Canadian diagnosed with brain tumour in Thailand has travel insurance declined because he had the flu a month ago

[Moonfire]

Under their picture I see this text:

 

Alex Witmer is fighting to get home after his travel insurance was declined 

 

Is the claim the insurance company will NOT medically transport him back home? It's about 20 hour flight where health care is free for the most part. They should be prepared to pay their own way home from Thailand anyway.

 

I hope the insurance company and the Thai government looks into his claim, seeing their is a Go Fund Me page. 

[new2here]

6 hours ago, ezzra said:

i'm not a big fan of insurance companies ways of doing business but there's some information missing from the OP...With all due sympathy here, not sure whether the insurance company should be liable for what is undoubtedly a pre existing condition, surely this massive tumor hasn't come about when he was traveling right?...

It’s always going to be a politically unpopular viewpoint, but I agree... SO LONG AS the facts support that it WAS in fact a pre-existing, then I think they were both right and correct to deny claim... but I do think that the insurer has the burden to be able to reasonably prove this fact.... 

 

so for me, before I vilify the insurer, I’d want to have more facts... It really could go both ways.

[Odysseus123]

19 minutes ago, zydeco said:

Hopeless. ^^^

Indeed....

[Just Weird]

5 hours ago, zydeco said:

All insurance is a scam. All of it. It's there for the companies to make a profit. They only make a profit if you pay more in than they pay out.

Obviously!  Can you point to any business that does not have that strategy?  If that wasn't the point of the existence of insurers they'd be registered as charities!

[Just Weird]

4 hours ago, SteveK said:

No, they are out to make money for themselves and their shareholders. Take in more from premiums than you pay out, very simple.

Why else would a commercial business exist?  

[SymS]

So that means if you have travel medical insurance, and find out about a long term disease during your travel you are out of luck. But he surely could go back home, and get treatment there provided he's insured back home.

[Gudge]

47 minutes ago, kingstonkid said:

Not surprised I also have Allianz and know that it is a <deleted> shoot for reimbursement.

 

I truly feel sorry for them

I agree 100%. I had allianz for years and they turned out to be a complete <deleted> company. I had a problem in Thailand and was turned down for cover and had to pay bill myself. I visited a Dr in Canada about a month before going to Thailand on a completely unrelated thing and they turned me down saying I had a pre existing condition. Took months of fighting them when I returned but was eventually re imbursed. 

[Curmudgeon1]

5 hours ago, worgeordie said:

Never trust Lawyers,Banks or Insurance companies,I have

been screwed by all 3,they can get out of anything, using

the fine print.

regards worgeordie

As I lay here in a phrathai hospital bed, the cashier has been up twice looking for additional deposit to cover huge pharmaceutical bills.

Not only are the pricing ridiculous but they bill by the box and not what you use.... you have to pray that the nursing staff are trained to account for crediting,  which the paperwork indicates they have failed to do so. I could go on but please add thai hospitals to your list. Despicable to pray on the sick. 

[ThaiBunny]

Just now, Curmudgeon1 said:

Despicable to pray on the sick.

Only the religious hospitals surely?

[Just Weird]

4 hours ago, Sheryl said:

Obviously a brain cancer --  or any other cancer for that matter --  doesn't just occur all of a sudden and would have existed when he took out the policy,  but there is no evidence that he knew of it or could reasobably have been expected to know. The doctors who examined and treated him for flu didn't detect it,  so how would he have?

A lot depends on the answers he provided to the application's questionnaire about medical consultations before he bought the policy.  Maybe he didn't disclose everything that he should have, that would account for the insurer's decision.  And if that is the case he is not in any position to complain.

[Sheryl]

10 minutes ago, new2here said:

It’s always going to be a politically unpopular viewpoint, but I agree... SO LONG AS the facts support that it WAS in fact a pre-existing, then I think they were both right and correct to deny claim... but I do think that the insurer has the burden to be able to reasonably prove this fact.... 

 

so for me, before I vilify the insurer, I’d want to have more facts... It really could go both ways.

Of course it was pre-existing. It would have to be . So would  heart disease, kidney disease, any cancer and just about anything other than an accident ir infectious disease be.

 

But pre-existing is not the same as known to, or could reasonably be known to, exist.

 

It is  expected that  travel insurance eould pay for emergency care related to heart attacks if the insured was not previously known to have underlying heart disease. And they are expected  to pay for other chronic diseases that unexpectedly manifest for the first time  while someone is travelling.

 

The company was not claiming nonliability on the grounds that unknown to anyone the tumor was already there. They were trying to claim that an episode of the flu a month prior accompanied by a headache was actually a sign of the brain tumor. They cannot prove this and the examining doctor found at that time nothing to suggest it wasn't simple flu.

 

It does sometimes happen that people without insurance or access to free health care, knowing they need an expensive treatment, take out a travel policy and then arrange to "discover" the problem while abroad. ..ans insurance companies are alert to this. However, Canadians obviously have no reason to do this. And thete is no evidence that this man had any idea he had a brain tumor. Neither did the doctor who saw him a month before.

[Just Weird]

4 hours ago, kingdong said:

So why do so many insurance companies not investigate blatant fraud because it isn,t worth their while and easier to up the premium of the punter being conned as they still get their money?

Insurance companies certainly do investigate fraudulent claims, why on earth would you claim that they don't? 

[Just Weird]

4 hours ago, zydeco said:

The government doesn't require me to buy a T shirt or use an internet provider.

The government doesn't require anyone to have travel insurance either!

[zydeco]

What all this illustrates is that parasitic private for profit insurance companies should simply be banned and put out of business. Every country should have universal health coverage for its citizens. And when those citizens travel or reside outside their countries, they should simply pay an additional fee for coverage from their home country to be made available. An entire parasitic infrastructure operates sucking money out of sick and dying people just to line the pockets of CEOs and executives of these blood suckers.

[Sheryl]

7 minutes ago, SymS said:

So that means if you have travel medical insurance, and find out about a long term disease during your travel you are out of luck. But he surely could go back home, and get treatment there provided he's insured back home.

The problem is he cannot safely travel in normal fashion. If he could the issue would never have arisen.

 

You should be covered for immediate stabilization and if necessary for medical evacuation if a long term disease that you did not know of and there were no indications of, was newly detected while travelling. The burden is on the insurance company to prove that the condition was, or could reasonably have been, known. In this instance they tried to claim this on very flimsy grounds and reversed when the couple put up a publicized fight.

 

Some insurers will also pay for "acute exacerbations" of known pre-existing conditions if declated at time of application.

 

[Just Weird]

1 hour ago, richard_smith237 said:

They only 'folded' after the issue garnered media attention. 

They did not "fold"!  They are still investigating the claim, no decision has been made, but they agreed to repatriate him anyway pending a decision that could still go against him.

[Just Weird]

9 minutes ago, zydeco said:

What all this illustrates is that parasitic private for profit insurance companies should simply be banned and put out of business.

It doesn't illustrate anything of the sort.

[SteveK]

Surely he can still get on the plane with a brain tumour?

[Spock]

1 hour ago, Rama said:

Travel insurance is not general medical insurance. It on;y covers emergencies and accidents. It does not cover all medical conditions that you can travel back home for treatment, or that existed before travel. If the doctors told him he had a tumor a month ago instead of the flu, why hasn't he flown home already. He should read his policy.

Whatever drugs you're on seem to be doing their job well. Wouldn't mind some myself!

[ThaiBunny]

12 minutes ago, SteveK said:

Surely he can still get on the plane with a brain tumour?

If the airline even suspect he has a medical condition they'll demand a medical certificate that he's fit to fly

[Spock]

2 hours ago, Skallywag said:

Not sure how "minimal medical personnel or equipment can help with a brain tumor.  Though I admit Sheryl, your advice has always been the best, assume you were/are a doctor or medical practitioner. 

They did tell him at the hospital to fly home.  I would have gone straight to the airport, changed my return ticket and flown home.   

Insurance can be dealt with later.  

 

From the related news article: "The couple was then told the medication to reduce the pressure inside Alex’s head will only work for a few days and it would only be safe for him to fly home during that time." 

 

It does appear there was a window of opportunity for them to get out while the swelling was down. Unfortunately they believed the insurance company would pay for their treatment OS and delayed. I have my car and house insured with Allianz. I will be reading the find print in the policies before renewing them.

[Sergeant]

Here is a prim reason not to trust Thailand Insurance Company. First Immigration is a part of the profits and second is Health insurance have no morals while doing business in Thailand. If Immigration and Govt. wanted to help the tourist living and coming to Thailand, They would set up a fund to pay  hospital bills for all foreigners and Thais, Its just not impossible to trust what Immigration set up as they know nothing about Insurance.

I wish the best for the traveler

[cardinalblue]

Emergency evac insurance is for an event that happens while traveling....the whole issue is whether if he knew he had a tumor...

 

the insurance company must prove it...also what about his regular insurance? Should get home immediately to be covered at home?

 

worry about evac costs later...

[Nip]

6 hours ago, Peter Denis said:

I presume he bought the travel-insurance before travelling to Thailand.

If he was aware of his condition for sure he would never have made the trip.

It's scandalous that the insurance-company wants to cop out on this.

Imo when sueing them, a good lawyer would win the case anytime.

I agree entirely with you but if I read the story correctly could it be that the insurance company are questioning their story of selling up and and starting afresh knowing of the existence of the tumor? I don't wish this awful circumstance on friend or foe but .....

[peter14]

insurance company are scam....   and thailand wants  retire to have insurance to get visa..  what a stupid idea.  they old  they  are unlikely to gt insured !  think !!

[dotpoom]

7 hours ago, Denim said:

Scandalous.  One of the reasons I prefer to self finance rather than trust in the small print of an insurance policy.

 

For those who prefer to have insurance make sure you have enough cash or alternative method of payment in case your insurance won't cough up.

 

Otherwise ....... Go fund me will be your next stop.

Surely you mean to " not trust in the small print"...and with respect, I would think that the majority of people who take out this insurance, do so because they would "not"  have alternative funds to cover these tragedies were they so unfortunate to be afflicted by same? 

[Tropposurfer]

Guy has flu... headache and infected sinuses usual with flu, dr does not do any tests ... patient leaves doctors rooms believing he has a simple case of the flu... recovers from flu ... goes on holidays ... discovers he has a tumour... insurance refuses to pay for treatment and repatriation ... filthy scumbags !

[hotchilli]

7 hours ago, ezzra said:

not sure whether the insurance company should be liable for what is undoubtedly a pre existing condition, surely this massive tumor hasn't come about when he was traveling right?...

depends on whether the condition was known when he took out the insurance, it was obviously pre-existing but if he'd had no symptoms, had no tests then he didn't know either.

Insurance is being in-humane!

[Miss Pickle]

That is really terrible these insurance company’s are a disgrAce they will do anything to get out of paying .

[Ketyo]

I wonder if his insurance company is Cigna. They are the worst. Expensive, and decline almost 50% of claims. They have a small print policy of ways to decline claims that they will not make available to customers. So customers don't know if they will be covered until they claim. 

 

The best way is to assume the Insurance company won't pay. Buy a low price policy that covers major emergencies. (Many low cost companies pay out more often than high price companies like Cigna). And then self insure with enough cash to cover most things except for the extreme cases.