39 minutes ago, Yellowtail said:

Except that waking on a sidewalk is assumed to be a safe activity and excluding it would never hold up in court, so it would be covered.

Walking on a sidewalk, with a pitcher of gasoline balanced on one's head and a lit candle in each hand would not be assumed to be a safe activity and it would be excluded.

So, should walking on a sidewalk, with a pitcher of gasoline balanced on one's head and a lit candle in each hand be listed as one of the exclusions?

One example would be the alcohol exclusion clauses commonly found in travel insurance policies. In principle, they sound reasonable. In practice, however, the wording is often vague enough to leave considerable room for interpretation at claim stage.

For example, imagine walking along an uneven pavement in Thailand, twisting your ankle and tearing a ligament after having had a few beers earlier in the evening. You attend hospital, bloods are taken, and the insurer later argues that alcohol contributed to the incident. That is not a hypothetical concern - insurers do, in some cases, investigate whether alcohol was directly or indirectly connected to an accident or injury.

There have also been publicised disputes involving serious injuries abroad where insurers initially declined or questioned claims because alcohol was allegedly involved. I recall a case involving an Australian woman seriously injured after a fall at a hotel in Thailand, where the insurer argued intoxication exclusions applied after they 'estimated' her BAC to be high based on her height, weight and bar-bill and used an expert to estimate how drunk she was based on her walking (from CCTV footage).

The real issue is that many policies do not clearly define what level of alcohol consumption invalidates cover. Some insurers specify a BAC threshold, while others rely on broader wording such as “under the influence” or “excessive alcohol consumption”. That creates understandable uncertainty, particularly where higher-value claims are involved and investigations become far more detailed - Of course, some will argue "why should someone be covered when they get smashed and walk out into traffic without looking ?" etc - but thats the point of holiday cover, guards drop, people indulge and that line between recklessly intoxicated and happily merry is a very grey line given peoples different tolerance levels for alcohol in the first place.

And yes, someone will inevitably respond with statistics showing that 90% of claims are paid out. That may well be true overall. But the persistent distrust people have towards insurers generally stems less from routine claims, and more from concerns over how exclusions, ambiguities, and policy wording may be interpreted when substantial payouts are involved - that 'simple broken' ankle and treatment (cast) from the pavement slip may not draw a great deal of attention, if exactly the same incident involved a head or spine injury and significantly greater costs insurers the claim has to be water tight.

There is also the separate issue of claims being initially rejected, delayed, or disputed until the policyholder escalates the matter through formal complaints procedures, ombudsman schemes, or legal pressure, at which point insurers sometimes reverse their position and ultimately pay out in accordance with the policy wording.

That does not necessarily mean insurers are acting unlawfully as a matter of routine, but it does contribute to the widespread perception that parts of the industry are structurally incentivised to minimise payouts wherever reasonably possible. After all, insurance companies are commercial enterprises, and claims handling departments exist not only to validate legitimate claims, but also to identify exclusions, inconsistencies, non-disclosures, or technical grounds upon which liability may be reduced or declined.

There have been numerous ombudsman decisions in the UK and elsewhere where insurers were found to have interpreted policy wording too narrowly, relied upon ambiguous exclusions, or rejected claims in circumstances where the ombudsman later determined the claim should in fact have been honoured. That, understandably, reinforces public scepticism - particularly when policyholders feel they must become quasi-legal experts simply to obtain the cover they believed they had purchased in the first place.

(and no LL - I'm not going to quote examples - I've already run through your little dance on this issue in the past and earlier in this thread).

12 hours ago, FritsSikkink said:

Just show your insurance card when entering, no money upfront needed.

She was apparently initially told she was “covered”, only for complications and exclusions to emerge afterwards, including issues relating to policy conditions and where she had travelled in from.

At this stage, whether the insurer was technically correct or not is almost beside the point - the issue is that people often only discover how these clauses are interpreted once they actually need to make a claim.

And that is exactly why I spend time digging through the wording and find a huge deal of ambiguity.

For example, I’ve just looked at a policy offering “60 days travel cover”. Sounds perfectly clear on the surface. But once you get into the definitions and conditions, cover could potentially become void or disputed if travelling from Thailand to Vietnam or Singapore (for example) and then back to Thailand - despite still being within the original 60 days from departure from the UK.

That’s the kind of thing people mean when they refer to “fine print”. Not that the phrase “60 days” is difficult to understand, but that the actual application of the policy depends on layers of definitions, exclusions, territorial clauses, and interpretations that are often far less obvious than the headline wording implies.

21 hours ago, impulse said:

FWIW, here's a disturbing little tidbit from BritBrief:

Insurance Shock

After nearly a week in hospital, Chloe was discharged on Wednesday but faced a £4,000 bill for treatment. Her insurance policy was only valid if she had flown directly from the UK, not from Vietnam, where she had travelled prior to Thailand. A hospital insurance liaison initially assured her she was covered, but later she was told otherwise.

https://britbrief.co.uk/politics/immigration/thailand-bike-crash-leaves-woman-with-4000-bill.html

6 hours ago, jippytum said:

.. Do you really want us to belive Thai hospitals would accept anyones insurancr card I have had first clasc insurance cover in Thailand for over 35 years i can assure you they fo not avcept insurance cards on sight. Prior to amajor operatlon at a major hospital my incurancr confirmed in advance but the hospitsl still required a returnable holding deposit from me prior to admission.

Been in different hospitals several times, had both SSO and private insurance from a Thai company. Never paid upfront, they phoned the insurance company.

Just show your insurance card when entering, no money upfront needed.

I did just that, and here's the response from my travel insurance carrier to the hospital (Bumrungrad) when they contacted the company:

Hello.

 

To confirm; our insurance coverage is typically a pay and file for reimbursement scenario. 

I do sincerely apologize for any inconvenience and welcome you to contact our licensed agents for any other questions or concerns.

I had to pay and file for reimbursement. Which they (no surprise) denied. Based on their interpretation of the fine print.

On 5/9/2026 at 9:14 AM, BritManToo said:

Broken ankle about 5,000bht ..........

No other injuries apart from a bit of road rash.

And that wouldn't have happened if she'd been wearing a helmet.

No need for insurance payout!

But the government minimum on the m/c would have easily covered it if the guy had hung around (covers 30,000bht).

If the tax certificate was current and the driver passed a sobriety test ?

1 minute ago, impulse said:

I did just that, and here's the response from my travel insurance carrier to the hospital (Bumrungrad) when they contacted the company:

Hello.

 

To confirm; our insurance coverage is typically a pay and file for reimbursement scenario. 

I do sincerely apologize for any inconvenience and welcome you to contact our licensed agents for any other questions or concerns.

I had to pay and file for reimbursement. Which they (no surprise) denied. Based on their interpretation of the fine print.

I had a similar experience with April Thailand. They pre-authorised treatment at Bumrungrad International Hospital for a kidney stone - so naturally I proceeded with the procedure - all signed off, bill covered directly when I departed the hosptial after treatment and a short over night stay.

A few months later I started receiving letters from Bumrungrad advising that April had subsequently rejected the claim following a deeper review of my medical records and I had to pay them directly.

The issue related to a note in my file from a routine annual medical check-up which mentioned the absence of a previously observed renal stone that had appeared in an earlier MCU several years prior.

Apparently, even a note made approx 4.5 year previously confirming the absense of renal stones still fell within their 5-year moratorium period.

Thus: In short, a medical note stating that a condition was not present was considered sufficient grounds to void the claim because of the mere 'mention' of it within 5 years.

Had I known the claim would ultimately be rejected, I would have sought treatment elsewhere at less cost, especially as the procedure itself was very straightforward.

This was bonkers to me - I felt I had a strong claim to fight back - however, the insurer were unresponsive and I was forced to deal directly with Bumrungrad who ultimately threatened legal action - I had to travel a lot for work so did not have time, nor was it worth my while to risk any potential fall out.

This is one of the reasons I go so deep down the rabbit hole when assessing new cover (either health or travel insurance). It’s also why I’m highly critical of policy wording, the legalese, and what often feels like the deliberate use of ambiguity and subjective interpretation to create room for claim rejection.

1 hour ago, Yellowtail said:

Except that waking on a sidewalk is assumed to be a safe activity and excluding it would never hold up in court, so it would be covered.

Walking on a sidewalk, with a pitcher of gasoline balanced on one's head and a lit candle in each hand would not be assumed to be a safe activity and it would be excluded.

So, should walking on a sidewalk, with a pitcher of gasoline balanced on one's head and a lit candle in each hand be listed as one of the exclusions?

So you don't get the issue.

Btw, i worked in insurance and even developed a travel insurance policy for the company. My input was from the marketing side, the colleague i worked with from the underwriting side.

45 minutes ago, cracker1 said:

If the tax certificate was current and the driver passed a sobriety test ?

Gov min insurance pays out all hospital claims despite the legality of any driver or passenger. The only conditions are a police report must be handed to the hospital, and the maximum claim is 30,000bht.

24 minutes ago, BritManToo said:

Gov min insurance pays out all hospital claims despite the legality of any driver or passenger. The only conditions are a police report must be handed to the hospital, and the maximum claim is 30,000bht.

Medical Expenses: Up to 30,000 THB (at fault) or up to 80,000 THB (not at fault) per person.

I’m sure all those delighting in this young woman’s predicament have adequate health insurance with accident coverage included.

28 minutes ago, roo860 said:

Medical Expenses: Up to 30,000 THB (at fault) or up to 80,000 THB (not at fault) per person.

IF the MC had Por-for-bor cover in the first place.

This accident was on KPG - I’d guess no basic insurance - moot point anyway, the ayhole rode off.

57 minutes ago, BritManToo said:

1 hour ago, cracker1 said:

If the tax certificate was current and the driver passed a sobriety test ?

Gov min insurance pays out all hospital claims despite the legality of any driver or passenger. The only conditions are a police report must be handed to the hospital, and the maximum claim is 30,000bht.

@BritManToo - are you suggesting that even without MC Por-for-bor this girl would be covered up to 30,000 baht ? & should have been even though the ride rode off ?

15 minutes ago, richard_smith237 said:

@BritManToo - are you suggesting that even without MC Por-for-bor this girl would be covered up to 30,000 baht ? & should have been even though the ride rode off ?

No, because the girl wouldn't know the plate number to put on the police report.

27 minutes ago, Chomper Higgot said:

I’m sure all those delighting in this young woman’s predicament have adequate health insurance with accident coverage included.

Most of us know better than to get treated at a ripoff private hospital.

2 minutes ago, BritManToo said:

Most of us know better than to get treated at a ripoff private hospital.

So that’s one confirmed no then.

1 minute ago, BritManToo said:

Most of us know better than to get treated at a ripoff private hospital.

Expats, yes, but a tourist who believed she had valid insurance, probably not.

And she woke up in a hospital, so probably had no say in the choice of hospital.

2 minutes ago, BritManToo said:

Most of us know better than to get treated at a ripoff private hospital.

I've been here ages and always used private hospitals, I'd love to know the procedure/protocol how to use a government hospital in Chiang mai for example...........

13 hours ago, richard_smith237 said:

The issue was never the rudimentary semantic comprehensibility of the isolated phraseology “30 day limitation” per se, but rather the jurisprudentially convoluted, contextually contingent, and structurally interdependent interpretive matrix within which such ostensibly straightforward temporal restrictions are habitually embedded throughout insurance policy documentation. In practical application, the operative construction of such provisions is frequently rendered dependent upon an unnecessarily labyrinthine amalgamation of exclusionary qualifications, jurisdictional caveats, procedural contingencies, disclosure obligations, endorsement supersessions, and recursively cross-referenced definitional sub-clauses dispersed throughout the broader contractual corpus, thereby materially obscuring what might otherwise appear facially unambiguous.

Accordingly, I have already expended an entirely disproportionate quantity of time engaged in the deconstruction and interpretive exegesis of policy instruments specifically to identify the very loopholes, restrictive contingencies, and latent ambiguities your somewhat reductive one-line response appears unwilling to acknowledge. The difficulty does not arise from lexical incomprehension, but from the intentionally prolix, syntactically obfuscatory, and structurally fragmented drafting conventions characteristic of insurance contracts, wherein seemingly unequivocal provisions are routinely diluted, qualified, contradicted, or contextually subordinated elsewhere within the documentary framework - rather like this comment itself.

You right that lawyer smarter than drunk unlisenced motorcycle rider... usually.

But clauses you have quoted, make sense both in that they can be understood, and also they are "reasonable" even "expectable".

Of course travel insurance not "forever" or it called "forever insurance". So you take out 30 day insurance for 31 day holiday. Obviously you take risk, save money. Just as if you insure car at home for one year and then not pay premium next year, you take same risk.

1 hour ago, Off Piste said:

I've been here ages and always used private hospitals, I'd love to know the procedure/protocol how to use a government hospital in Chiang mai for example...........

You turn up at 7am, see the nurse at the entrance, and she gives you a ticket number to see the triage nurse. Then you just follow instructions, usually in English, but you might need Google translate for the medical questions.

Assume you'll be there all morning, and you need your passport as ID.

NakornPing is a decent hospital, on the road to Mae Rim.

Maharaj if you're in the middle of town.

It ain't quick, if you're not bleeding, but the price is right.

20 minutes ago, BritManToo said:

You turn up at 7am, see the nurse at the entrance, and she gives you a ticket number to see the triage nurse. Then you just follow instructions, usually in English, but you might need Google translate for the medical questions.

Assume you'll be there all morning, and you need your passport as ID.

NakornPing is a decent hospital, on the road to Mae Rim.

Maharaj if you're in the middle of town.

It ain't quick, if you're not bleeding, but the price is right.

Really appreciated..............

4 hours ago, richard_smith237 said:

One example would be the alcohol exclusion clauses commonly found in travel insurance policies. In principle, they sound reasonable. In practice, however, the wording is often vague enough to leave considerable room for interpretation at claim stage.

That is one clause that concerns me. I can't remember the actual term use but certainly mentions consuming alcohol as a reason for refusing a claim. So at what level would a claim be refused, one beer, a bit merry, can't walk in a straight line, falling over drunk, collapsed on the floor drunk? Just seems like an open ended get out clause.

Also I found a worrying get out clause in my policy when examining the small print. There is a list of permitted activities and a list activities not covered. Then a clause stating any claim for anything not listed in the permitted and obviously not an exempted activity was automatically not covered. So for example if I trip on the stairs and fall down is that covered as an accident or as walking on stairs is not listed is it automatically not covered? Ok that is may be a bit too obvious but you get my drift. How far would the insurance company go to use that clause to stop a claim. If I did anything and it was not specifically listed will a claim be rejected. When does the obvious cease to allowed?

4 minutes ago, Geoff914 said:

That is one clause that concerns me. I can't remember the actual term use but certainly mentions consuming alcohol as a reason for refusing a claim. So at what level would a claim be refused, one beer, a bit merry, can't walk in a straight line, falling over drunk, collapsed on the floor drunk? Just seems like an open ended get out clause.

Also I found a worrying get out clause in my policy when examining the small print. There is a list of permitted activities and a list activities not covered. Then a clause stating any claim for anything not listed in the permitted and obviously not an exempted activity was automatically not covered. So for example if I trip on the stairs and fall down is that covered as an accident or as walking on stairs is not listed is it automatically not covered? Ok that is may be a bit too obvious but you get my drift. How far would the insurance company go to use that clause to stop a claim. If I did anything and it was not specifically listed will a claim be rejected. When does the obvious cease to allowed?

It is not possible for insurance companies to list every event that is included or excluded.

If you buy a month of travel insurance from Tommy's Travel for $8, not much is covered.

On 5/9/2026 at 4:03 PM, Liverpool Lou said:

People should stop commenting in this manner, there is no "fine print " on insurance policies, there are policy conditions which are printed in normal font.

“Fine print” is a common expression that most of the population understands. You should probably not take it literally.

Exclude alcohol is NOT reasonable, even if it sounds as alcohol is bad so people who drink it are bad. Alcohol is legal and common. Cannot exclude legal aspect of normal life, let alone of holiday.

Very different to exclude medical claim from drunken accident (not reasonable) rather than liability to compensate victim of own drunk driving (very reasonable). But two get mixed together.

1 hour ago, Yellowtail said:

It is not possible for insurance companies to list every event that is included or excluded.

If you buy a month of travel insurance from Tommy's Travel for $8, not much is covered.

Which is exactly what gives the insurance companies their “wiggle room”.

Getting drunk, riding a motorcycle without a licence, and not wearing a helmet obviously voiding coverage is fair enough. Most people would accept that.

The problem is the huge grey area in between.

For example, plenty of ordinary tourists have jumped into the back of a pickup truck to be driven up a steep road for a rafting or kayaking trip. If that truck crashes, does the insurer suddenly classify that as participation in a “dangerous activity”? Then what happens if the kayaking trip itself results in a capsized boat and a head injury? Does some obscure helmet clause suddenly appear?

That’s the issue. While it may be unrealistic to expect a travel insurer to list every conceivable excluded activity, I don’t think it’s unreasonable to expect clear, guaranteed cover for common tourist activities and recreational sports.

I ended up in nearly two months of back-and-forth emails just trying to get confirmation for very ordinary activities, and the company seemed extremely reluctant to give direct answers.

At one point I became very blunt in my emails:

“Would I be covered for the following activities? Please answer yes or no only"

• Skiing on piste

• Skiing off piste

• Skiing off piste with a guide

• Scuba Diving (Pad qualified up to 18m)

• Wake Boarding (lake - cable pull / Boat in lake / Boat in Sea)

• Water Skiing (lake - cable pull / Boat in lake / Boat in Sea)

• Cycling - On the road / Around a dedicates cycling park

• Recreational and competitive sports (non-proffessional)

  • Tennis (and tournaments) Football (and tournaments)

This is just what I remember off the top of my head, but I actually provided them with a much longer list. I really had to push to get straight answers - and the reason I did so was after reading so many of these 'insurance void' reports.

My concern was exactly this sort of scenario: you suffer a head clash during a casual football game, end up with a brain bleed, and then suddenly the insurer argues it was a “dangerous sporting activity” requiring separate sports coverage.

That was precisely the type of retrospective interpretation I was trying to avoid.

I wanted clear confirmation, in advance, that anything reasonably foreseeable as part of my normal trips and activities would actually be covered if something went wrong - its not a big ask.

1 hour ago, Geoff914 said:

That is one clause that concerns me. I can't remember the actual term use but certainly mentions consuming alcohol as a reason for refusing a claim. So at what level would a claim be refused, one beer, a bit merry, can't walk in a straight line, falling over drunk, collapsed on the floor drunk? Just seems like an open ended get out clause.

Also I found a worrying get out clause in my policy when examining the small print. There is a list of permitted activities and a list activities not covered. Then a clause stating any claim for anything not listed in the permitted and obviously not an exempted activity was automatically not covered. So for example if I trip on the stairs and fall down is that covered as an accident or as walking on stairs is not listed is it automatically not covered? Ok that is may be a bit too obvious but you get my drift. How far would the insurance company go to use that clause to stop a claim. If I did anything and it was not specifically listed will a claim be rejected. When does the obvious cease to allowed?

Lots of lawyers get paid lots of money for writing vague limits on insurance that often allows them to flat out refuse payments or at least delay delay delay in the hopes you will just give up.

Even if you carefullky read and review every single word of exclusions (excuses) that still does not mean that your interpretation of the words will be the same as an insurance adjustor.

How do insurance companies stay in business if all they do is deny claims?

3 minutes ago, Yellowtail said:

How do insurance companies stay in business if all they do is deny claims?

Exactly so, as writing "unreadable" (for many not all) agreement that exclude exactly all claims not that hard, real issue is loss of reputation from actual denial. And this is big pushback even sometimes "unfair" to insurer.

4 minutes ago, Yellowtail said:

How do insurance companies stay in business if all they do is deny claims?

That's one way but mostly it's because many will never use their insurance, making claims. Premiums pay them more than what they pay out.

1 minute ago, Yellowtail said:

How do insurance companies stay in business if all they do is deny claims?

To be fair, I’ve also had plenty of claims approved over the years.

My criticism is less about insurers denying obviously invalid claims, and more about the policy wording itself - particularly the amount of “wiggle room” built into the grey-area situations.

Examples being things like a girl getting on the back of a motorcycle, a brief weekend trip out of the insured country technically voiding cover, or an insurer later using something as minor as a 1,500 baht bar bill to argue the claimant had been drinking and was therefore negligent or intoxicated (which has happened given some reports I've read).

With travel insurance especially, it often feels like the small and routine claims go through without issue. But when something genuinely serious and expensive happens, and the circumstances fall anywhere near one of those policy grey areas, insurers become extremely quick to deny or limit cover.

I experienced something similar myself. I suffered an injury overseas and the travel insurance initially covered the initial medical costs incurred abroad (which were relatively cheap - and just a cast to immobilise torn ligaments / tendons and keep me going for a couple of days).

Rather than undergoing a very expensive operation overseas, I chose to return to Thailand and have the surgery here instead (with a known Dr), which was significantly cheaper and ultimately would have saved the insurer money.

Only after returning did I discover that the policy would only cover treatment while I remained overseas. The moment I returned to my point of origin, the cover effectively stopped.

I’ll admit I was naïve and didn’t realise that at the time, but nowhere in the policy wording was this made clear. After the claim issue arose, I went back through the documentation specifically looking for clarification and still couldn’t find anything that clearly explained that ongoing treatment for an injury sustained abroad would immediately cease once you returned home.

Apparently, that’s simply something travellers are expected to already know - I'll admit, not knowing this was my own fault, I thought covered all facets of predictable risk.