| Non-motoring > Travel Insurance claim query | Tax / Insurance / Warranties |
| Thread Author: BobbyG | Replies: 11 |
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New Wed 4 Jun 14 09:47
Travel Insurance claim query - BobbyG
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Long story that I will try and cut short. Dad (81) was on holiday in Bulgaria last September when took not well. Went to see the doctor at the local Thomsons rep place who advised that he would need to go into hospital. Ambulance was to be paid up front which he did. Spent a night in the hospital after "being told" that the ins co had cleared it. Got discharged the next day (although his paperwork was dated for the following day), came home at end of his holiday. Subsequently ended up in hospital back here with pneumonia and was lucky to pull through. Which was a total different diagnosis of the gastro enteritis that they had came up with! Yesterday he received a letter from the Bulgarian hospital saying his ins company had refused to pay as they only pay for state hospitals as opposed to private which this was. My dad had no idea at the time what kind of hospital it was and really wasn't in a fit state to care too much! So the hospital are looking for 1100 Euros from my dad for the stay and have itemized everything including ECGs etc. Interestingly they have charged him for a second overnight which of course is what it stated on the paperwork...... My dad has had no correspondence with the ins company. Now my dad has a whole load of info he needs to find out here and look into the exclusions and rules etc but my initial thoughts are what sort of legal claim does that Bulgarian hospital have to chase a UK resident for money? If my dad just refuses to pay what would be the process involved that the hospital would follow to get this money? Unfortunately as dad has basically seen death and pulled through, he is now very much of the opinion of not going to waste time fighting things like this but I would like to make sure that he is also not being screwed over! A few months ago I saw a TV program about this sort of thing in Bulgaria whereby the ambulances all park up outside the tourist areas to be first on the scene, even just casually driving past to pick up business and get referral fees from hospitals. So if he refuses to pay what would happen next? |
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New Wed 4 Jun 14 09:55
Travel Insurance claim query - CGNorwich
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All sounds very odd to me. First thing I would do would be contact the insurance company to corroborate the story. Why would the insurer not pay for a private hospital after initially saying they would? |
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New Wed 4 Jun 14 10:01
Travel Insurance claim query - Duncan
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Presumably, insurance companies have a set procedure which must be followed in order to ensure that any claim is valid and will be paid out. Was that procedure followed? |
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New Wed 4 Jun 14 10:02
Travel Insurance claim query - Gromit
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Bobby, sounds like you and/or your Dad need to talk to your insurer, Thompsons (as they called the ambulance that brought him to this hospital) and possibly CAB/your solicitor/the police depending on what satisfaction you get at each stage in the process. Any way you look at it, he shouldn't be the one to pay: If the insurer has already paid up, this is a scam If they haven't because its a private hospital, Thompson's rep should be aware of the issue (that's why you book package holidays with reps that have local knowledge, after all) If the ambulance company 'diverted' him to a private hospital, that's dodgy too. |
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New Wed 4 Jun 14 14:09
Travel Insurance claim query - Meldrew
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| Bulgaria in is the EU so an EHIC card would have provided/paid for some service but not at a private hospital, obviously |
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New Wed 4 Jun 14 15:36
Travel Insurance claim query - No FM2R
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>>So if he refuses to pay what would happen next? The difficulty is that there may a difference between what could happen next and what will happen next. They can certainly pursue you for it if they wish; the question is whether or not they would. Motor Insurers have got a lot smarter about recovering money across the EU, so everybody else might have as well. Who told your Father that the insurance company had cleared it? Ignoring this could/would be bad. Was it me, I would reply thanking the Bulgarian Hospital for their letter. I would ask if this was the same address that should be used for a counter-claim. Explain that they mistreated / mis-diagnosed him and that their explanation of gastroenteritis was so wrong that he ended up in hospital on his emergency return to the UK with pneumonia. Explain that the opinion in the UK is that their mis-diagnosis exacerbated his condition and endangered his life. Point out also that their records are as good as their health care since he was in their hospital only one night. Then dump the initiative on them. Ask for a reply by return with an amended/corrected invoice and state that you will then hold this invoice pending any legal action over the standard of their health care. Then state something like you look forward to receiving their comments before deciding how exactly to proceed. He can then sit on his hands until they reply, which I would suspect is unlikely. In the meantime I would also communicate with the insurance company to ascertain exactly what, if any, correspondence has occurred. It is unlikely that they have refused to pay on the basis of private/public hospital, they would need more information than that, and that could only come from your Father. It is possible that they refused to deal with it without a formal claim from your Father though. |
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New Wed 4 Jun 14 19:08
Travel Insurance claim query - mikeyb
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All sounds a bit suspect to me. I would have expected them to have established how they were going to be paid early on. I wonder if this is a common scam where the insurance pay up and they chance getting the money a second time |
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New Thu 5 Jun 14 14:29
Travel Insurance claim query - BobbyG
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Slowly trying to get more information out my dad - when he was taken to hospital his partner phoned the ins company and they said they didn't cover private hospitals. She said but this is where he was brought and he is really unwell and ins co said that they would deal with it. Of course, no names, no record of the conversation. The hospital have included in the correspondence a copy of a letter from his ins co saying that they are not covering it which I didn't realize. So on the face of it, it would appear that he has hung himself out to dry but of course, when you are that unwell you assume these things will be sorted later. In his favour is there does not actually appear to be a state hospital anywhere near this (or so I am told). He is still chewing over what to do, worse case scenario I like Mark's approach of hitting back with false paperwork and mis diagnosis. |
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New Thu 5 Jun 14 14:58
Travel Insurance claim query - Gromit
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Try to establish when that call to the insurance company was made - the outgoing call log on your Dad's partner's phone should give you a date and time at least. We're forever told insurance companies and the like 'may record calls for training and verification purposes' which may help in tracking down a record of the call. Also double check exactly what the policy says it will/will not cover and what steps a claimant is supposed to make to get prior approval for claims. If, for example, the policy says 'you must get our approval on our helpline number' you have grounds to argue on. If it says 'this policy covers public hospitals only' then I fear you're out of luck. Don't get your arguments mixed up though. For now, your debate is with the insurance company. The insured party were told the company would pay for the hospital your Dad was admitted to (I assume this is what you mean by "ins co said that they would deal with it"). If they're paying up, how long the stay was or what care was provided are issues for the insurance company to deal with, not you. If your Dad ends up paying, how long the stay was and how good the care was are also two separate issues. If you intend to refuse to pay the bill on both grounds, set out both arguments - seperately - from the start. Adding 'and another thing' later on weakens your case because you appear to be getting into the territory of looking for any excuse not to pay. Before you get that far, I'd be inclined to contact the tour operator at home (or ABTA if you get no satifaction). Its not unreasonable to argue that a local rep should have been aware of the difference between private and public hospitals, and whether you'd be insured to attend the latter. Also, who sold the policy? If it didn't cover private hospitals or ambulances, but there really wasn't a public alternative where your Dad stayed, then it wasn't an appropriate policy for him - if the same travel company who sold the holiday sold the policy, you could argue they should know that too. |
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New Thu 5 Jun 14 18:14
Travel Insurance claim query - CGNorwich
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All sound advice Gromit. Who is this insurance company that doesn't cover private medical care? Seems a fairly useless sort of policy especially when travelling in areas where public health facilities are somewhat lacking |
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New Thu 5 Jun 14 18:28
Travel Insurance claim query - Meldrew
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| Who organised your grand father's holiday. Was it a package holiday and the did the agent that sold it include the travel insurance policy? If it was part of the "Package" they may have mis-sold the policy in that it did not cover the traveler's needs on the basis of the cover offered |
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New Thu 5 Jun 14 20:54
Travel Insurance claim query - Bromptonaut
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>> Who organised your grand father's holiday. Was it a package holiday and the did the >> agent that sold it include the travel insurance policy? If it was part of the >> "Package" they may have mis-sold the policy in that it did not cover the traveler's >> needs on the basis of the cover offered That is an excellent point. Very easy for a travel company to offer a policy that only covers 'public' hospitals as standard product with no regard to national differences, availability of public facilities at given location or needs of particular client groups. |
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