British personal trainer needs £250,000 to get home from Thailand after falling from third-storey balcony and suffering horrific injuries while on holiday

[mikeymike100]

1 hour ago, Neeranam said:

Isn't the Ombudsman only for affairs related to government?

No, I have used the Ombudsman, many years ago, around 1998, for a claim I made on my travel insurance. My wife had money stolen, around 1000USD, the insurance company refused to pay, because she was 'careless'. Ombudsmen came down in our favor, insurance had no choice to pay out, but it took several weeks. I don't think this guy can hang around in hospital, while the bills pile up?

[BangkokReady]

7 hours ago, ezzra said:

What is it with travel insurance companies who are quick to tame your money but very slow and playing hard to get when the chips are down and they have to pay?

It's basically their business model.

 

I believe a claim handler's primary job is to find a way to avoid paying.

[Jiggo]

8 hours ago, Pique Dard said:

...it is not good to blame someone in his position, but how can he travel so faraway from his country without insurance?

Did not say in the full article that he did not have insurance, just they would not help, typical of those company's, take your money and look for anything in the small print to refuse claims. 

[aussienam]

Building code certifications are not the same here as UK, etc. So suing for low balconies,.good luck with that one.  But never read about a claim being voided over an unsafe balcony. I personally doubt it had anything to do with that.

Article is lacking detail regarding insurance claim issues.  Plenty of exclusions in clauses of policies to invalidate claims. Alcohol is a usual one, but there are specific conditions. A reasonable guess for voiding a claim in this case would be this. Repatriation cover may also be invalidated due to alcohol voiding claim from outset, or because it was not selected and paid for when cover initially taken out. 

I do feel sorry for the fellow.  Potentially will ruin him financially for life.

Edited February 28, 2023 by aussienam

[MaiChai]

Hopefully the 300 baht Tourist tax will save us from insurance companies that wont pay up or overpriced private Thai hospitals! 

[The Fugitive]

6 hours ago, itsari said:

The insurer would have to prove that alcohol was the root cause of the accident .  

Just the fact the insured has been drinking is not enough for the insurer to deny the claim .

That is interesting, many thanks. Gives cause to ponder! Moto accident claim can be rejected if not wearing helmet even though no head injuries suffered and, obviously, lack of helmet didn't cause the accident. I suppose the main factor would be the amount of alcohol but if the railing was extremely low and/or insecure?

[wealthychef]

I thought Brits had free healthcare, did they Brexit that away too?  I'm sorry for this lad's misfortunes.  Something's weird about the price tag is all I'm noticing.  

[Gottfrid]

1 hour ago, Sheryl said:

As I previously mentioned most policies would exclude accident due to intoxication, ditto suicide attempts.

 

Certainly a "fall from balcony" would raise questions in an insurer's mind. Though the onus of proving drugs or alcohol were involved, or that it was self-inflicted,  would fall on the insurer. If no evidence of same in his medical record then the family should appeal to the relevant Ombudsman. 

Yeah, you are right. However, I am pretty sure they do what they can to find such evidence from the hospital. That´s why dragging the case. Also, it´s very hard to believe that a person who is in the prime of their life just falls from a balcony. People just don´t go out and fall down. As the guy probably can´t prove that he was sober, they might try stating statistics in their favor. In that case they will find that the larger percentage is suicidal or affected by alcohol or other drugs.

Edited February 28, 2023 by Gottfrid

[itsari]

10 minutes ago, The Fugitive said:

That is interesting, many thanks. Gives cause to ponder! Moto accident claim can be rejected if not wearing helmet even though no head injuries suffered and, obviously, lack of helmet didn't cause the accident. I suppose the main factor would be the amount of alcohol but if the railing was extremely low and/or insecure?

When I lived in Norway the insurance companies refused any payout if you had any alcohol in your blood . That changed after entering the agreement with the European Union . 

[The Fugitive]

13 minutes ago, wealthychef said:

I thought Brits had free healthcare, did they Brexit that away too?  I'm sorry for this lad's misfortunes.  Something's weird about the price tag is all I'm noticing.  

We do and still do. But our National Health Service won't pay repatriation costs. 

[KhunLA]

8 hours ago, ukrules said:

Why do you think he didn't have insurance?

 

They don't want to help, that's the message I read. I wonder who his insurer is and why they're dragging their heels on paying?

Because they can, and that's what ins co. do.   Probably hoping the 'go fund' will pay for the bills and flight, and they'll just pay the balance ... or nothing at all.

 

Why I never bothered with insurance, if not mandatory, except once, as had to sue them every time for a claim.  From home owners, to workmans comp, to extra waiver (the optional one), to SS disability ins.   6 settlements in all, all in my favor.   They are scum.

[DjSilver]

As everyone have, a travel insurance. So easy, no fuzz.

[Ralf001]

6 minutes ago, DjSilver said:

As everyone have, a travel insurance. So easy, no fuzz.

This lad had/has insurance.......... sure is a big fuzz for him and family !!

[spidermike007]

8 hours ago, ukrules said:

Why do you think he didn't have insurance?

 

They don't want to help, that's the message I read. I wonder who his insurer is and why they're dragging their heels on paying?

All insurance companies are like the mafia. Any excuse to not pay. It is always about finding a clause or an excuse to not fulfill their obligations and behave in an ethical fashion. I have no trust in any of them and use them as little as possible. 

[racket]

I always wonder what happens if people can’t pay. So the hospital kill him? It pretty much sounds as a threat each time someone falls victim to these hospital scam bills. 

[Mr Meeseeks]

4 hours ago, Artisi said:

As a previous poster pointed out - stay well away from Thai balcony rails,

for 2 reasons 

1. Low 

2 Insecurely fixed into the floor /wall. 

???? This.

 

Thai construction is NOT on par with Western standards regardless of what they claim.

[John Drake]

1 hour ago, bradiston said:

Yes, you're right. And worse still, leaning against one, for instance with a drink in your hand chatting to a friend and simply tipping over backwards when it gives way. Nightmare. Maybe that's what happened here.

 

I don't know where this happened but couldn't a local paper, Pattaya/Phuket News, or some such, get to interview him or his girlfriend and find out?

All true. And the situation with balustrades probably will not change. I've been seeing these stories since I came here almost 14 years ago. There's never even been so much as a ripple of discontent over building safety. Doubt will see liability on the part of building owners/hotels either. But seeing the continuing body count related to falling off balconies, perhaps embassies should put a warning on their websites for their citizens to keep away from balustrades while in Thailand.

[Artisi]

3 minutes ago, Mr Meeseeks said:

???? This.

 

Thai construction is NOT on par with Western standards regardless of what they claim.

Having built here, that I know from 1st hand experience. 

[Sheryl]

1 hour ago, Gottfrid said:

Yeah, you are right. However, I am pretty sure they do what they can to find such evidence from the hospital. That´s why dragging the case. Also, it´s very hard to believe that a person who is in the prime of their life just falls from a balcony. People just don´t go out and fall down. As the guy probably can´t prove that he was sober, they might try stating statistics in their favor. In that case they will find that the larger percentage is suicidal or affected by alcohol or other drugs.

 

"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.

 

 

[tonypattaya]

People dont just fall off hotel balconies for no reason. Was he pranking about? His insurance is apparently withholding paying out.

[FritsSikkink]

5 hours ago, Blumpie said:

She has travel insurance, but let's just pretend she doesn't so we can gabber about this for 30 pages.  ????  

It is a "he" to start with.

[kiko11]

9 hours ago, thaibeachlovers said:

 

I can't see them getting 250,000 quid from strangers so I have no idea as to what can happen now.

 

Isn't the new tourist fee which will be implemented in June for cases like that?

[malibukid]

why won't the NHS pay?  doesn't the Uk cover its citizens abroad?  why not?  could save the UK taxpayers millions

[The Fugitive]

3 minutes ago, malibukid said:

why won't the NHS pay?  doesn't the Uk cover its citizens abroad?  why not?  could save the UK taxpayers millions

There are a few (not many) Countries that have reciprocal agreements with UK. Some of those give you the same treatment as a local would receive in that Country. Others provide emergency treatment only. 

[Rimmer]

Troll post removed

[NoshowJones]

10 hours ago, ukrules said:

Why do you think he didn't have insurance?

 

They don't want to help, that's the message I read. I wonder who his insurer is and why they're dragging their heels on paying?

Just an insurance company being an insurance company, probably looking through their fine print and legal jargon to avoid paying out.

[Liverpool Lou]

10 hours ago, thaibeachlovers said:

perhaps the UK government can fly him home on a military flight.

Yeah, right.

[Liverpool Lou]

9 hours ago, ezzra said:

What is it with travel insurance companies who are quick to tame your money but very slow and playing hard to get when the chips are down and they have to pay?

In the majority of cases that does not happen, most insurance claims are met.  The usual reason for claims being denied is because the policy holder did not comply with the policy conditions and voided the policy.

[Liverpool Lou]

9 hours ago, sletraveler said:

Isn’t that standard for insurance companies?   They look for any means possible to deny payment since it affects their bottom line. 

Nonsense.  Insurers have no issue paying legitimate claims which do not have any significant effect on their bottom line...the insurers are insured.

[Liverpool Lou]

9 hours ago, Dazkkk said:

Do Thai hospitals take routine blood tests for alcohol consumption from patients admitted for emergency care, I doubt it.
So how can an insurance company know anyone had imbibed? 

Just because you'd like to doubt it doesn't mean that it cannot be established.