Canadian diagnosed with brain tumour in Thailand has travel insurance declined because he had the flu a month ago

[impulse]

42 minutes ago, realenglish1 said:

He is Canadian He has free health care in Canada He needs to get home

 

You did see the part about the air ambulance costing $265,000 and the dozens of posts indicating that a commercial flight is dangerous, if not impossible in his condition?

 

[Caine]

God bless him, but needs to get a proper diagnoses don't listen to these money making cowboys who masquerade as doctors over here. I've had two mates diagnosed with cancer over here by cowboys got home to the UK to see real doctors nothing wrong with them. We all know what useless <deleted> they are.

[GoodieAfterDark]

16 hours ago, webfact said:

Kitchener resident Alex Witmer and his wife Jennifer Witmer, who had been living in Moncton for the last five years, quit their jobs earlier this year and went on a six-week trip to Thailand before planning to relocate to Toronto. 

Hmmm, me thinks...

[worgeordie]

5 hours ago, Rod the Sod said:

Respectfully suggest that the next time you read the small print. That is why it is there, for you to understand what you get for your money. To get stung once for not reading the small print was unlucky. Twice was downright careless. Three times, well, what can I say?

I should have had you for my lawyer Rod,a real clever b*gger.

fine print was just a term,they can screw you so many ways.

regards worgeordie

[gk10002000]

15 hours ago, kingdong said:

We have a brain surgeon in our midst

Certainly have somebody with more brain power than you

[Mac98]

16 hours ago, bkk6060 said:

Go Fund me Page is up.

 

Travel insurance to me is not for a guy traveling with a brain cancer.  With a previous documented symptom.

How is any of it related to his travel?

 

So, I am a 30 year alcoholic with liver cancer.  I come to Thailand on holiday and get sicker the insurance should pay??

Many seem totally clueless that possible scams may be involved in some of these cases.

Think outside the box folks..  

No pay seems correct.

He's from Canada. Free health care. Why would you travel to a foreign country just to scam an insurance company for care there or a flight home, especially if you know you have brain cancer that needs immediate attention?

[Mac98]

40 minutes ago, GoodieAfterDark said:

Hmmm, me thinks...

I took a buyout, made my first trip to Thailand in '98, relocated and took a good job offer. Also took a year off work in '73 to travel and relocated. It happens.

[Isaanbiker]

2 hours ago, SiSePuede419 said:

Huh?  None of this makes any sense. Why not return for treatment in Canada, ya hoser.

Did you not read the OP. They both quit their jobs, left for Thailand and were planning to move to Toronto. Does that make any sense?

 

   Anybody would first move to Toronto and then go for a holiday.

 

   No job, no address, eventually no insurance at home. Then it looks like a planned, well something. 

 

  

[Mac98]

My daughter traveled to Thailand with me. She had a medical emergency that ran up a significant bill. She had insurance. She had to pay up front and then make a claim for repayment. The insurance company fought her for years, even thought the bill was 1/10th what it would have been in the USA. She eventually got about half her money back. <deleted> insurance.

[Isaanbiker]

53 minutes ago, GoodieAfterDark said:

Hmmm, me thinks...

Methinks the same. And that's called fraud in my book. 

[Isaanbiker]

2 hours ago, impulse said:

 

You did see the part about the air ambulance costing $265,000 and the dozens of posts indicating that a commercial flight is dangerous, if not impossible in his condition?

 

A flight is not impossible. It depends on the type and size of the cancer.

But there's medication that would help him to fly the ordinary way.

 

There was no correlation with brain tumor size or pre-operative symptoms. Of the 41 patients, ten (24.4%) reported new or worsened symptoms during airflight, although most of these symptoms were minor and resolved after landing. Only one patient developed a major symptom (seizure), which was also transient. If patients had no symptoms prior to their flight, none of the patients developed new symptoms during or afterwards.

 

Specifically, for larger tumors, consideration should be given to preflight and inflight administration of steroids to reduce brain edema and anticonvulsants to reduce seizure risk. In some patients with very large brain tumors already causing cranial pressure, air flight may be considered unsafe and not recommended.

 

https://www.pacificneuroscienceinstitute.org/blog/brain-tumor/is-it-safe-for-patients-with-brain-tumors-to-fly/

 

  Do they even have a return ticket? 

 

  

[impulse]

6 minutes ago, Isaanbiker said:

A flight is not impossible. It depends on the type and size of the cancer.

But there's medication that would help him to fly the ordinary way. 

....

 

If a normal flight were advisable, I doubt that the insurance carrier would have offered them a $265K evacuation flight.

 

And now, it seems that the insurance carrier will front the $265K, (leaving open the possibility of suing later to get the money back.)

 

[Odysseus123]

10 minutes ago, impulse said:

 

If a normal flight were advisable, I doubt that the insurance carrier would have offered them a $265K evacuation flight.

 

And now, it seems that the insurance carrier will front the $265K, (leaving open the possibility of suing later to get the money back.)

 

They are very quick to condemn,aren't they?

[impulse]

Here's an excellent YouTube from Canada (CBC Expose) about travel insurance.

 

Kind of long if you're not really interested in the topic.  My favorite take-away- You'd need a doctor and a lawyer sitting down together to fully analyze the small print.  A lawyer won't understand all the medical details and a doctor won't understand all the legal details.  

 

We poor consumers?  We don't stand a chance.

 

 

 

[Teddy3943]

17 hours ago, ezzra said:

i'm not a big fan of insurance companies ways of doing business but there's some information missing from the OP...With all due sympathy here, not sure whether the insurance company should be liable for what is undoubtedly a pre existing condition, surely this massive tumor hasn't come about when he was traveling right?...

Most insurance companies throughout the world are not there to help you. They only want profit and give a damn about your health. In The Netherlands where I live insurance is mandatory and the insurance companies have to accept you, whether or not you're old or suffer from a pre existing health problem and everybody pays about the same rather low premium. This is a social system where Americans are very afraid of, because for them it has the smell of socialism..... brrrrr. But it is really good for everybody.

[impulse]

8 minutes ago, Teddy3943 said:

This is a social system where Americans are very afraid of, because for them it has the smell of socialism..... brrrrr. But it is really good for everybody.

 

It's really only good for people who come down with health problems, which are a minority.  That's how insurance works, spreading the risk.  The problem is that none of us can predict whether we or a loved on will be one of the minority that benefits. 

 

The even bigger problems are that the US health care industry doesn't want to be subject to the same price controls that are implemented in countries where there is universal health care, and corporate America really wants to keep their employees stuck in lousy work situations because we need the insurance for our families.

 

[Just Weird]

9 hours ago, kingdong said:

12 hours ago, Just Weird said:

Insurance companies certainly do investigate fraudulent claims, why on earth would you claim that they don't? 

Well they didn,t with a claim I made,my neighbour made a fraudulent claim and they simply paid it.my subsequent payments then went right up for the next 6 years so in effect I paid it,insurance companies should have a duty of care regarding their clients but all they seem to want to do is wriggle out of paying.

"Well they didn,t with a claim I made..."

 

You get some real laughable nonsense posted here but that really takes the biscuit!  You seriously think that because a fraudulent claim that you made, and a neighbour allegedly made, that the insurer did not know about, your insurer increased your premiums for the next six years to compensate for it?  Good grief....   You really have to try to think of better stories to post here, yours leak like a sieve at the moment!

 

 

 

[Visarghhhh]

The insurance company was Allianz! 

[Ron jeremy]

Fact is the tumour didn't develop while he was in Thailand, it was pre- existing, the company shouldn't be on the hook for anything.

tough luck for the guy and his wife. I'm sure it wasn't planed when he is covered in Canada.

good luck to him.

[AussieBob18]

19 hours ago, zydeco said:

So you get appendicitis and you're out of luck? That ought to make people feel safer.

An appendicitis attack would be covered (unless already diagnosed). But something like Lung Cancer is not. 

But the lesson is to get the inusrance, but always have access to back up funds just in case.

 

 

[AussieBob18]

19 hours ago, Sheryl said:

Apparently his headache was not a migraine but rather due to increased intracranial pressure.

Strong pain killers in that instance are neither safe nor effective.

The intracranial pressure needs to be reduced and fast.  Steroid drugs and other measures can give some temporary help and sounds like this was done. But what is really needed is surgical intervention to reduce pressure on the brain and it is needed soon.

With something like this it is understandable the insurer would dig through the records a bit since the tumor obviously existed when the policy was issued (and probably for a year or more before that).  But if, as the article says,  the only thing they found was a medical visit for what was diagnosed as flu, they are clutching at straws and unlikely to prevail on appeal.

 

I understand - flying gome would not have been possible for him.

 

I guess the lesson not to tell the doctors, when suddenly ill overseas and wanting insurance to cover the costs, all  about any pre-existing diagnosis by a docrotr that could be related in any way, as that means you will be excluded from insurance coverage on that basis.  I know doctors need to know certain things, but saying that he saw another doctor about headaches was the 'gotcha' they are using.

 

I dont agree with spidermike on any thing in politics, but we are as one about the global insurance companies. 

[SkyFax]

7 hours ago, impulse said:

 

Have you ever tried to convince a doctor to do an MRI or CAT scan because you have what looks like the flu with no other history?  Especially in an NHS country where the doctor has incentives to reduce costs?

A.  No and I don't know that anyone goes to the hospital with the flu unless the symptoms are severe or they are in an 'at risk' category.

B. He apparently had a history of severe headaches that he said were  migraines in Thailand but for which he never consulted with a doctor about the cause of those severe headaches.

[Davedub]

Disgusting. How do the people that work at these companies making these decisions sleep at night? 

 

I can't imagine potentially condemning someone to death to protect my employer's / shareholder's profits. I'd rather starve than do that for a living.

[SkyFax]

12 hours ago, Sheryl said:

 

Nobody does thorough medical exam, or even usually any medical exam, for issuance of a travel policy.

 

Pre-existing is usually defined for health insurance purposes as a condition which was known or could reasonably have been known. If it were defined as you suggest then the majority of cancers, heart attacks, strokes etc etc would never be covered and insurance would be almost pointless.

 

Travel policies are even more liberal in their definition, since they cover only emergency care.   Allianz, the insurer in question defines it as follows:

 

"

• We define a pre-existing medical condition as an injury, illness, or medical condition that, within the 120 days prior to and including your plan purchase date:

  1. Caused a person to seek medical examination, diagnosis, care, or treatment by a doctor;
  2. Presented symptoms; or
  3. Required a person to take medication prescribed by a doctor (unless the condition or symptoms are controlled by that prescription, and the prescription has not changed).

https://www.allianztravelinsurance.com/faq.htm

 

So why in listing the above Allianz Travel FAQ for pre-existing conditions did you decide not to include the final sentence to that FAQ which is:

 

"The illness, injury, or medical condition does not need to be formally diagnosed in order to be considered a pre-existing medical condition."

 

[Road Warrior]

i have experienced refusal to pay by insurance  in Thailand .take caution with Thai insurers  

[webfact]

UPDATE:
 

Kitchener-Waterloo

Canadian man to come home from Thailand for emergency brain surgery

A doctor found a large tumour in Alex Witmer's brain while he and his wife were in Thailand

Julianne Hazlewood · CBC News

 

Alex and Jennifer Witmer were taking a six-week trip to Thailand when Alex was diagnosed with a brain tumour. (Source: Facebook)

 

A Canadian couple travelling in Thailand has won a fight with their travel insurance company to return home for emergency surgery by air ambulance.

 

Full story: https://forum.thaivisa.com/topic/1138145-canadian-man-to-come-home-from-thailand-for-emergency-brain-surgery/

 

[Sheryl]

A lot of very ill informed posts recently from people who appear to have no understanding of the medical situation or of travel insurance and also obviously did not read through the thread. Some also apparently did not read the link.

 

1. He has increased intracranial pressure and cannot safely fly on a normal commercial aircraft, at least not without medical accompaniment (personnel, equipment & supplies).

 

2. The insurance company has already agreed ti transport him back to Canada.

 

3. There has never been any question about his access to free care once in Canada, the issue has been getting him safely back there.

 

4. Travel insurance usually includes cover for medical expenses due to emergencies while travelling, including medical evacuation, and theirs did.

 

5. There is no universally applicable definition of "pre-existing condition" nor do all insurance policies exclude all pre-existing conditions. Each policy contains its own definitions and provisions. Those of travel insurance policies are typically less restrictive than normal health insurance policies both in how they define pre-existing conditions and whether they cover them (many travel policies will include cover for "exacerbations" of pre-existing conditions if declared on the application.

 

6. As already explained in this thread, the insurer - who is in fact clearly names in the linked article - defines as follows for their travel insurance policy:

• We define a pre-existing medical condition as an injury, illness, or medical condition that, within the 120 days prior to and including your plan purchase date:

  1. Caused a person to seek medical examination, diagnosis, care, or treatment by a doctor;
  2. Presented symptoms; or
  3. Required a person to take medication prescribed by a doctor (unless the condition or symptoms are controlled by that prescription, and the prescription has not changed).

https://www.allianztravelinsurance.com/faq.htm

 

Which as can be seen is very, very different from the draconian definitions proposed by some posters.

 

An insurance policy is a legal contract and the definitions that apply are those specified in the policy, not what someone  thinks is or should be  the definition.

 

Therefore the entire issue hinges for this specific case under the terms of this specific Allianz travel policy hinges on whether he sought medical care for, or took medication for, the brain tumor in the 120 days prior to taking out the policy. Not on whether the brain tumor existed previously, which obviously it must have, possibly even for years.

 

The insurer's loss adjusters, after combing carefully through all his medical records (a normal procedure when the claim is related to something like cancer or other disease that take time to develop) could find nothing other than a visit for the flu a month prior at which time he had a "mild headache" such as often accompanies the flu and which the treating doctor considered unremarkable and consistent with the flu.

 

Their initial denial was based on the assumption that the mild headache  he had when he had the flu was in fact due to the as yet undiagnosed brain tumor. The burden of proving this is on them and there is no way they can, it is the flimsiest of grounds in my opinion and would not have stood  up on appeal. (Will not, if the insurance company proceeds to try to deny the claim and seek reimbursement but, barring any new information coming to light, I much doubt they will do that).

 

What is damaging about many of the recent posts is that they seriously misrepresent travel insurance policies in particular and health insurance in general in a manner that would lead people to think there is no possible value to being insured.

 

It is not the case that health insurance policies can deny coverage for any condition that existed prior to the policy regardless of whether it  was known or  could reasonably have been known.   Cigna Global , which one poster specifically referenced (probably not in relation to travel policy) can and does cover people who discover they have cancer after taking out a policy even though the cancer likely existed for years before hand. Indeed one TV member received more than 6 million baht of cover for 2 different cancers within 5 years of getting a policy, the first one within 2 years, and for sure those cancers took many, many years to develop.  Millions of people each year are covered for stents and cardiac bypasses on policies that existed far less time than it takes to develop coronary artery disease.

 

While wording varies by policy, the usual  key point for general health insurance is whether the condition was known or suspected or could reasonably have been known. The "could reasonable have been known or suspected" part is there to prevent people from trying to get a pre-existing condition covered by delaying diagnosis. If you have a palpable lump in your breast and are uninsured you can't get around that by delaying going to the doctor until you buy an insurance policy; if you are having chest pains and are uninsured you can't get around it by putting off that stress test or angiogram until after you buy insurance. 

 

Travel policies are usually much more liberal, since their coverage is limited to emergency care/medical evacuation and obviously only issued to people well enough to travel in the first place.  This specific policy would exclude only coverage for a condition for which medical treatment or medication was necessary in the 4 months prior to the issue date and even then, would cover conditions requiring long term medication of the person's condition was completely stable.

 

Insurance company loss adjusters are there to minimize costs to the company and some act over-zealously. Wrongful denials do happen. Not as constantly as posters here suggest, they are the exception not the rule,  but they do occur. (And yes, Thai insurers seem to do this much more than Western ones. Probably assuming most people won't know their rights or how to appeal).  Insurance denials  can be appealed,  and they are often overturned on appeal.  The burden of proof is on the insurer and any denial that involves unproven assumptions or tenuous leaps of logic isn't likely  to hold up.

 

 

[ifmu]

at issue is the fact that it was not diagnosed prior ... AFTER it is diagnosed then it is preexisting ...... assuming all info is in report then it was not preexisting .. and of course your right. it grew over a long period of time ..

we all should email the <deleted> ins company and complain

[Sheryl]

1 hour ago, SkyFax said:

So why in listing the above Allianz Travel FAQ for pre-existing conditions did you decide not to include the final sentence to that FAQ which is:

 

"The illness, injury, or medical condition does not need to be formally diagnosed in order to be considered a pre-existing medical condition."

 

Because not relevant to the point being made in that post, whioch was repsonding to inaccurate statements by other posters of what a "pre-existing condition" is.

 

Yes, the condition did not have to be diagnosed, but under the policy terms it would have to have caused him to seek medical care or take medication within 120 days prior to policy issuance.

 

The insurance company would have to establish that the mild headache he had at the time he had the flu was not in fact due to the flu but due to the brain tumor which he also had, unknown to anyone. They cannot possibly prove that, and it is in fact unlikely given how common mild headache is with the flu and that headache from a brain tumor would usually not go away but rather persist and worsen steadily.

[heybuz]

14 hours ago, Rod the Sod said:

Respectfully suggest that the next time you read the small print. That is why it is there, for you to understand what you get for your money. To get stung once for not reading the small print was unlucky. Twice was downright careless. Three times, well, what can I say?

If they are not trying to hide something why not make it large print and in a simple language that people of all educational levels can understand.