Travel Insurance Discussion Area

Dave_and_Aleks

I'm having a nightmare of huge proportions. My partner and I flew to Orlando on Xmas Eve for a 17 night holiday. We're still here. 2 days before flying home, my partner had a cardiac arrest followed by complications with pneumonia and surgery. He's still in hospital and has been for 5 weeks now.

I got travel insurance for us before we left home through http://www.travelinsuranceweb.com paying £42 for a single trip policy for both of us.

On the day of my partner's cardiac arrest, I contacted the medical assistance people Specialty Assistance Services to notify them of the claim. I signed two consent forms - one for the release of my partner's medical records from his GP (he was in no fit state to sign them himself) and one for permission for the doctors in the US to speak to the insurance company. The consent for my partner's medical history was not accepted by our GP - it had to come from him (erm, sedated, unconscious, massive cardiac arrest, intensive care unit - how the hell could he have given consent?).

Anyhow, after four weeks we receive a decision - they are NOT going to cover my partner's hospital bill which stood last Tuesday at $270,000 (although they give a 40% discount for not having insurance). I guess the cost is rising by about $1,000 to $2,000 each day.

The reason for the repudiation - something must have cropped up in my partner's GP notes and records which the travel insurance company didn't like. Whatever my partner has gone through in the last five weeks has not stemmed from a pre-existing condition. I think the insurance company are taking this stance because of the fact that there was a pre-existing condition, even if it didn't lead to what he's going through now.

So now I'm stuck. They are going to make an ex-gratia payment to cover my hotel bill (approximately £29 a night since 8 January) but will not pay for it indefinitely - they are covering to the end of the week and then will review it.

My partner has been told by two cardiologists that it is too dangerous for him to fly to the UK on a commercial airline without medical assistance (heart monitor, oxygen, medication, defibrilator, nurse and/or doctor) so a medical evacuation needs to be done (which I think would cost about £25,000).

The only way he would be allowed to fly home unaided would be if he had an implantable cardioverter defibrilator surgically implanted. To be a candidate, they need to figure out whether he is going to live at least 10 years. Given everything else going on, that's no guarantee - it could be a year, could be 20 years. He needs to undergo a series of tests first to see if he is suitable (electro physiology studies). Again, there's a cost. Who can pay for the tests and the surgery?

Another thing that sticks with the travel insurance company is the following - the first paragraph is what I e-mailed to Claim Assistance Service to ask about appealing; the second paragraph is their reply:

"I do have one further question/concern. When I first reported the claim to the insurers on 8 January, and up until the date of the decision to repudiate the claim, I was under the impression that doctors and nurses, etc were in almost constant contact with the insurers regarding Mr M's treatment and that some sort of authorisation had to be sought from the insurers before a go ahead was given for the relevant treatment (investigative scans, surgery, ongoing care, etc). If that is the case, I am baffled that the insurers saw fit to give the go ahead for treatment, knowing full well the substantial cost involved and then in effect pulling the rug. I appreciate the position regarding Mr M's non-disclosure; however, I would like to hear your comments on this issue."

"I have noted your comments regarding the hospital and can confirm that, while Specialty Assistance Service acting on our behalf have been in regular contact with the hospital, they have not provided the hospital with authorisation for treatment or any guarantee of payment for their costs. The hospital have been aware of this when providing treatment and care to Mr M. As such, it would not be correct to say that we gave any go ahead and then pulled out."

The travel insurance policy specifically states:
You are covered up to £10,000,000 for costs incurred outside your country of residence for:

1) reasonable emergency medical treatment (including necessary physiotherapy but only
when authorised by the Assistance Service);

Conditions

1) You must contact the Assistance Service immediately should you be admitted to
hospital or require on-going out-patient treatment overseas.
2) All treatment or expenses must be authorised by the Assistance Service.

Not covered:

10) any costs for in-patient treatment, on-going out-patient treatment or curtailment of a trip on medical grounds without prior authorisation from the Assistance Service;

It seems to me that from the second bold paragraph above, they are saying that authorisation for treatment was not provided. Before the decision to not pay out under the claim was made, for approximately four weeks, I was under the impression that authorisation for treatment had been sought. I still think that they pulled out as soon as they found the first thing they could find. I need to speak to the hospital staff on that one to see if "authorisation was sought" in advance of my partner receiving treatment.

What I want to know now is how to get my partner home - neither of us own property or any substantial assets, our families are not rich to the tune of £150,000 to cover hospital bills and medical evacuation. I've been in touch with the British Consulate in Orlando but does anyone know what help they can offer? Can the NHS fund treatment abroad if it is necessary to get a British Citizen back to the UK? Are there any charities I could apply to?

Does anyone else have anything constructive to say - something I could be doing that I've not thought about? I racked my brains to figure out a solution but to no avail.

Thanking everyone in anticipation of your answers.

Aleks

Steve_xx

The reason for the repudiation - something must have cropped up in my partner's GP notes and records which the travel insurance company didn't like. Whatever my partner has gone through in the last five weeks has not stemmed from a pre-existing condition. I think the insurance company are taking this stance because of the fact that there was a pre-existing condition, even if it didn't lead to what he's going through now.


I'm sorry to hear that you are in this plight. I cannot see any way that this treatment would be met by the NHS becuase as you know, there is no reciprocal arrangement between the UK and the USA.

It seems that you might be intimating that something pre-existing has caused the insurer to refuse your claim. Firstly, do you know what the reason is? What have they said that they have discovered in his medical notes that has caused them to refuse the claim? This is probably the most important point to establish before trying to deal with this problem further with the insurer.

UKoap

Our hearts go out to you and Alex..are the insurance company telling you exactly what condition Alex failed to disclose? On the face of it the Insurance company are being flippant, why not take this to TV's 'watchdog' or even a National newspaper like the SUN? Your case is the kind of material they like to challenge. I realise that being away from the UK is a hinderance to obtaining help, hopefully Martin will use his media influence and alert
those who might be able to highlight your plight.
Keep us informed and meantime I suggest forum members contact http://www.travelinsuranceweb.com requesting they do something to relieve your worry and stress.

madkitty

my uncle had to be accompanied home on a commercial flight from ibiza with a private nurse and defib - it was too risky due to the changes in pressure to risk it without. He had 2 stents implanted though and I dont know if that makes a difference. The cost is mind numbing as its the US - I know my uncles claim was c£30k but that was from Ibiza

Baritone

I am 70, my Wife is 60 and we both require travel insurance that has a duration of more than 31 days. For instance, we wish to go to France for a trip lasting 74 days but find that almost impossible to insure. I'm sure we can't be the first to encounter this problem so can anybody help?

Steve_xx

Baritone wrote: »

I am 70, my Wife is 60 and we both require travel insurance that has a duration of more than 31 days. For instance, we wish to go to France for a trip lasting 74 days but find that almost impossible to insure. I'm sure we can't be the first to encounter this problem so can anybody help?

Halifax seems to offer cover upto 185 days. See here:

http://www.halifax.co.uk/insurance/travelinsurance.asp

agedhippy

Hi
all a bit new so please bear with me!! I,m trying to find a single trip policy for my 15 year old, who is off ski ing in austria for a week.(with adult friends!!) Unfortunately all the on line searches dont quote for under 16,s!!!!!!! Can anyone help??
Cheers:beer:

Paul64_2

Hi,
From April 1st I will be living and working in Transylvania, Romania. What travel insurance policy would be available to me based there rather than the UK?

Thanks in advance

Paul

ConsumerWarrior

My daughter (14) wants to travel to Florida in July with her friend and her parents, They already have their own travel cover but cant include my daughter.
When I try to buy separate cover for my daughter the insurers refuse due to her age or assume that I will travel with her (wish I was).
They don't seem to have an option to allow her to carry her own insurance cover while traveling with another party.

Anyone know this one? (links welcome)
Thanks

ConsumerWarrior

Dave_and_Aleks wrote: »

Travel Insurance Nightmare
Thanking everyone in anticipation of your answers.

Aleks

Wow!

Well I always contact the CEO's of any company I have trouble with, I would say a good option for you is email the Prime Minister and the President of the USA, (http://www.connectotel.com/marcus/ceoemail.html)

Get UK and US tv companies on your case.
Are there any charities that can assist?
Try contacting Celebs like John Travolta (he has his own aircraft and loves publicity)