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

[KKr]

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....

Actually, you are factually wrong.
If the Policy does not provide cover while a clerk mistakenly gave a go ahead on the phone, the Insurance Company is legally correct not providing compensation. (Contract prevails)
There is a complaints procedure, and in the UK recourse to an Ombudsperson.
I have been there and that is how it is, and as I read the Policy 48.000 USD later, they were absolutely correct.

but dream on... and make sure you have valid cover if you cannot afford to go to hospital..

[scubascuba3]

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.

  -- [emoji767] Copyright Thai Visa News 2018-5-3

It's a shame in this thaivisa exclusive they didn't ask any decent questions, like clarification on the insurance issue, why was it declined, did he have correct cover, etc

 

[Mace648]

6 minutes ago, scubascuba3 said:

It's a shame in this thaivisa exclusive they didn't ask any decent questions, like clarification on the insurance issue, why was it declined, did he have correct cover, etc

 

It says in the article that his policy had lapsed and he was no longer covered.

[monkfish]

Same thing thing happened to my mother whilst on 2 week vacation the Insurance refused to pay for treatment at the hospital.
At first a hospital representative dealt with the insurance company on her behalf.
Reason given by the insurance company is this hospital is over priced.

Edited May 4, 2018 by monkfish

[scubascuba3]

It says in the article that his policy had lapsed and he was no longer covered.

It doesn't say that in the op, and the original thread was grey on the subject and people were jumping to conclusions with no facts given

[Chris Lawrence]

5 hours ago, Get Real said:

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.

 

 

Don't forget the guy who had 127 pages written on his plight with the hospital. Sounds like no one's friend.

 

This surfer may have a friend? Story like this also sells. 

 

Even when I first read it the story didn't add up. I am sorry for the mans trouble, but a cub reporter is not what we need on Thaivisa. Stories like this only confirm that westerners are a pack of whingers.

 

In the haste to get someone probably better from potential life threatening injuries a mistake was made but was cleared up in 4 days. I got the money to pay that bill, but I wouldn't embarrass myself by trying to get my community to pay.

 

Its a hard one, but only made difficult by not checking facts first.

[Mace648]

8 minutes ago, scubascuba3 said:

21 minutes ago, Mace648 said:

It says in the article that his policy had lapsed and he was no longer covered.

It doesn't say that in the op, and the original thread was grey on the subject and people were jumping to conclusions with no facts given

It says clearly in the article that the policy had lapsed.

"He told the meeting that Mr Danielsen was insured in Norway and initially the company agreed to shell out 250,000 - an offer that was later rescinded after it was discovered that the policy had run out."

 

"Many policies have a  time limit and the Norwegian had been away several months." 

[monkfish]

21 minutes ago, Mace648 said:

It says clearly in the article that the policy had lapsed.

"He told the meeting that Mr Danielsen was insured in Norway and initially the company agreed to shell out 250,000 - an offer that was later rescinded after it was discovered that the policy had run out."

 

"Many policies have a  time limit and the Norwegian had been away several months." 

The Article says this
"It was reported in the Thai media that he had been away too long and the policy had expired."

 

Which article are you referring too?

Edited May 4, 2018 by monkfish

[Mace648]

2 minutes ago, monkfish said:

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

 

Which article are you referring too?

I took that quote from the article that is posted on Thaivisa. The one that is connected with these comments.

[Thaidream]

I had a similar situation when I was a claims adjustor in California- The insurance company gave the authorization for a repair to a damaged auto- then after the repair had already started decided the policy had lapsed.  the customer sued- and the company was found liable.

 

A verbal authorization is as good as a written authorization made by a competent company oficial and  eve though later  it was found the policy was not in force- since the authorization waas given- the company must make their customer whole- meaning the company pays.

 

I see this situation as the same- the customer called the insurance carrier- it's representative gave the authorization to proceed- they are liable for the bill. It is not the customer's fault that the  insurance company did not check their own policy and immediately tell the customer the policy was not covering the incident. I would sue the insurance company and demand payment as well as damages/i

[monkfish]

6 minutes ago, Mace648 said:

I took that quote from the article that is posted on Thaivisa. The one that is connected with these comments.

Maybe they edited the article because I don't see what you quoted.
Let quote you again below.

"He told the meeting that Mr Danielsen was insured in Norway and initially the company agreed to shell out 250,000 - an offer that was later rescinded after it was discovered that the policy had run out."

Edited May 4, 2018 by monkfish

[Mace648]

1 minute ago, monkfish said:

Maybe they edited the article because I don't see what you quoted.

I just read it prior to responding to you just t make sure I hadn't read it somewhere else. Its there 

[8OA8]

The devil is in the details. I found out many years ago that although I was covered for medical treatment following an accident, that was all that was covered. The repatriation to my home country, where I was living, was going to be at my own expense. This was until some friends back in my home country put a bit of pressure on an insurance company and then the Insurance company called me to say they were making an exception and would cover the repatriation cost and did I require a medivac flight or could my stretcher be on a scheduled flight. It was okay with the stretcher on a regular flight, so then I was asked if I could pay for everything and reclaim it afterwards. Nothing in writing just a voice on the phone telling me that they would reimburse me in full for the repatriation costs, which they duly did as soon as I faxed a copy of the airline tickets.

Edited May 4, 2018 by 8OA8
Sentence incomplete

[stevenl]

14 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.

That's what happens when you don't fully disclose all facts. Like having been in Thailand too long for the insurance to cover.

[monkfish]

22 minutes ago, Mace648 said:

It says clearly in the article that the policy had lapsed.

"He told the meeting that Mr Danielsen was insured in Norway and initially the company agreed to shell out 250,000 - an offer that was later rescinded after it was discovered that the policy had run out."

 

"Many policies have a  time limit and the Norwegian had been away several months." 

I don't find this quote in the article.

[JLCrab]

How would someone at the insurance company in Norway be able to check their computer and know exactly on what date the gent actually was ex-Norway?

[Mace648]

6 minutes ago, Thaidream said:

I had a similar situation when I was a claims adjustor in California- The insurance company gave the authorization for a repair to a damaged auto- then after the repair had already started decided the policy had lapsed.  the customer sued- and the company was found liable.

 

A verbal authorization is as good as a written authorization made by a competent company oficial and  eve though later  it was found the policy was not in force- since the authorization waas given- the company must make their customer whole- meaning the company pays.

 

I see this situation as the same- the customer called the insurance carrier- it's representative gave the authorization to proceed- they are liable for the bill. It is not the customer's fault that the  insurance company did not check their own policy and immediately tell the customer the policy was not covering the incident. I would sue the insurance company and demand payment as well as damages/i

When I was taken to the hospital in Thailand they would not admit me until they had received written authorization from my insurance company that they would pay ,so if the insurance company gave a written approval that is one thing, but the only one saying that the insurance company gave approval is the man who was injured I have seen nothing saying that the insurance company gave a written authorization to pay the hospital bills. I cant imagine any insurance company would only give verbal authorization or that any hospital would accept verbal authorization.

[hashmodha]

Extremely unfortunate and I am sad to write this.....But it is the Hospital's responsibility to Contact the Insurance provider who then refers the call to Thailand office/representative....who then give an authorisation code. .to the Hospital.. which has  set limits....... they check every few days about recovery/well being/charges.....Global knowledge that all Hospitals behave extortionately disgustingly about charges..   that's why our Insurance premiums are skyrocket high!

My opinion is this patient should hold the Hospital and The phone conversation as proof.A shark in our water is rare...I live at seaside....and swim often....

[scubascuba3]

It says clearly in the article that the policy had lapsed.

"He told the meeting that Mr Danielsen was insured in Norway and initially the company agreed to shell out 250,000 - an offer that was later rescinded after it was discovered that the policy had run out."

 

"Many policies have a  time limit and the Norwegian had been away several months." 

It doesn't clearly say anything useful as to why he wasn't insured. Just vague info which is no use

[monkfish]

8 minutes ago, Mace648 said:

When I was taken to the hospital in Thailand they would not admit me until they had received written authorization from my insurance company that they would pay ,so if the insurance company gave a written approval that is one thing, but the only one saying that the insurance company gave approval is the man who was injured I have seen nothing saying that the insurance company gave a written authorization to pay the hospital bills. I cant imagine any insurance company would only give verbal authorization or that any hospital would accept verbal authorization.

So he should have waited for written authorization from Norway?

Edited May 4, 2018 by monkfish

[Thaidream]

In most Western countries a verbal authorization is as legal as a written authorization. I really believe if the customer presses the issue- he will get reimbursed.

[colinneil]

5 minutes ago, Mace648 said:

When I was taken to the hospital in Thailand they would not admit me until they had received written authorization from my insurance company that they would pay ,so if the insurance company gave a written approval that is one thing, but the only one saying that the insurance company gave approval is the man who was injured I have seen nothing saying that the insurance company gave a written authorization to pay the hospital bills. I cant imagine any insurance company would only give verbal authorization or that any hospital would accept verbal authorization.

Spot on mate, as i have already posted, i was taken to Pattaya memorial.

The first thing they wanted to know before any treatment was... Do you have insurance?

As i had a Barclay card i had some cover, then they wanted written consent from my insurance company.

[Mace648]

2 minutes ago, scubascuba3 said:

33 minutes ago, Mace648 said:

It says clearly in the article that the policy had lapsed.

"He told the meeting that Mr Danielsen was insured in Norway and initially the company agreed to shell out 250,000 - an offer that was later rescinded after it was discovered that the policy had run out."

 

"Many policies have a  time limit and the Norwegian had been away several months." 

It doesn't clearly say anything useful as to why he wasn't insured. Just vague info which is no use

WHAT?....do you not see the quote sayig

...."an offer that was later rescinded after it was discovered that the policy had run out."? "Run out" means the policy was not in effect. It is crystal clear.

[Mace648]

4 minutes ago, monkfish said:

So he should have waited for written authorization from Norway?

We have this new thing called the internet , they can send written authorization immediately.

[monkfish]

4 minutes ago, Mace648 said:

WHAT?....do you not see the quote sayig

...."an offer that was later rescinded after it was discovered that the policy had run out."? "Run out" means the policy was not in effect. It is crystal clear.

No what are you talking about no where in the article does it say that which you have quoted.

[JLCrab]

The policy could have been within a one year validity but that each trip ex-Norway could not be longer than 60 or 90 days. So the company might have just looked at the policy issue date and determined that the policy was still valid but was not informed that the time allowed each trip ex-Norway had been exceeded.

 

NB to BwindiBoy who posted much the same earlier. I recently [purchased an AXA-Thailand Travel cover for a trip to USA and it had much the same maximum time per stay ex-Thailand clause.

Edited May 4, 2018 by JLCrab

[Mace648]

1 minute ago, monkfish said:

No what are you talking about no where in the article does it say that which you have quoted.

I copied and pasted those quotes directly out of the article attached to these comments.

[Sheryl]

3 hours 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.

That would be my guess - that the policy had not passed a specific expiration date but rather that it covered being abroad for only X period of time which he had exceeded.

 

Insurance company staff who receive calls,  check that the policy is in effect and that it covers the type of care needed. It is hard to imagine them being so incompetent as to miss the fact that the policy had already lapsed, that would show immediately in their database. 

[cat handler]

Something smells bad here, he claims his Insurance Company told him he would be covered at that hospital yet his policy had expired, you would have thought the Insurance Company would have check the validity of his policy before authorising treatment. I wonder how much he has made from all of this. Also 300,000 baht for 4 days in hospital seems extremely high for what was a minor wound that required only cleaning and 19 stitches, did he also take the happy ending option?

 

[monkfish]

5 minutes ago, Mace648 said:

We have this new thing called the internet , they can send written authorization immediately.

The thing is the hospital will offer to do it for you and you rely on what the tell you.