Potential refusal of medical treatment without substantial payment (despite having insurance)?

NoodleDoodleMan

katejo said:

sheramber said:

https://www.gov.uk/guidance/in-hospital-abroad

Make sure you have enough money or a credit card with you. You will often have to pay upfront for medical care abroad, even if you are fully insured.

I have just found the original FB query and more details have been added since I first read it. The person  found that neither her cruise line (Norwegian) nor the Panama hospital was prepared to liaise with her insurer. The onus was on her to pay up and claim back . Her bills were $23000 to the hospital and $9000 to Norwegian Cruises but the credit limit on her CC was insufficient to prove she could pay $25000 (which the hospital required before starting any treatment)  She had further CC cards at home so had to ask a friend to go to her house and take photos of her credit card numbers. She still has further expenses incurred to get her safely home. I only have 1 fully paid off credit card and the max value is below this. 

Perhaps a call to your insurer would answer relevant concerns should you (God forbid) need to use your policy cover on a cruise ?

Voyager2002

NoodleDoodleMan said:

DullGreyGuy said:

NoodleDoodleMan said:

katejo said:

NoodleDoodleMan said:

Is it not standard practice for the hospital to contact the insurance company to confirm the patient is covered for medical treatment charges ?

That's what the solo traveller expected but the hospital refused to do so. 

I was just curious to understand why this particular hospital was being so difficult.

Since this is a second hand story there may be more to it than we are being told ?

Also a secondhand story but in the case of a relative the hospital said they had bad experiences of the insurer in question not paying or paying only after excessive delays and as such they won't extend credit to them/give them payment terms and so either the insurer or the insured must pay up front if they want treatment at their facility.

That sounds as if it could be a likely scenario in this case.

Without knowing specific details it's conjecture to assume the hospital is completely in the wrong.

The insurer may not be one of the reliable major league UK operators ?

That is how major league insurers behave now...

There was a long thread on MSE (later removed after threats of legal action) about one of the largest players in the UK market. Allegations were made by the 'Times' newspaper and echoed by many victims.

Thankfully, the insurer in question went out of business during the pandemic.

DullGreyGuy

Voyager2002 said:

NoodleDoodleMan said:

DullGreyGuy said:

NoodleDoodleMan said:

katejo said:

NoodleDoodleMan said:

Is it not standard practice for the hospital to contact the insurance company to confirm the patient is covered for medical treatment charges ?

That's what the solo traveller expected but the hospital refused to do so. 

I was just curious to understand why this particular hospital was being so difficult.

Since this is a second hand story there may be more to it than we are being told ?

Also a secondhand story but in the case of a relative the hospital said they had bad experiences of the insurer in question not paying or paying only after excessive delays and as such they won't extend credit to them/give them payment terms and so either the insurer or the insured must pay up front if they want treatment at their facility.

That sounds as if it could be a likely scenario in this case.

Without knowing specific details it's conjecture to assume the hospital is completely in the wrong.

The insurer may not be one of the reliable major league UK operators ?

That is how major league insurers behave now...

There was a long thread on MSE (later removed after threats of legal action) about one of the largest players in the UK market. Allegations were made by the 'Times' newspaper and echoed by many victims.

Thankfully, the insurer in question went out of business during the pandemic.

No travel insurer has failed that I am aware of, let alone a major one. 

You have the likes of Atlas that did fail in 2021 but they were just an intermediary not the actual insurer

Voyager2002

DullGreyGuy said:

Voyager2002 said:

NoodleDoodleMan said:

DullGreyGuy said:

NoodleDoodleMan said:

katejo said:

NoodleDoodleMan said:

Is it not standard practice for the hospital to contact the insurance company to confirm the patient is covered for medical treatment charges ?

That's what the solo traveller expected but the hospital refused to do so. 

I was just curious to understand why this particular hospital was being so difficult.

Since this is a second hand story there may be more to it than we are being told ?

Also a secondhand story but in the case of a relative the hospital said they had bad experiences of the insurer in question not paying or paying only after excessive delays and as such they won't extend credit to them/give them payment terms and so either the insurer or the insured must pay up front if they want treatment at their facility.

That sounds as if it could be a likely scenario in this case.

Without knowing specific details it's conjecture to assume the hospital is completely in the wrong.

The insurer may not be one of the reliable major league UK operators ?

That is how major league insurers behave now...

There was a long thread on MSE (later removed after threats of legal action) about one of the largest players in the UK market. Allegations were made by the 'Times' newspaper and echoed by many victims.

Thankfully, the insurer in question went out of business during the pandemic.

No travel insurer has failed that I am aware of, let alone a major one. 

You have the likes of Atlas that did fail in 2021 but they were just an intermediary not the actual insurer

I was thinking of TIF.

This link is to a seven-year-old news story about them:
https://www.bbc.com/news/business-46274918

Contessa

I read the FB post just this morning and found it was quite worrying. However, it was a timely reminder to check I have my insurance details with me when away from the ship.

DullGreyGuy

Voyager2002 said:

DullGreyGuy said:

Voyager2002 said:

NoodleDoodleMan said:

DullGreyGuy said:

NoodleDoodleMan said:

katejo said:

NoodleDoodleMan said:

Is it not standard practice for the hospital to contact the insurance company to confirm the patient is covered for medical treatment charges ?

That's what the solo traveller expected but the hospital refused to do so. 

I was just curious to understand why this particular hospital was being so difficult.

Since this is a second hand story there may be more to it than we are being told ?

Also a secondhand story but in the case of a relative the hospital said they had bad experiences of the insurer in question not paying or paying only after excessive delays and as such they won't extend credit to them/give them payment terms and so either the insurer or the insured must pay up front if they want treatment at their facility.

That sounds as if it could be a likely scenario in this case.

Without knowing specific details it's conjecture to assume the hospital is completely in the wrong.

The insurer may not be one of the reliable major league UK operators ?

That is how major league insurers behave now...

There was a long thread on MSE (later removed after threats of legal action) about one of the largest players in the UK market. Allegations were made by the 'Times' newspaper and echoed by many victims.

Thankfully, the insurer in question went out of business during the pandemic.

No travel insurer has failed that I am aware of, let alone a major one. 

You have the likes of Atlas that did fail in 2021 but they were just an intermediary not the actual insurer

I was thinking of TIF.

This link is to a seven-year-old news story about them:
https://www.bbc.com/news/business-46274918

TIF again were an intermediary not an insurer and they didnt technically fail but were barred from conducting regulated activities  without explicit consent from the FCA other than for some historic policies, and oddly doublely barred from operating with a two insurers.

They have remained solvent, with parental support, and indeed have relaunched as https://www.suretravel.co.uk/ with a view of returning to profitability again this year. 

silvercar

When I had a claim, that the insurer had supposedly dealt with, the hospital kept sending me invoices. When I queried this with the insurer, they kept reassuring me that I was covered, that they were paying. Turned out it was in the hands of the insurance negotiators in the country where the hospital was. These negotiators aim to reduce the amount the hospital will accept in payment of their invoices! The actual amount they paid (as one statement was mistakenly sent to me) turned out to be only 55% of the invoiced amount. Apparently it is a standard procedure to do this and the negotiations often go on for as long as the hospital hold out from issuing procedures against the patient. 

So it is not surprising that in some cases payment is required up front - it is the only way that they can guarantee getting all their money.

DullGreyGuy

silvercar said:

When I had a claim, that the insurer had supposedly dealt with, the hospital kept sending me invoices. When I queried this with the insurer, they kept reassuring me that I was covered, that they were paying. Turned out it was in the hands of the insurance negotiators in the country where the hospital was. These negotiators aim to reduce the amount the hospital will accept in payment of their invoices! The actual amount they paid (as one statement was mistakenly sent to me) turned out to be only 55% of the invoiced amount. Apparently it is a standard procedure to do this and the negotiations often go on for as long as the hospital hold out from issuing procedures against the patient. 

So it is not surprising that in some cases payment is required up front - it is the only way that they can guarantee getting all their money.

Some places dont have fixed prices but charge as much as they think you can pay. Insurers want to pay the appropriate local price, not the gringo price. 

Hip replacement in a private clinic in the UK is circa £15,000, in the US its highly variable but averages around us$40,000. A relative had an accident whilst traveling in latin America, a hip replacement had been on the cards at some point in the future but after a fall needing doing there and then. The clinic tried to charge us$75k. Do you think they charge locals 2x what the US charges? 

silvercar

DullGreyGuy said:

silvercar said:

When I had a claim, that the insurer had supposedly dealt with, the hospital kept sending me invoices. When I queried this with the insurer, they kept reassuring me that I was covered, that they were paying. Turned out it was in the hands of the insurance negotiators in the country where the hospital was. These negotiators aim to reduce the amount the hospital will accept in payment of their invoices! The actual amount they paid (as one statement was mistakenly sent to me) turned out to be only 55% of the invoiced amount. Apparently it is a standard procedure to do this and the negotiations often go on for as long as the hospital hold out from issuing procedures against the patient. 

So it is not surprising that in some cases payment is required up front - it is the only way that they can guarantee getting all their money.

Some places dont have fixed prices but charge as much as they think you can pay. Insurers want to pay the appropriate local price, not the gringo price. 

Hip replacement in a private clinic in the UK is circa £15,000, in the US its highly variable but averages around us$40,000. A relative had an accident whilst traveling in latin America, a hip replacement had been on the cards at some point in the future but after a fall needing doing there and then. The clinic tried to charge us$75k. Do you think they charge locals 2x what the US charges? 

In my case it was a fixed price A&E visit that included any consultation, x-rays, meds and equipment. I actually needed 2 x-rays, crutches an injection and some meds. Total cost was the fixed price of about £1,200. This was in Canada in 2023, had I been over the border and in the USA you could add two zeros to those figures. So totally reasonable. The insurers ended up paying around £800.