British student’s harrowing balcony plunge leaves him fighting for life in a Thailand hospital

[Liverpool Lou]

1 hour ago, nchuckle said:

18 hours ago, Liverpool Lou said:

Consumption of alcohol does not necessarily void a policy, it is the excess consumption of alcohol (that would contribute to the incident) that generally does.

 

But you are right, if a person is inclined to over-imbibe there is no point in buying a policy that doesn't cover those circumstances.

Expand  

You are quite right on the alcohol over consumption,but it would also have to be a clear contributory cause.

I know, that's what I said. 

Just being over the policy's prescribed blood/alcohol limit is all the insurer needs for the policy to be voided.

[craighj]

Why is pretty much all of these type of stories are the same, dream one in the life time holiday, accident or motor bike accident, travel insurance won't pay for "some reason"?   Please can everyone help as he is the best person anyone has every met!

 

Are they copying each others scripts?

 

Craighj

[VBF]

1 hour ago, richard_smith237 said:

Where can that line be drawn ?

 

My 'health insurance' has paid out for injuries received as a result of sport - would travel insurance pay out the same or count sport has a higher risk activity ? (depends on the policy I imagine).

 

My health insurance has no such 'alcohol clause'... I'm perhaps less likely to get hurt slipping over while drunk than I am going into a tackle on the football pitch or riding my motorcycle (legally). 

 

 

When I read of such news it gives me the impression that travel insurance is a sham - then we criticise so many people for not having insurance, but why would they bother if the insurance doesn't pay out...  

OR... are there 'no fault' travel insurance policies which cover everything ???

 

Certainly, the marketing for such insurance policies do not make it clear that they 'exclude injuries while under the influence - customers would have to read the pages and pages of terms and conditions which use 'language beyond the every day layman' and for many are extremely difficult to follow.

 

My annual travel insurance with Nationwide in UK contains the following, under "Exclusions" 

 

We will not pay any claim resulting from:

 

Deliberate harm or recklessness
Any claim made as a result of you:
•
Dying by or attempting suicide.
•
Deliberately injuring yourself or making yourself ill.
•
Putting yourself in danger, including danger that could reasonably be predicted, unless you were trying to save someone’s life.
•
Contracting a sexually transmitted disease.
•
Being under the influence of drugs or solvents, other than any drugs prescribed for you and taken under medical supervision. This includes any claim directly related to drug abuse.
•
Drinking so much that your judgment is seriously affected. This includes any claim directly related to alcohol abuse.

 

Which begs the question, of course: Who decides that your judgement is "seriously affected"?

Or, as you say, "Where can that line be drawn?"

[khunPer]

9 hours ago, kwilco said:

there needs to be a serious revue of balcony designs in Thailand - the rails are dangerously low especially for Westerners who are generally taller than Thai people.

Yes. However, we don't know if that is the case here.

[Mickboy]

Maybe the insurance didn't cover flying off third floor balconies ?

[Chongalulu]

45 minutes ago, Liverpool Lou said:

I know, that's what I said. 

Just being over the policy's prescribed blood/alcohol limit is all the insurer needs for the policy to be voided.

No it wouldn't. If you were drunk sitting in a roadside bar which a car ran into injuring you there would be no contributory factor. The insurer would have no grounds to reject the claim and the ombudsman would rule as such 

[Yellowtail]

1 hour ago, KhunLA said:

for those curious, balcony height:

... 900mm (TH), average male ht: 171.61cm

... 1100mm (UK). average male ht: 178.21cm

 

So not to get deleted ... IMHO

(actually the regulation, feel free to Google)

male ht

I think 900mm it's the minimum balcony railing height in Thailand

 

I think the minimum balcony railing height in the US varies from state to state from ~915mm to ~1070

 

Average center of mass is what matters, not height. 

 

Blaming the height of the railing is silliness. 

[Dont confuse me]

Sad state of affairs,  I would love to know the reason (which the insurance company surely must have provided) why they are refusing to assist.

If possible the name of the insurance company.

[richard_smith237]

7 minutes ago, Dont confuse me said:

Sad state of affairs,  I would love to know the reason (which the insurance company surely must have provided) why they are refusing to assist.

If possible the name of the insurance company.

I think LL make the right assumption on the first page of this thread regarding this issue. 

 

People can be judgemental, even if he was only the equivalent of 1 drink over some arbitrary insurance limit.

 

I do agree - Naming the company is definitely a must in these cases. 

 

19 hours ago, Liverpool Lou said:

Perhaps the family does know something about the circumstances of the denial of the claim from the insurer but are reluctant to include it in a request for money so that other people to pay the bills?

 

 

[thailand49]

2 hours ago, Scouse123 said:

Here we go loudmouth know all yank Brit bashing as is usual.

There you go the truth comes out it wasn't my response but the hate you have for Americans and America! 

you shot your big mouth off when you got backed into corner you basically did what is natural threw out the race card. 

Whatever cause you to have these ill feelings get over it not healthy every country has problem just look at America, I don't buy stuff like Trump make American great again and you shouldnt hate other why Britain is no longer Great it is what it is! 

" The more patriotic the more stupid "

I still think Brit's make the best Fish and Chips be glad of that LOL. 

[thailand49]

20 hours ago, Liverpool Lou said:

Consumption of alcohol does not necessarily void a policy, it is the excess consumption of alcohol (that would contribute to the incident) that generally does.

 

But you are right, if a person is inclined to over-imbibe there is no point in buying a policy that doesn't cover those circumstances.

Agree!

[Yellowtail]

29 minutes ago, richard_smith237 said:

I think LL make the right assumption on the first page of this thread regarding this issue. 

 

People can be judgemental, even if he was only the equivalent of 1 drink over some arbitrary insurance limit.

 

I do agree - Naming the company is definitely a must in these cases. 

 

 

 

Drunk guys generally do not fall off balconies unless they're sitting or climbing on them, or perhaps attempting to jump from the balcony to the pool, or nest balcony, perhaps on a bet, while watching a Tom Cruise movie. 

 

I've been falling down drunk on balconies thousands of times without an issue. 

[kwilco]

1 hour ago, khunPer said:

Yes. However, we don't know if that is the case here.

We know no about any of the suggestions - have you measured your balcony?

 

[Taboo2]

Does anyone have documented cases where Insurances does pay for accidents that occur over here? 

[kwilco]

20 hours ago, Liverpool Lou said:

Consumption of alcohol does not necessarily void a policy, it is the excess consumption of alcohol (that would contribute to the incident) that generally does.

 

But you are right, if a person is inclined to over-imbibe there is no point in buying a policy that doesn't cover those circumstances.

Drinking alcohol in a private apartment won't invalidate your insurance - if it was shown to be to the extant it incapacitated the persom they might question it.

[richard_smith237]

35 minutes ago, Yellowtail said:

Drunk guys generally do not fall off balconies unless they're sitting or climbing on them, or perhaps attempting to jump from the balcony to the pool, or nest balcony, perhaps on a bet, while watching a Tom Cruise movie. 

 

I've been falling down drunk on balconies thousands of times without an issue. 

 

Would you be implying that the injured lad was either sitting, climbing or attempting to jump from the balcony because he was 'drunk' because you've been drunk on balconies thousands of times without an issue ???

... i.e. because you've never had an actual accident on a balcony, its impossible that anyone else could ????

 

 

[Yellowtail]

1 minute ago, richard_smith237 said:

Would you be implying that the injured lad was either sitting, climbing or attempting to jump from the balcony because he was 'drunk' because you've been drunk on balconies thousands of times without an issue ???

No. I would be implying that it is likely that the poor guy was sitting, climbing or attempting to jump from the balcony railing, probably while he was drunk. 

 

1 minute ago, richard_smith237 said:

... i.e. because you've never had an actual accident on a balcony, its impossible that anyone else could ????

No, I'm not saying that at all. What I'm saying is that, assuming the railing did not fail, it is virtually impossible for fall from a balcony unless one is sitting, climbing or attempting to jump from the balcony railing. 

 

Clear? 

 

[Yellowtail]

I ain't no Indian, but that sound like war talk to me!!

 

I ain't no checker player, but it's your move...

[NIRVANA1]

9 hours ago, Sig said:

Wow... that's pretty amazing! Perhaps you always stay in very posh places? Not sure how you could have avoided seeing that. I don't disbelieve you, just find it amazing because I've also been in Thailand a bit over 2 decades and have seen railings that I thought "Oh that looks a bit low" countless times! Especially in condos and hotels.

yeah he is a midget

[kwilco]

6 hours ago, Gottfrid said:

There is nothing wrong with Thai balconies and their railings. The only thing that is wrong, is the human error that does not check it´s surroundings, and create an undesirable result

rubbish

[Yellowtail]

Just now, kwilco said:

rubbish

Hey, aren't you the one that blames Thia law enforcement for all the motorcycle deaths? 

 

Now you're blaming Thai balcony for people falling from them? 

 

 

[dunroaming]

23 hours ago, arithai12 said:

Looks quite serious, I hope he pulls through, best wishes.

 

As for the insurance refusal to pay, difficult to express an opinion without knowing the circumstances of his fall and the details of what was supposedly covered and what not.

Recently been looking at travel insurance for my son for travelling in South East Asia. He is similar age.  Thailand does appear to flag up more than it's fair share of exclusions, mainly concerning medical costs.  I spoke to a friend about this (he is an insurance broker) and he said that Thailand is notorious for whacking up medical costs for insurance purposes. Also for adding costs for treatment when no such treatment was administered.   Therefore insurance companies tend to shy away from covering medical expenses, especially for the young and foolish.

 

I olny have his word for this, but it does seem to fit with all the unsuccessful insurance claims we hear about.

[The Fugitive]

11 hours ago, HappyExpat57 said:

I dated an insurance agent for a year and got to see the "behind the scenes" operations. It's nothing but legalized extortion and their default position is to deny anything and everything they can.

 

Yes, the circumstances surrounding this event are unknown to us, but the insurance companies' primary goal is always clear - deny, deny, deny!

Exactly! I attempted to make a claim in the days when you could go into an office and talk to someone face to face. The young lady gave me the 'stock' answer; 'Which of course isn't covered under your policy'. Fortunately, I had thoroughly read the booklet that came with it that clearly stated it WAS covered. Two possibilities; she didn't know her job or, more likely, was under instruction to fend off all claims with that line in the hope the customer didn't know and would give up.

[kwilco]

Claims about drunkenness and insurance are mere furphies...people always make mistakes and health and safety helps to mitigate this

 

Whether or not the lad was intoxicated is more or less irrelevant – to suggest that people on holiday in their room shouldn’t drink is just ridiculous - most inevitably will and often more than they drink at home.

 

I would however argue that when selling themselves  as a holiday destination, Thailand has a responsibility of care to their customers. …and that would include a certain level of safety in hotels, resorts, pools etc.

 

There are building regulations in Thailand but anyone who has lived here will know that there is always a corrupt alternative to following them.

Secondly I wouldn’t be at all surprised if the said regulations themselves are inadequate.

regulations

 

When it comes to balcony regulations, I wonder if anyone has ever bothered to seriously look at or measure the balcony in their own accommodation?

 

In the UK the MINIMUM height for the rail on a balcony is 1.1 metre – check that against the one you have.

 

Bear in mind the centre of gravity of a person who is relatively tall – if they fall against a railing that is just a few mm too low they may well tip over – building regulations are designed to anticipate this with the minimum height regulations.

 

As I said, I doubt very much if regulations like this are rigorously enforced in Thailand and I suspect that the legal height may be lower in a country where the average height is a lot lower than in the West. .

 

There are other points to consider too

 

Balconies should must pass combustibility regulations – i.e. no wood or other flammable materials.

 

DECK  or platform.

The floor/platform must be level, well drained and the surface must not become slippery when wet. It should be non-slip. This factor is stipulated in regulations and I’m sure construction engineers will know well the pendulum test that assesses the friction offered by a floor surface when a foot comes into contact with it. It can measure slip potential of both dry, wet and contaminated flooring. Slipping on a wet floor is a perfect way to exit involuntarily via the balcony. I’ve NEVER seen tiling either on balconies or around pools that look like they come anywhere near to complying with that.

 

Then there is the concern of materials and  fastenings which must be of standard and correctly affixed. Flammable materials are of particular concern.

And of course fastenings must be of standard and correctly affixed. The width of the balcony and the access have to be set up in a way that the entrance if higher than the balcony floor is at a safe distance from the railing….trip and fall being the result to avoid here. The size of the balcony is also relevant to the amount of people allowed to accommodate.

 

[kwilco]

53 minutes ago, Yellowtail said:

Hey, aren't you the one that blames Thia law enforcement for all the motorcycle deaths? 

 

Now you're blaming Thai balcony for people falling from them? 

 

 

And you appear to be to be the one with low reading and comprehension skill?

[The Fugitive]

5 hours ago, thailand49 said:

With nothing to hide I told them I cycle and still play Basketball at 70, they had to call the office. 

Interesting thank you! Makes you think that although participation may not be a stated exclusion, insurance companies may be able to resist your claim on the basis that such activities become 'extreme' after a certain age?

[richard_smith237]

7 hours ago, nchuckle said:

Travel insurance will cover you for a lot so it's unwise not to buy it based on your reasoning. It will exclude say skiing but you can pay extra to have it included. The "small print ” isn't that small and there's always a separate section,not difficult to read, identifying the exclusions. Very many are too lazy to spend the ten minutes or less to read it. You post intelligently and would have no difficulty at all.

Appreciate the compliment. 

 

With a 'previous' health insurance it took me two months to secure written confirmation of their 'dangerous activities' clause. I had to push the company into a corner and answer specifics regarding riding a bicycle in Thailand (on the road), Motorcycle (with licence or pillion), Diving (only recreational) and Skiing (on piste & off with a guide)... It was a battle, however their premiums were competitive and I was being particularly bloody minded. 

To be honest, after checking all of this and going into detail, it is only recently that I have even been made remotely aware of a 'booze clause' on this forum.

 

My current insurance through work covers everything no questions asked. 

The Cover for my Wife and Son is somewhat vague in its policy wording, I wonder if deliberately so, so, I when stepping into that 'vague world' such as ensuring cover for skiing I take out additional insurance specifically for skiing (with World Nomads) because I just can't be bothered getting into that two month 'dance' again. 

 

I have a low opinion of many insurance companies, because, even when being astute a combination of complex terminology and vagueness in the language they use provides them with wiggle room, of course, deliberately so. 

 

 

In this example a young lad has taken insurance, visited Thailand and fallen off a balcony.

IF there is an alcohol clause its wrong IMO - falling off a balcony was not a deliberate act. 

 

 

 

 

[chalawaan]

On 7/5/2023 at 6:30 PM, Yorkshire Tea said:

I'm guessing alcohol consumption voided his insurance.  In which case, what's the point of travel insurance?

How many beers does it take to do really silly things? 

A lot. 

Insurance companies get these tragedies by the hour, they crunch the numbers to oblivion. 

 

I once side swiped a lad who was in a line of stationary cars. 

Nothing too serious, paintwork. 

I swore in all honesty he had turned into my path, insurance were adamant I had grazed him, on the phone they told me they knew by the pics of the damage who was at fault, they see it hundreds of times a day!

 

Same with the nature of the accident, I've been drinking on hotel balconies several times in this life and never managed to fall off. 

 

You're just not going to have that fall unless you're being daft and dangerous. 

 

I doubt he'll pull through in that state, pneumonia will get him if the injuries don't. 

A just a bleeding lung and pneumonia nearly killed me, but it was not due to any hi jinks and travel insurance paid out every penny. 

[richard_smith237]

8 hours ago, nchuckle said:

Drunk and falling from a balcony is a whole different matter.

If he were 'one drink over' ???...     I think the clause is unfair if the boundaries are 'tight'.

 

The policy wording of course matters, but when selling insurance to a 20 something year old, is there not an onus on the company to ensure what they are selling is fully understood by the customer ?

 

i.e. IF when shopping for insurance I was told by an insurance provider that I'm not insured for slips, trips or falls after 4 beers (BAC equivalent of) I'd go elsewhere, many would, as drinking on holiday is a very normal activity. 

 

I've read on this forum that some providers use the term 'reasonable consumption'...   whats reasonable ?

 

... of course, we still do not know what the cause of rejection was. That would help the discussion.

 

[richard_smith237]

5 minutes ago, chalawaan said:

You're just not going to have that fall unless you're being daft and dangerous. 

I disagree......  genuine accidents happen all the time...  ever slip or lose footing on a wet floor ?... wet balcony ?...    

 

The application of statistics and probability comes into calculation of the premium, destination and duration of trip - with the information and stats you mentioned, the insurance company already know the probability of an incident and have 'costed' that out in the premium offered. 

 

Again... we don't know the reason for rejection, but discussing the booze clause specifically - these companies know people drink and party when going on holiday. They should be far more transparent in their information so people can make 'readily' informed choices. I don't mean language hidden in a policy document, I mean to suggest that these companies should make issues such as a 'booze clause' front page policy info for obvious reasons - I believe there is a deliberate reason companies do not do this and think it borders on 'dishonest' and they should be held accountable for their lack of transparency.