Seriously Ill Pensioner Trapped In Mexico….

[naomi24]

…..after insurers refuse to pay £40k medical bill

A man who fell critically-ill on holiday is trapped in a Mexican hospital after his insurers refused to settle a £40,000 bill. The company, Axa, refuse to pay up because he failed to disclose his high blood pressure when he took out the policy. The company is perfectly within its rights to refuse payment, but the family are living a nightmare need help urgently. Should the government fund his medical expenses and his return to the UK - or a charity perhaps? Somehow he has to be brought home.

http://www.express.co.uk/news/world/672328/pensioner-trapped-mexico-insurers-refuse-pay-40k-bill

[EDDIE51]

The story actually says he would have been refused the standard insurance if he had disclosed the extent of his problems and told he had to get a specialist policy. As I said, he must have had far more problems than just high blood pressure. Yet again a newspaper being 'selective' with the facts!

[naomi24]

Eddie, The newspaper has quoted the insurance company. It hasn’t been selective with the facts.

[EDDIE51]

The 'header' of the story just says 'because he did not disclose his high blood pressure' then further down it says that if he had disclosed the full extent of his full medical problems he would not have been offered the insurance.
The 'header' ,which is all most people read, is inaccurate, it should say something like
''Sick Pensioner Trapped,Mexico, for not disclosing medical history''
But that would not have evoked the reaction the Express was seeking.

[naomi24]

Well, they know he has high blood pressure. Maybe they're not aware of the details of his full medical history.

[EDDIE51]

As soon as a claim that could be an expensive one like this is made the insurance company immediately investigate your medical history.
You give them permission to do this in the small print of the insurance policy that you have to sign. Every Insurance company has teams of people who's sole job is to find ways of getting out of paying claims, they call them 'Claim management' or some similar name, but their only function is to find ways out of paying. It is the same with house hold and car insurance they will look for a way to avoid paying.

[Smowball]

I actually have a few medical conditions, none of which I would call serious - IBS, severe acid reflux, under active thyroid etc.... I don't normally list any of them but yr before last my IBS played up quite bad on holiday and I had to seek medical attention. So last yr when buying policy online I listed EVERYTHING - which I then had to double check and confirm before paying - price didn't go up by much more than a tenner. I would always always list everything now- better to be safe than sorry.

[EDDIE51]

^^ That's the only safe thing to do. They have a limit of a few £100 on claims that they will pay without investigation, but as soon as a claim with potential for a large payout is made they check your medical history to find a way out of paying if possible.

[Smowball]

Exactly Eddie. It's just not worth the risk

[Maydup]

I feel sorry for the family. They have the responsibility and are indeed living a nightmare through no fault of their own. They didn't withold information on the form, the patient did. But sadly it happens all the time.

I know of someone who went to the other side of the world with no insurance at all and needed serious medical treatment. He couldn't afford to pay and the family had the same awful worry. There wasn't a happy ending.

So I don't think the government should pay as this happens every week; this one is not an isolated case. There are unlikely to be too many charities raising money to bring sick uninsured people home, but maybe the Red Cross could support the family in some way? And the local Citizans Advice Bureau can help them to sell the person's assets and raise what they can to pay for the flight?

No easy answer.

[Peter Pedant]

yeah I agree if you do disclose - then you wont get cover for that condition.
good argument for going on line ( getting it ) when young and healthy

I have been uninsurable for coming up to twenty years
and I just go on holiday to be honest ....

[naomi24]

Eddie, //As soon as a claim that could be an expensive one like this is made the insurance company immediately investigate your medical history. //

That's true - but why would you expect the insurance company to divulge details of his medical history to anyone else? I don't understand your criticism of the newspaper report.

[Peter Pedant]

// but as soon as a claim with potential for a large payout is made they check your medical history to find a way out of paying if possible.//

to be further honest Ed

I insured my income ( in other circs ) against cancer and when i sent in my doctors note, they said they would pay within five days
( I did write and say that was completely unexpected and I anticipated squirming and squawking and I think they wrote back saying no we dont to that ....) Lead in time was five years tho. Axa again

[EDDIE51]

Naomi, I'm not criticizing the newspaper report, it simply says >
''had he disclosed the full extent of his medical problems we would not have offered him insurance''
That is not divulging any details, just explaining why the claim was void.

[THEMOTLEY1]

What they are quoted as saying is actually

///Had Mr Read told his tour operator of the extent of these existing conditions at the time of booking he would not have been provided standard travel insurance cover and would have been directed to a specialist.///

[sp1814]

This is an utterly horrible situation for the family involved to be faced with.

But it is utterly avoidable.

When you take out travel insurance, you need to disclose any previous medical issues.

If you don't, and you need to make a claim, you may be in trouble.

It's not down to the insurance company or the government to bail people out. What needs to be done now, is that the family needs to get a remortgage on the uninsured chap's house.

It's horrible, but that's the only way out.

[Bazile]

Given that these insurers actively employ people to comb through claims , in order to come up with a reason not to pay - i think to be sure what you could should do ( especially people with extensive medical history ) is give them access to your medical records , when you apply .

Then again perhaps not

[EDDIE51]

Bazile, as I said earlier in this thread, when you sign a medical insurance policy there is a clause in the small print that says you give them permission to access your medical records. So you don't 'have' to do it they already can. (and will if you make an expensive claim)

[naomi24]

Eddie, //I'm not criticizing the newspaper report//

We know why the claim was refused but you most definitely criticised the newspaper report.

//Yet again a newspaper being 'selective' with the facts! //

Perhaps you hadn't thought it through.

[Bazile]

what i'm saying Eddie , is say to the insurer , here is my medical file - look through it and tell me if you can insure me