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

[Liverpool Lou]

8 hours ago, pomchop said:

It's what they do and one reason they make massive profits a lot of which is spent on lobbying politicians to keep them from being more closely regulated and transparent with fine print loopholes.  

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

[Liverpool Lou]

8 hours ago, pomchop said:

Insurance companies are experts in wiggling out of claims as there are always lots of loopholes in the fine print that a gaggle of lawyers wrote and most people never read and don't have their own gaggle of lawyers to go through it all. 

 

It's what they do and one reason they make massive profit

No the reason that the insurance companies make profits is because they do pay, on average, 90% of all claims...that is why they are so profitable, if they didn't pay out most claims they'd have no new policy holders confident enough to take out new policies to give them that profit.

[Liverpool Lou]

8 hours ago, thaibeachlovers said:

9 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 would be dependent on the small print in the policy.

That would actually be dependent on the policy conditions, there is no "small print" in UK insurance policies.

[kingstonkid]

4 hours ago, jimn said:

The chances are that the insurance only covers treatment at a local government hospital and not an expensive private hospital like the Bangkok Phuket hospital. This is common with travel insurance.

That is the biggest issue, and a lot of tourists do not understand it.  I use BNH and while my VAC covers most of my treatment, is does not fully cover meds as they only reimburse Ontario rates.  

My medical coverage, not VAC covered, is an issue as there are cost limitations as well as things they will not cover.  Other nurse services are one of them

In Canada there is no such charge, so they do not reimburse it even though we all know that the charge is included in the doctor's actual fee.

 

Question 1

 

Pardon my ignorance BUT is med evac flights covered in these plans and if so is there not usually a max amount.

 

 Question 2 

 

Would it not be cheaper if covered to get the surgery done here instead of trying to fly back and then get the UK Government to pay.  

[Liverpool Lou]

8 hours ago, Srikcir said:

Thailand hospitals are not capable of doing the required surgery/repairs and it must be done in the UK?

"Thailand hospitals are not capable of doing the required surgery...?"

Where has that been stated?

[Liverpool Lou]

8 hours ago, HappyExpat57 said:

Just spit balling here, but couldn't they fly a team of specialists in to Thailand to do the surgery at a fraction of the cost? I'm sure some hospital in LOS has the necessary hardware.

Jesus...

[bradiston]

4 minutes ago, Liverpool Lou said:

No the reason that the insurance companies make profits is because they do pay, on average, 90% of all claims...that is why they are so profitable, if they didn't pay out most claims they'd have no new policy holders confident enough to take out new policies to give them that profit.

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.

[Liverpool Lou]

7 hours ago, Jerno said:

What is it with Insurance companies?  Very simple: They are there to pay out the fewest possible claims for the least amount of payout

What is it with Thaivisa posters?  Very simple, you're wrong when it comes to legitimate claims. they are businesses, not charities and all policy holders agree to the terms of the policy they bought and read.

[Liverpool Lou]

7 hours ago, proton said:

For less than 250k he could get the operation he needs here

Only if he has the means to pay for it.

[Liverpool Lou]

7 hours ago, Mywayboy said:

Travel insurance companies are Axeholes when it comes too paying out.

That must be why, statistically, 90% of all claims are paid.  

[Liverpool Lou]

6 hours ago, James105 said:

A very, very quick google search suggest that this cost should be about £65,000 on a learjet.

 

https://www.iasmedical.com/asia/air-ambulance-thailand/#:~:text=Our medical transportation services from,The number of medics required

 

Not surprised the insurance are questioning this.   

That is the starting price...

Our medical transportation services from Bangkok to the UK start from £65,000

[KhunLA]

31 minutes ago, Liverpool Lou said:

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

You obviously haven't been on the other side of collecting larger claims.  They stonewall, wait as long as possible, as their money is earning elsewhere, and if you die, even better.

 

Most people don't have the funds to sue, or to live on while waiting a settlement.  

[Liverpool Lou]

5 hours ago, Pedrogaz said:

I wonder why so many people fall from balconies in Thailand?

"So many people" do not fall from balconies here, a very small number have done so.

[bradiston]

34 minutes ago, kingstonkid said:

That is the biggest issue, and a lot of tourists do not understand it.  I use BNH and while my VAC covers most of my treatment, is does not fully cover meds as they only reimburse Ontario rates.  

My medical coverage, not VAC covered, is an issue as there are cost limitations as well as things they will not cover.  Other nurse services are one of them

In Canada there is no such charge, so they do not reimburse it even though we all know that the charge is included in the doctor's actual fee.

 

Question 1

 

Pardon my ignorance BUT is med evac flights covered in these plans and if so is there not usually a max amount.

 

 Question 2 

 

Would it not be cheaper if covered to get the surgery done here instead of trying to fly back and then get the UK Government to pay.  

I think it's the only hope they've got. The colossal funds for flying him home are surely far in excess of hip replacement surgery, or whatever it is that is required. One of my main reasons for getting myself insured was to cover exactly that, from eg slipping over in the bathroom. Course, he's come crashing down from 10m (?) up, so his injuries must be a lot more serious. But he looks pretty ok. Er, maybe that's not a fully qualified medical opinion, but I still agree with you. Surely the surgery is available here at a much less costly rate than the evac amount? I was quoted minimum 300k THB for hip replacement. £8000. Up to maybe 1.5m THB, £35k. So allow for extras, £50k in total? They've had £16k at time of going to press in the UK.

 

A rather late afterthought. Is the 3rd floor as in Thai 3rd floor, which would be the 2nd floor in UK. So he might have fallen from the floor of the 2nd floor, about 6m? Ouch!

[gbswales]

Having travelled a lot in my life, always with comprehensive travel insurance, I am appalled by the thought that having a few drinks on holiday could invalidate your claim.  It makes you question whether all those policies were worth the paper they were printed on.  I hope they end up doing the decent thing and give this poor man the help and support he now needs.

[Liverpool Lou]

5 hours ago, Smokey and the Bandit said:

They need to name the Insurance Company and the Insurance Company needs to explain what is going on?

The insurer does not need to explain to anyone except the policy holder what is going on and, presumably, he has a reason for not naming the company that could be working on a solution for him.

 

One reason for not publicly naming the insurer could be that the policy holder could have voided his policy and does not want the backlash from the insurance company if he makes accusations when he was in the wrong.

[James105]

7 minutes ago, Liverpool Lou said:

That is the starting price...

Our medical transportation services from Bangkok to the UK start from £65,000

Sure, the doctor is an extra £700 per day, £350 per nurse according to that link so they will have to be added on.   I don't think there is enough space on a learjet to fill it up with the medical personnel to get it to even £100,000 yet alone £250K. 

 

The expensive part is the private jet which includes the pilot.   Unless they are hiring Salt Bae to provide the in flight meals of course then maybe it could go up to as much as £100,000 with such an expensive food menu.    

[Sheryl]

34 minutes 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.

 

But regardless, this "fine print" business is a myth.

 

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

 

From Nomad Insurance list of Exclusions (Safety wings) - a very popular policy because low cost and easily bought online:

 

13. Intentional self-inflicted injury or illness and/or suicide or attempted suicide whether sane or insane.
14. Injury sustained that is due wholly or partially to the effects of intoxication or drugs other than drugs taken in accordance with treatment prescribed by a physician and except drugs prescribed for the treatment of substance abuse.

 

https://safetywing.com/nomad-insurance

 

Now I am not saying either of those 2 exclusions - which are common to most policies, both travel and general insurance - apply in this case.  But I can certainly see why injuries due to a fall from a balcony would immediately lead an insurer to question (and investigate) whether they might.

 

 

[Liverpool Lou]

5 hours ago, jimn said:

The chances are that the insurance only covers treatment at a local government hospital and not an expensive private hospital like the Bangkok Phuket hospital. This is common with travel insurance.

"The chances are that the insurance only covers treatment at a local government hospital ... This is common...".

No, that is not common.  What is common is a limit on the insurer's liability.

[Sheryl]

9 minutes ago, gbswales said:

Having travelled a lot in my life, always with comprehensive travel insurance, I am appalled by the thought that having a few drinks on holiday could invalidate your claim.

 

The alcohol exclusion is often worded with reference to the legal blood level limit under local laws .  Or else, it is worded in terms of the accident having been due to intoxication.

 

Not the case that simply having had a "few drinks" invalidates a claim.  It would have no effect at all on a claim for illness. For accidents, would depend on how high your blood alcohol level was (i.e. if you met the legal definition for intoxication) or if the accident can be considered due to intoxication.

 

In practice, insurers tend to check for this only for injuries of a type where alcohol is often to blame. 

[Sheryl]

10 minutes ago, James105 said:

Sure, the doctor is an extra £700 per day, £350 per nurse according to that link so they will have to be added on.   I don't think there is enough space on a learjet to fill it up with the medical personnel to get it to even £100,000 yet alone £250K. 

 

The expensive part is the private jet which includes the pilot.   Unless they are hiring Salt Bae to provide the in flight meals of course then maybe it could go up to as much as £100,000 with such an expensive food menu.    

 

No reason to hire a private jet. This sort of medical evacuation is done on commercial aircraft all the time.  While still not cheap, it is far, far less than a private plane charter.

 

There may well be a medivac company trying to sell the family on chartering a plane, but if so they should look elsewhere (including DIY by contacting airlines).

 

Contact airlines, explain the requorements (i.e. stretcher as he cannot sit up) and overall condition etc (e.g: conscious, not on  a ventilar, etc etc. Will likely be told have to pay for a full row of seats (and costs of their removal to accomodate a stretcher) and medical personnel accompaniment.

 

 

[Adumbration]

He will never recover financially from the initial mistake.  Letting himself be taken to Bangkok hospital.  Surgery could have been done at Vachira, or Mission, by the same doctors and at 25% of the cost.

[kingstonkid]

1 hour 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

Could also cost the taxpayer billions.  Imagine if you did not have to wait for surgery at the NHS and could just pop down to Bangkok and get the surgery.

 

 

[kingstonkid]

22 minutes ago, Liverpool Lou said:

The insurer does not need to explain to anyone except the policy holder what is going on and, presumably, he has a reason for not naming the company that could be working on a solution for him.

 

One reason for not publicly naming the insurer could be that the policy holder could have voided his policy and does not want the backlash from the insurance company if he makes accusations when he was in the wrong.

This is from a UK provider website notice the wording up to

 

Up to £10 million for emergency medical expenses outside the UK:

• Emergency medical treatment
• Dental treatment for emergency pain relief
• Emergency medical repatriation to the UK

The challenge is what is covered and how much.  I am sure they do not have the top plan

 

I am also sure that UK insurers and Travel agents are getting tired of these articles showing up in the newspaper.

 

 

[Liverpool Lou]

5 hours ago, PingRoundTheWorld said:

I have a friend who was hospitalized at Bangkok hospital Phuket last year. The whole thing, including flying him out to Bangkok, cost about $20k. Sure it's expensive, but it's not 250k.

There's a big difference between a flight from Phuket to Bangkok and a repatriation flight for a completely immobilised patient from Thailand to the UK!

[Liverpool Lou]

5 hours ago, Neeranam said:

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

No.

[kingstonkid]

1 hour ago, Liverpool Lou said:

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

Anyone admitted that may need blood is tested so that they can have the blood on hand.  Thai hospitals especially the top tier do that immediately if for not other reason than to bill it.

[Woof999]

6 hours ago, James105 said:

A very, very quick google search suggest that this cost should be about £65,000 on a learjet.

 

https://www.iasmedical.com/asia/air-ambulance-thailand/#:~:text=Our medical transportation services from,The number of medics required

 

Not surprised the insurance are questioning this.   

With the aircraft they use, at least 1 and much more likely 2 fuel stops would be required for any Thailand > UK flight. I think I'd prefer the direct commercial flight with a row of seats removed or, even better, not need a flight at all.

[Liverpool Lou]

5 hours ago, Mike k said:

Same as most insurance companies they want your money but don't want to pay out 

Same as from even well-established AN members, complete nonsense. 

 

If insurers were renowned for not paying claims there wouldn't be any insurers as no one would buy the policies.

[Liverpool Lou]

5 hours ago, Mike k said:

Same as most insurance companies they want your money but don't want to pay out 

You got some personal experience of that happening?