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

[kingstonkid]

6 hours ago, Sheryl said:

 

Might be an issue of his having been intoxicated at the time - or insurer may be trying to ascertain if this was the case.  Or ditto that it was not a suicide attempt. An accident due to intoxication (alcohol or drugs), and suicide attempts,  would be excluded from most policies.

 

He does not have to travel by air ambulance, can go on a commercial flight but would have to buy out a full row in business class to accommodate stretcher and have a medical attendant (nurse). Often done and hospitals can help coordinate it, or there are companies that do this. Still not cheap but nowhere near the price mentioned here. From what I recall something along the lines of US$40,000 all in.

 

They likely also need funds to pay accumulated hospital bill, though, and hospital won't let him leave until it is paid.

 

Still not likely to reach much more than  100,000 pounds though.

https://www.asiaairambulance.com/services/

 

Yes you can do commercial flights

 

[ukrules]

1 hour ago, Liverpool Lou said:

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.

Yes, once I lost a mobile phone and because I didn't report it within the required 24 hours all cover for said phone was null and voided and that was the end of that.

 

All was above board though and the insurance company did an honest job there ????

[Liverpool Lou]

4 hours ago, crazykopite said:

Why are they struggling to get the insurance company to cover the cost they have a contract with the insurers 

Perhaps because he did not comply with the policy conditions and voided the policy?

[Liverpool Lou]

4 hours ago, retsdon said:

4 hours ago, crazykopite said:

Why are they struggling to get the insurance company to cover the cost they have a contract with the insurers 

Having a contract and having the means to enforce it are two different things. 

Having a contract that's possibly been voided and then trying to enforce it is a different thing also.

[Liverpool Lou]

4 hours ago, BangkokReady said:

11 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.

Yes, a business model in which  around 90% of all insurance claims are paid out.

[ukrules]

9 hours ago, madmitch said:

I would guess that a drugs/alcohol exclusion would be the most likely reason to deny liability but without knowing the facts I wouldn't want to speculate further.,

Indeed, I've read about cases where people have jumped from balconies into swimming pools and to put it bluntly, they missed the pool.

 

At this stage we have no idea why they're not paying up, would be nice to have some additional information.

 

[Liverpool Lou]

4 hours ago, Jiggo said:

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. 

Time to give the take-your-money-small-print nonsense a rest unless you've got some personal experience to back it up.

[Liverpool Lou]

3 hours ago, wealthychef said:

I thought Brits had free healthcare, did they Brexit that away too?

He's not in Britain.

[jimn]

5 hours ago, Sheryl said:

I have never seen or heard of a travel policy that specifies only treatment at a government hospital. In fact, most government hospitals are unable to supply the documentation required by insurance companies (and this, more than lack of insurance, is why government hospitals in tourist areas often end up unreimbursed. It takes more than an invoice to get payment from an insurance company).

 

The policy will of course have had a financial limit. What, we don't know. But as the article did not mention that as a factor, and seemed to indicate no insurance payment of any amount to date,  I think it morel likely an issue of the circumstances of the accident.

I am surprised that you, as the so called "expert" on here does not know about the limit on using private hospitals without prior agreement with the insurance company. I enclose a screenshot from the t&c of a well known UK insurance company. it clearly states its not for use for private treatment. Although I am able to find it, somewhere else in the document it states only government hospitals unless prior agreement is obtained.

[freedomnow]

I wonder if this kind of event will be "stagecrafted" soon enough...a photo of a guy in a hospital bed and then the gofund me page appears...no-one bothering to contact where the person is supposed to be bed-ridden...etc etc....

[kennypick]

Why would any hospital give out information about alcohol being in his blood knowing the insurance company will not pay out therefore the hospital will not get paid

[Liverpool Lou]

3 hours ago, spidermike007 said:

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. 

Nonsense, insurers in general will never have any issue with a legitimate claim, they have no need to as their risks are insured also.

[Liverpool Lou]

3 hours ago, racket said:

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. 

Which "scam" is being perpetrated by the hospital he is in?

[Doctor Tom]

29 minutes ago, kennypick said:

Why would any hospital give out information about alcohol being in his blood knowing the insurance company will not pay out therefore the hospital will not get paid

The Insurers would have insisted on a report to them on alcohol or drug levels.  Don't tell them and they won't pay out, so the hospital will comply, by first obtaining permission from this idiot, no permission, no insurance pay out. Its all in the exclusions that too many don't bother to read, or if they do, ignore. 

Edited February 28, 2023 by Doctor Tom

[Liverpool Lou]

2 hours ago, Sheryl said:

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.

Getting a report translated from Thai to English would be no issue whatsoever to an insurer.

[Liverpool Lou]

2 hours ago, kiko11 said:

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

Today's date is 28th February, I think.

[Liverpool Lou]

2 hours 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

Does your country (or any country) cover its citizens' uninsured medical costs when they're overseas?   If not, why not?

[Liverpool Lou]

1 hour ago, bradiston said:

Insurance companies assess the risk (the odds) on each policy they underwrite. And like a bookmaker taking a bet, they will lay off the bet with other underwriters, so their exposure is minimised if faced with a large claim. The higher the risk, the higher the premium. Probably only a small percentage of people ever actually make a claim. That's where they make their money. If they didn't do their work properly (due diligence on an applicant for instance), they'd be out of business very quickly. And you'd find yourself uninsured.

Yes, I know that.

[Etaoin Shrdlu]

5 minutes ago, jimn said:

I am surprised that you, as the so called "expert" on here does not know about the limit on using private hospitals without prior agreement with the insurance company. I enclose a screenshot from the t&c of a well known UK insurance company. it clearly states its not for use for private treatment. Although I am able to find it, somewhere else in the document it states only government hospitals unless prior agreement is obtained.

I don't see anything in this that stipulates use of government hospitals only. There is a requirement to notify the insurance company if the policyholder is admitted to hospital or is likely to incur more than GPB 500 in outpatient expenses.

 

I think the reference to "private hospital treatment" may be intended to address non-emergency or elective treatment which would not be covered under travel medical policies. 

[Liverpool Lou]

1 hour ago, Sheryl said:

1 hour ago, Liverpool Lou said:

UK insurers are highly regulated and there in no "fine print" that the ordinary man in the street should not be able to understand.

 

Actually we don't know if their insurance is from a UK company, could have been from elsewhere.

Actually, the chances of the policy not having been sold in the UK is remote.

[Liverpool Lou]

1 hour ago, Sheryl said:

this "fine print" business is a myth.

 

Every insurance policy I have ever seen lists its exclusions in clear lay language in normal print.

Thank God for a rational comment on this subject, at last!  Perhaps you could point it out to all those who are posting false and misleading information about it?

Edited February 28, 2023 by Liverpool Lou

[BangkokReady]

32 minutes ago, Liverpool Lou said:

Yes, a business model in which  around 90% of all insurance claims are paid out.

I'm not sure what point you're making.  Do you think this is in some way contrary to what I said?

[Liverpool Lou]

27 minutes ago, jimn said:

6 hours ago, Sheryl said:

I have never seen or heard of a travel policy that specifies only treatment at a government hospital. In fact, most government hospitals are unable to supply the documentation required by insurance companies (and this, more than lack of insurance, is why government hospitals in tourist areas often end up unreimbursed. It takes more than an invoice to get payment from an insurance company).

 

The policy will of course have had a financial limit. What, we don't know. But as the article did not mention that as a factor, and seemed to indicate no insurance payment of any amount to date,  I think it morel likely an issue of the circumstances of the accident.

Expand  

I am surprised that you, as the so called "expert" on here does not know about the limit on using private hospitals without prior agreement with the insurance company. I enclose a screenshot from the t&c of a well known UK insurance company. it clearly states its not for use for private treatment. Although I am able to find it, somewhere else in the document it states only government hospitals unless prior agreement is obtained.

I'm surprised that you didn't read your own link before commenting on her expertise.  That extract does not state that treatment in private hospitals, as opposed to government hospitals, is not covered.

[Liverpool Lou]

28 minutes ago, kennypick said:

Why would any hospital give out information about alcohol being in his blood knowing the insurance company will not pay out therefore the hospital will not get paid

It's to do with ethics and the potential of being sued for fraud.

[Liverpool Lou]

9 minutes ago, BangkokReady said:

42 minutes ago, Liverpool Lou said:

Yes, a business model in which  around 90% of all insurance claims are paid out.

I'm not sure what point you're making.  Do you think this is in some way contrary to what I said?

Not exactly, just adding a comment but some people would think that you were heading in that direction!

[bradiston]

I still don't understand their hurry to get back to the UK. The treatment required here is surely cheaper than the evac costs. So why all the hoohah about medical evacuation? No mention of the costs for treatment. All hysterical nonsense if you ask me.

[KKr]

11 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 .

Some companies use wording meaning :
alcohol level above the level allowed for driving. car,
moreover, self inflicted injuries and negligence would be excluded.

[Doctor Tom]

5 minutes ago, bradiston said:

I still don't understand their hurry to get back to the UK. The treatment required here is surely cheaper than the evac costs. So why all the hoohah about medical evacuation? No mention of the costs for treatment. All hysterical nonsense if you ask me.

Its really rather obvious. Because they haven't got the money to pay for the treatment and after care.

[jimn]

15 minutes ago, Liverpool Lou said:

No, it is not common.  I take it that you are unable to show any insurer's current policy condition that specifically states that only treatment at "local government hospitals" is covered.   That's rhetorical, I know you cannot.

I thought I said I cant find the comment. I will look again. Or maybe I wont or cant be bothered, but its there somewhere on a page in a large document.

[KKr]

1 hour ago, kingstonkid said:

Yes you can do commercial flights

 

many years ago I was flown to Europe, as I was bedridden, for treatment, c.q. operation.
flew on commercial flight, was carried on and off by airport staff, including at a stopover and change of planes. (only time I entered the plane on the lift of a catering truck 555) One accompanying person sat somewhere nearby.
Stretcher occupied 6 or 8 seats, do not remember. 
That was at the time charged as 7 (or 9) seats plus ground transport-ambulance , not hundreds of thousands.

Having said that, I did not need a drip or other medical care during the flight.
Just a double vodka and a sleeping pill .