holiday disaster and travelsafe

Grumpelstiltskin

From the standard policy document.


Be Aware This policy does not cover the cost of private medical treatment unless it has been approved in advance by our 24 hour medical helpline.


Did you contact the 24 hour helpline ASAP?

snowpup

The American lady from the hospital, who was the only person who spoke any English, spent a lot of time faxing various documents and information to Holidaysafe, and was eventually happy that our insurers were okay with my husband being there. We have looked through all the paperwork that he eventually left hospital with, and there seems to be nothing in writing from holidaysafe at all, only information about his treatment.

snowpup

Grumpelstiltskin wrote: »

From the standard policy document.


Be Aware This policy does not cover the cost of private medical treatment unless it has been approved in advance by our 24 hour medical helpline.


Did you contact the 24 hour helpline ASAP?

It couldn't be approved in advance because my husband was unconscious, and in the hospital.! And I was stranded with our 10 year old daughter up in the mountains with no transport, no phone, no way of contacting anyone!! Horrendous situation! When I managed to get a lift to Ortaca, where the hospital is, the next day, I took all the paperwork, and Erica from the hospital contacted the insurers, faxes went backwards and forwards , and I think we assumed the insurance was fine. I assume the hospital has all the communications between themselves and holiday safe, and they must have thought the insurers were ok with the situation.

snowpup

It was quite strange as well that it was nearly Christmas before we heard anything at all over this matter, and had, stupidly assumed everything was sorted. But just before Christmas I was out and received a mobile call from Erica at the hospital, saying that the hospital hadn't been paid. She went on to say that she had called the insurers, and they told her they hadn't paid because we hadn't filled in the forms that they had sent us several times! We had received nothing! But, on returning home later that day what should I find through the letterbox? Yes, Forms to fill in for the insurance company!!! My husband got them filled in that same evening, and made copies of them to keep, before posting them first class the next day. Then we heard nothing until we received the £8000 bill yesterday!!

thegirlintheattic

What is a bit confusing is you seem to imply that he could have gone to the public hospital but would have been transferred to the better equipt private hospital. This suggests that SOMEONE told them to take him to the private hospital rather than the public one. If I was the insurer, I would be questioning this.

If it was the ambulance staff's decision to take him to the private hospital due to the facilities, then you need to make this clear to the insurers and also make it clear that it was not possible for your husband or yourself to contact them prior to his admission.

Voyager2002

Don't panic...

It is clear from your other post that you acted reasonably in the circumstances. If your insurance company were to persist in refusing to pay, you could complain to the Ombudsman and would eventually win (unless this was a pre-existing condition).

From what you have posted, it sounds as if the insurance company have not administered things properly (forgetting to send you forms, and so on). The hospital, quite reasonably, sought help from a debt collector. The insurance company now understand the problem and have told you not to deal with the debt collector but send them any letters from the agency, which is fine.

snowpup

We have done all this. The public hospital had no ICU or cardio specialist, so there would have been no point taking him there. It seemed like the public hospital was never an option due to his state, and this was made clear to me later when I was worried about the fact he was in the private hospital. He needed to get to the right care as quickly as possible, or the whole thing could have ended much worse than a big bill!

snowpup

But is it fine ? The insurers say it will be up to the hospital to claim from the state, and that leaves us in a very dodgy position if we ever need emergency care in that area again! The hospital staff were fantastic and helped us through this terrifying experience. I feel dreadful that they have received no payment 6 months on.

snowpup

And it wasn't a pre-existing problem. And are the debt collectors reputable? What happens when they don't get their payment?

vegasvisitor

It sounds like there is nothing you could have done with regards to pre-authorisation. I don't think it's reasonable for them to insist on pre-authorisation in a life/death situation which is what you are describing.

I don't understand however how your husband was rushed to the hospital without anyone accompanying him to deal with the paperwork. It sounds like you didn't attend until the next morning. I would have thought you would accompany him in the ambulance (assuming you were there when he was taken away).

Have you tried calling the insurance company? Speak to customer service, if you don't get any satisfaction ask to speak to a manager. Use the word 'complaint' if you have to. Insurance complaints are reportable to the FSA, and they should take you seriously if you say that.

At the end of it all though, I hope you get the bill paid. But that said, at first I thought you were talking about A LOT of money, £8k is really nothing when you are considering a life/death situation.

Edited to add: I have heard of insurance companies not paying out when the person is under the influence of alcohol, and I believe they are within their rights to do so under terms and conditions. I'm not saying that this is what was wrong, but as you were on holiday it is possible there was alcohol consumed, I hope this isn't their reason, as if it is you may have problems with the claim. Good luck with it all, hope it gets sorted...sounds stressful