a gofundme campaign?

[HLover]

32 minutes ago, zyphodb said:

Do I sound like an insurance broker to you HLover?

No, just asking for advice.

[Mace648]

It is the responsibility of the insured to know the status of his/her insurance and to make sure that he/she has a valid policy. If he let the policy expire it is no ones fault but his own.

[KKr]

13 hours ago, darksidedog said:

Reneging on a promised bill payment after four days of treatment is a nasty thing to do. I am a little surprised the hospital didn't get written confirmation of the insurance cover, which they normally like to do when expensive treatment is needed. I am glad he is recovering well. He sounds like a nice guy, who I am sure will be using a different insurance company in the future.

was the name of the insurer mentioned somewhere ? // Never mind, as I read the full thread it became clear that the policy was not valid when the accident happened.

[Mace648]

1 hour ago, zyphodb said:

I am quite surprised to see all these members above defending the insurance company when it's common knowledge that these "human sharks" will do anything that they can to get out of paying up on a claim.....

 Looks like a large lack of empathy to me...

But then again, this is Thaivisa so I shouldn't be surprised I suppose,

 It does make me grieve for the "human condition" these days....

So you think that insurance companies should pay claims  even if the formerly insured has let his policy lapse? You do realize that if they paid invalid claims that it would raise the rates for anyone who accepts personal responsibility for making sure they had insurance don't you?