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


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15 minutes ago, jimn said:
33 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.

"...its there somewhere...".

I doubt it but if you can post that only local government hospitals can be used for treatment I will humbly apologise.  Insurers usually limit their liability in terms of maximum monetary claim levels, not where the treatment takes place.

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22 minutes ago, jimn said:

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.

Some policies may have wording to the effect that if the insured is eligible for coverage under a government medical scheme, the insured must first seek coverage from that scheme. But requiring the insured to seek treatment only at government hospitals would be quite the exception.

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14 minutes ago, wealthychef said:

I see, so UK healthcare for its citizens ends at its borders?  That's still better than the US but a strange rule

UK citizens are covered by agreements with most of the EU countries, Norway, Switzerland, Aus and NZ - and one or two others.  We have a Global Healthcare Insurance Card (GHIC) but its not very global at the moment. The plan is to roll out to more countries - I doubt Thailand will be included.

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22 minutes ago, ThailandGuy said:

How can this be so much money?  Is this also part of the dual pricing system?

Air ambulance or similar dedicated, chartered aircraft with specialized equipment along with medical staff are extremely expensive. I don't doubt that this could cost upwards of GBP200,000 from Phuket to the UK. The plane and staff would, of course, have to make a round-trip or possibly also to and from a third country.

 

Medical repatriation on commercial flights where the patient and equipment occupies several seats and may be accompanied by one nurse or other medical staff can be much less expensive. 

 

I suspect they were seeking the first one, but that is usually only approved by insurance companies if medical facilities and skills in country are inadequate, or possibly if the covered cost to evacuate and treat in home country were much less than the covered cost to treat in country.

 

The article is short on insurance details.

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1 hour ago, Doctor Tom said:

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

But they're nearer to getting the treatment costs met than the evac costs. Nobody's even mentioned the costs of treatment, only the insane costs for possibly an unnecessary evac.

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6 hours ago, Sheryl said:

though they may not be familiar with Thai balcony construction!

I agree with everything you posted, except the above. This is what everyone tries to blame. Just stop it! I have been on numerous Thai balconies, even in a drunk state, but I still know how to look at things and behave according to the presets.

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1 minute ago, Gottfrid said:

I agree with everything you posted, except the above. This is what everyone tries to blame. Just stop it! I have been on numerous Thai balconies, even in a drunk state, but I still know how to look at things and behave according to the presets.

Yes, but you haven't fallen off a balcony .

Its very easy to fall off a balcony, all you need to do is to be standing one step  further away from the balcony that you thought you were , lean back, and over you go 

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23 minutes ago, Mac Mickmanus said:

Yes, but you haven't fallen off a balcony .

Its very easy to fall off a balcony, all you need to do is to be standing one step  further away from the balcony that you thought you were , lean back, and over you go 

Have experience I can hear, or just protecting another Brit?

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4 hours 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 know your post was a reply to another member, @Sheryl, but I have been wondering what "private" is supposed to mean in the excerpt from an insurance policy you posted. First I thought "private" was meant as "non-government" but when I read on to the next paragraph it looked more like "private" was meant as "non-emergency"

 

From the policy (highlighting in red is mine)":

Quote

 

Medical and other emergencies
Your Direct Travel insurance policy is not a private medical insurance policy and does not cover private medical treatment, private hospital costs or other related expenses incurred unless these have been specifically agreed and authorised by the Medical Emergency Assistance Company.


This policy is only designed to cover you for emergency treatment. Emergency treatment means unforeseen and unplanned treatment that is needed for the sudden onset of an acute condition, which for medical reasons and in the opinion of our Medical Emergency Assistance Company, cannot be delayed until you return to the United Kingdom. The decision of the Medical Emergency Assistance Company is final.

 

Further down in the excerpt you quoted, there is this text:

Quote

 

Please note: This is not a private medical insurance. If you go into hospital abroad and you are likely to be kept as an in-patient for more than twenty four (24) hours or if your outpatient treatment is likely to cost more than £500, someone must contact the Medical Emergency Assistance Company for you as soon as reasonably possible. If they do not, we may not provide cover or we may reduce the amount we pay for your in-patient or outpatient treatment.


In the event that you require in-patient hospital treatment and/or evacuation /repatriation, it is imperative that the Medical Emergency Assistance Company is contacted and authorisation obtained prior to such treatment and/or evacuation/repatriation taking place.

 

Here again, I see "private" as the opposite of "emergency". Because this is not a private medical insurance but an insurance for emergency medical treatment, if you go into hospital...

 

In other words, regardless of the ownership or operator of the hospital, coverage for in-patient treatment over GBP 500 may be declined if prior approval from the insurance is not obtained.

 

I found the full text of the terms of insurance from which you appear to have quoted here:

https://www.direct-travel.co.uk/services/library/Documents/3/9358/dated/04-01-2022

The word "government" appears four times but never in the context of cost coverage.

Edited by Puccini
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14 hours ago, bradiston said:

I'm always curious to know how you fall out of a 3rd floor balcony, or any other balcony. I guess the insurance company is asking the same question. If the balustrades are dangerously low, don't go out there.

In 2008 I stayed in a newly built hotel in Pattaya that had no balcony railings at all. The builders hadn't put them in yet. 

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48 minutes ago, Gottfrid said:

Have experience I can hear, or just protecting another Brit?

Well yes , I was stood next to a knob high balcony of the fourth floor and I thought that I was nearly touching the balcony, but when I leant back I was less that a foot away and the momentum nearly caused me to fall over the balcony 

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54 minutes ago, Puccini said:

I know your post was a reply to another member, @Sheryl, but I have been wondering what "private" is supposed to mean in the excerpt from an insurance policy you posted. First I thought "private" was meant as "non-government" but when I read on to the next paragraph it looked more like "private" was meant as "non-emergency"

 

From the policy (highlighting in red is mine)":

Further down in the excerpt you quoted, there is this text:

Here again, I see "private" as the opposite of "emergency". Because this is not a private medical insurance but an insurance for emergency medical treatment, if you go into hospital...

 

In other words, regardless of the ownership or operator of the hospital, coverage for in-patient treatment over GBP 500 may be declined if prior approval from the insurance is not obtained.

 

I found the full text of the terms of insurance from which you appear to have quoted here:

https://www.direct-travel.co.uk/services/library/Documents/3/9358/dated/04-01-2022

The word "government" appears four times but never in the context of cost coverage.

Looks like travel insurance not health insurance 

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2 hours ago, Puccini said:

I know your post was a reply to another member, @Sheryl, but I have been wondering what "private" is supposed to mean in the excerpt from an insurance policy you posted. First I thought "private" was meant as "non-government" but when I read on to the next paragraph it looked more like "private" was meant as "non-emergency"

 

From the policy (highlighting in red is mine)":

Further down in the excerpt you quoted, there is this text:

Here again, I see "private" as the opposite of "emergency". Because this is not a private medical insurance but an insurance for emergency medical treatment, if you go into hospital...

 

In other words, regardless of the ownership or operator of the hospital, coverage for in-patient treatment over GBP 500 may be declined if prior approval from the insurance is not obtained.

 

I found the full text of the terms of insurance from which you appear to have quoted here:

https://www.direct-travel.co.uk/services/library/Documents/3/9358/dated/04-01-2022

The word "government" appears four times but never in the context of cost coverage.

In the policy linked to , page 27 section 8 if state facilities are available then private hospital are excluded. ( Paraphrased)

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4 hours ago, bradiston said:

But they're nearer to getting the treatment costs met than the evac costs. Nobody's even mentioned the costs of treatment, only the insane costs for possibly an unnecessary evac.

Tabloids have a way of distorting things.

 

If you go to the actual  fundraising site they are asking for 100k to cover cost of the surgery in Thailand.  The cost of evac is mentioned only in terms of "this is why that's not an option".   

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20 hours ago, ukrules said:

I'm going to guess that there's some kind of exclusion involving either an unsafe building or alcohol consumption.

 

I'm hoping it's due to the balcony not being high enough, at least there might be someone to sue.

 

I

 

Ah yes. Find someone else to blame. If the railing was broken, it would be part of the news story. Most farangs fall from belconies because of heavy drinking, drug using, dancing, fighting or showboating or some combination. 

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2 hours ago, Sheryl said:

Thrre are certainly balcony railings in Thailand   so flimsy that they give readily way when pressed against, or so low that one can easily trip or fall over them. And even, as mentioned above, sometimes  rooms rented out with balconies that have no railing at all.

 

it is also true that most often when people come off balconies here (or elsewhere) it is either  connected to intoxication or not an accidrnt.

 

Most often -- but not always. None of us know what applied in this specific case.

 

 

I didn't read the whole thread. Did someone post pictures of these alleged balconies with no railing at all? I've never read something so ridiculous. 

 

Does the hotel staff just mention it when you check in ? Oh hey. Your balcony has no railing. Might want to be careful

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4 hours ago, Mac Mickmanus said:

Well yes , I was stood next to a knob high balcony of the fourth floor and I thought that I was nearly touching the balcony, but when I leant back I was less that a foot away and the momentum nearly caused me to fall over the balcony 

Got any pictures ? There are some slightly lower balconies in Asia. But usually no more than 6 inches. 

 

Did you get a flat of beer and invite some friends over for a balcony party ? Probably not. A questionable belcony rail is an even bigger reason not to drink heavily around them. Which some people evidently do not do. 

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5 hours ago, Sheryl said:

It is a travel policy thst covers emergency medical care.

 

They aren't using the term"private" to mean they do not cover care in private hospitals. There is no restriction on type of hospital that can be used provided other terms of the policy are followed.

 

What they are saying is that this is not  comprehensive health insurance and only covers emergencies.

 

It is an odd choice of terms but it is clearly what they mean. 

Yes it sounds exactly like "travel insurance" you'd get from UK for emergency medical treatment

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I can’t see him getting that much from a fundraiser. Would take forever and bills are piling up at the hospital.

 

Relatives or friends need to travel here, discharge him, pull him together and get first class tickets home.

 

worst case you medicate him so he is half asleep and he gets a first class cabin with a bed.

Edited by JimTripper
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