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

[SkyFax]

 

16 minutes ago, Sheryl said:

Because not relevant to the point being made in that post, whioch was repsonding to inaccurate statements by other posters of what a "pre-existing condition" is.

 

Yes, the condition did not have to be diagnosed, but under the policy terms it would have to have caused him to seek medical care or take medication within 120 days prior to policy issuance.

 

The insurance company would have to establish that the mild headache he had at the time he had the flu was not in fact due to the flu but due to the brain tumor which he also had, unknown to anyone. They cannot possibly prove that, and it is in fact unlikely given how common mild headache is with the flu and that headache from a brain tumor would usually not go away but rather persist and worsen steadily.

I see not relevant. I am glad this has all worked out for the young couple but, in my reading, at least on health insurance policies, it often defines pre-existing conditions as (per Kaiser Health)

 

" ...a pre-existing condition could also include one that had not been diagnosed but that produced signs or symptoms that would prompt an “ordinarily prudent person” to seek medical advice, diagnosis or treatment."

 

Since, info from the wife in the OP, this gent has had more that one severe headache, it does not seem 'prudent' that he has never before had this checked out the recent flu episode aside.

 

[Rod the Sod]

19 minutes ago, heybuz said:

If they are not trying to hide something why not make it large print and in a simple language that people of all educational levels can understand.

If there are 32 pages of small print there will be 132 pages of big print. Either way, the task in reading it is just the same. 

 

I don't think it is a case of trying to hide. It is a case of clarifying what the headline comment means. I am a victim too. I have top level Chubb travel policy and recently got pick-pocketed in Madrid. Turns out I was not covered because I was not physically attacked or threatened. My fault - should have read the small print!!

 

I think it is a case of Buyer-beware and really don't just settle for a comment like "covered in the case of theft" because what it means is "covered in the case of theft in some circumstances". In my case I was stupid not to check this out at the time of buying, even more stupid not to check it out before taking time to make a claim but wiser in the end as Chubb will never again see any of my cash!

 

Just saying...stop blaming the insurance companies everyone and take some personal responsibility....we seem to live in a "blame everyone else but me" society nowadays.

[Curt1591]

Insurance companies are in business for one purpose - to make money. 

"Obamacare" was simply another means subsidize insurance companies, who, in turn, still increased the premiums.

 

[Fairynuff]

I rest my case. I have always maintained that insurance companies are in the business of taking your money and doing their absolute best to never give you any of it back.

[KKr]

Sounds like he had a headache before travelling that was misdiagnosed as due to flu.

So the patient did not know about cancer, hence allianz should pay out and seek regres on the misdiagnosing physician.

[KKr]

On 12/10/2019 at 9:35 AM, robblok said:

everyone has a car insurance and you don't hear people complain about that. 

Let's move this suggestion to the car forum after notifying Guinness book of records.

[Fairynuff]

On 12/10/2019 at 7:59 AM, gk10002000 said:

The article topic is dead wrong.  He was reporting a headache a month ago, but it was most likely NOT due to having the flu.  He had brain cancer and the flu may just have made things more sensitive.  having said that, this just point out the junk insurance policies that may be coming from the Thai immigration directives.

By that logic many of us are living with pre existing conditions we don’t know about and therefore can expect to have claims denied. 

[Sheryl]

39 minutes ago, KKr said:

Sounds like he had a headache before travelling that was misdiagnosed as due to flu.

So the patient did not know about cancer, hence allianz should pay out and seek regres on the misdiagnosing physician.

 

he had a "mild headache" along with flulike symptoms a month before traveling which  apparently resolved.

 

No evidence it was not in fact flu as diagnosed.  People with unknown brain tumors can get the flu just like anyone else.

 

[wcoast]

Every insurance company operates the same way, upon filing of a claim, any claim, the company rep will immediately deny the claim. Most people walk away at that point.

[richard_smith237]

2 minutes ago, wcoast said:

Every insurance company operates the same way, upon filing of a claim, any claim, the company rep will immediately deny the claim. Most people walk away at that point.

 

Insurance companies can be tricky, but, I've never had a Claim rejected for my Wife, Son or I.

 

That said - the decent insurance companies here use 'direct settlement' so that you are not out of pocket and then re-claiming. 

 

---------

 

My Insurance company (through work) will not commit in writing with sufficient clarity that I am fully covered for Skiing. The Policy wording is too vague and open to interpretation and a 'get out' should I become injured while skiing. Thus, I have had to take out additional 'Travel Insurance' (which covers skiing) 

 

My Wife and Sons insurance company have committed in writing that my Wife and Son are covered for Skiing, thus, I have written confirmation which has removed uncertainty from the sometimes deliberately vague policy wording. 

 

 

Health / Medical / Travel insurance policies in particular can be and generally are extremely tricky with their wording leaving a lot open to interpretation. 

[nrasmussen]

5 hours ago, Sheryl said:

 

he had a "mild headache" along with flulike symptoms a month before traveling which  apparently resolved.

 

No evidence it was not in fact flu as diagnosed.  People with unknown brain tumors can get the flu just like anyone else.

 

Why would an otherwise healthy young man go to the ER with a mild headache and flu-like symptoms? It doesn't make any sense.

 

Isn't it more likely that he had a sudden severe headache and went to the ER, where he was misdiagnosed with flu? At least that might have been the thinking of the insurance company and why they initially declined to cover the claim.

[Sheryl]

2 hours ago, wcoast said:

Every insurance company operates the same way, upon filing of a claim, any claim, the company rep will immediately deny the claim. Most people walk away at that point.

 

Absolute nonsense.

 

The entire US health care system is built on insurance (as are some European countries). It certainly has its flaws (costs of the middlemen for one thing) but obviously all claims are not immediately denied all the time. Majority of claims go through without a hitch and those that do hit snags more often than not get resolved between the doctor/hospital and the insurer without the insured person even being involved.

 

I've had health insurance my entire life including more than 20 years in Thailand.  Never experienced what you described, not once.

 

And while I have run into cases experienced by other people it does not remotely approach the majority of claims let alone "all claims, all the time" as you assert. Insurance companies would be out of business in  a flash if that were the case.

 

Overall, talking about health  insurance in general worldwide, most claims are processed and paid without a hitch. Obviously choice of insurer makes a big difference, as does carefully reading the policy document.

 

In Thailand getting the doctor or hospital to correctly and clearly fill out the paperwork is also sometimes an issue.

 

 

 

 

[Sheryl]

26 minutes ago, nrasmussen said:

Why would an otherwise healthy young man go to the ER with a mild headache and flu-like symptoms? It doesn't make any sense.

 

Isn't it more likely that he had a sudden severe headache and went to the ER, where he was misdiagnosed with flu? At least that might have been the thinking of the insurance company and why they initially declined to cover the claim.

 

It is described in the article as a mild headache, one that presumably then went away which is not what would be expected if due to the tumor.

 

People go to the ER for far more mild things than the flu, all the time, all over the world, Canada included.

 

In addition I very much doubt a Canadian doctor would have failed to do at least a basic neuro work up if it had been a severe headache.

 

I think it was simply over-reach by an over zealous loss adjustor who  was just clutching at straws. They have already reversed their decision:

 

"on Tuesday morning, Allianz told CBC News it would now cover the cost of bringing Alex back to Canada.

 

"There is full coverage for Mr. Witmer and his wife's return home, including by air ambulance,"  said Dan Keon, vice president of market management for Allianz Global Assistance in a written statement to CBC News.  "We are working with Mr. Witmer's treating physicians in Thailand to bring him and his wife home to Canada as quickly and safely as possible" 

https://www.cbc.ca/news/canada/kitchener-waterloo/kitchener-thailand-witmer-alex-jennifer-1.5390562

 

I don't think they reversed on a >$200,000 expenditure solely because of the publicity. It was because it was a wrong call that would not have stood up on appeal.  Whoever signed off on the original denial should be sanctioned by the company.

[GroveHillWanderer]

On 12/10/2019 at 9:48 AM, robblok said:

Thing is Sheryl, we are taking the word of one side for it. But sure if it is the way you think it is then this company is fully liable. 

Whose word do you think, "we are taking"? If you're trying to say we only have his (or his girlfriend's) word for it, that's not true.

 

As the linked Toronto CTV News article says, it was the insurance company who stated that:

 

Quote

they received his medical records and it showed he checked into an emergency room in Moncton a month ago and had symptoms of the flu [with] a mild headache ...

 

[GroveHillWanderer]

1 hour ago, nrasmussen said:

Why would an otherwise healthy young man go to the ER with a mild headache and flu-like symptoms? It doesn't make any sense.

Lots and lots of people go to the hospital with flu symptoms. My wife did exactly that when we came back from a trip and she had flu symptoms (including a headache). Now speaking personally, I probably wouldn't have gone to the hospital with the symptoms she had but she wanted to go, so she did.

[alfalfa19]

On 12/9/2019 at 5:42 PM, The Farang said:

True.  Most insurance only cover emergencies and this is clearly a preexisting condition.   Sucks but true.

Best bet is to get insurance from your own country that has International coverage.  Cigna and Aetna are good in Thailand. 

i've had cigna here in the states.  they are scumbags. 

[brianthainess]

On 12/10/2019 at 9:26 AM, ThaiBunny said:

An American acquaintance of mine knew he had terminal cancer with only a few weeks to live and insisted on flying from the West Coast in order to make a farewell tour. He was taken around in a wheelchair, forever <deleted>ting himself. It was an embarrassment to all he encountered but he didn't care

Adult diapers may have helped.

[impulse]

On 12/11/2019 at 3:15 AM, nrasmussen said:

Why would an otherwise healthy young man go to the ER with a mild headache and flu-like symptoms? It doesn't make any sense.

 

Isn't it more likely that he had a sudden severe headache and went to the ER, where he was misdiagnosed with flu? At least that might have been the thinking of the insurance company and why they initially declined to cover the claim.

 

One of the things that surprised me about health care in China and Thailand is that the first place you go for treatment is the hospital.  In the USA, you'd go to your GP's office first unless it's an emergency.  In Thailand and China, you'd be hard pressed to even find a GP's office independent of a hospital.

 

So when I tell the folks back home I "went to the hospital", it throws up all kinds of alarms.  I learned to tell them "I went to see the doctor".

 

So I don't assign a lot of significance to a young fellow "visiting the ER..."  

 

[SkyFax]

7 hours ago, impulse said:

 

One of the things that surprised me about health care in China and Thailand is that the first place you go for treatment is the hospital.  In the USA, you'd go to your GP's office first unless it's an emergency.  In Thailand and China, you'd be hard pressed to even find a GP's office independent of a hospital.

 

So when I tell the folks back home I "went to the hospital", it throws up all kinds of alarms.  I learned to tell them "I went to see the doctor".

 

So I don't assign a lot of significance to a young fellow "visiting the ER..."  

 

Before traveling to Thailand, he visited the ER in Canada:

 

The claim was rejected after just a few days, said Jennifer, then put under review.

The insurance company said since Alex had gone to the hospital in Moncton, N.B. the month before, complaining about a headache, it counted as a pre-existing condition.  

But his wife says she took him into the emergency room because the couple thought he had the flu. 

"I drove him there because I thought he was getting dehydrated. He was vomiting at that time. But because he reported headaches, they flagged it as a pre-existing condition," said Witmer.

https://www.cbc.ca/news/canada/kitchener-waterloo/kitchener-thailand-witmer-alex-jennifer-1.5390562

[yogavnture]

On 12/9/2019 at 7:47 PM, 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.

insurance in general is  a scam . 

[SkyFax]

44 minutes ago, yogavnture said:

insurance in general is  a scam . 

So about $265K for the air ambulance plus the medical fees on Koh Samui plus the cost (if not otherwise covered) for the surgery back in Canada or to wherever you were repatriated.

 

Nice self-insure fund for one to be able cover all that.

[GroveHillWanderer]

1 hour ago, SkyFax said:

So about $265K for the air ambulance plus the medical fees on Koh Samui plus the cost (if not otherwise covered) for the surgery back in Canada or to wherever you were repatriated.

 

Nice self-insure fund for one to be able cover all that.

I have to say, even though it's a longer distance I'm surprised by the quoted $265,000 for a medevac. Earlier this year, friends of ours had their son medevacked to the UK. It cost them £25,000. I'm not sure why it would cost nearly six times as much to Canada.

[SkyFax]

33 minutes ago, GroveHillWanderer said:

I have to say, even though it's a longer distance I'm surprised by the quoted $265,000 for a medevac. Earlier this year, friends of ours had their son medevacked to the UK. It cost them £25,000. I'm not sure why it would cost nearly six times as much to Canada.

Well that might be more due to the nature of the medical personnel and equipment required for the time enroute for this type of medical emergency rather than the distance.

 

However that £25K fee plus all the other associated medical costs in Thailand and maybe in UK should pose no problem for your average self-insured expat here in Thailand?

[GroveHillWanderer]

25 minutes ago, SkyFax said:

Well that might be more due to the nature of the medical personnel and equipment required for the time enroute for this type of medical emergency rather than the distance.

 

Their son was in a coma with severe brain swelling and needed two medical staff to accompany him. He was basically on full life support. Based on the description of this Canadian guy's symptoms, I'd say the Canadian's condition is if anything, slightly less serious.

[SkyFax]

4 minutes ago, GroveHillWanderer said:

Their son was in a coma with severe brain swelling and needed two medical staff to accompany him. He was basically on full life support. Based on the description of this Canadian guy's symptoms, I'd say the Canadian's condition is if anything, slightly less serious.

$265,000 is what was quoted as the cost by the insurer in the article. Maybe it's just as the gent above said: Insurance in general is a scam.

[Sheryl]

On 12/12/2019 at 10:39 AM, alfalfa19 said:

i've had cigna here in the states.  they are scumbags. 

 

Big difference between Cigna US and Cigna Global. Not at all similiar.

[Sheryl]

1 hour ago, GroveHillWanderer said:

I have to say, even though it's a longer distance I'm surprised by the quoted $265,000 for a medevac. Earlier this year, friends of ours had their son medevacked to the UK. It cost them £25,000. I'm not sure why it would cost nearly six times as much to Canada.

 

This quote was for air ambulance: a dedicated plane just to transport him alone.

 

At £25,000  your friends son did not go by air ambulance. Must have been commercial aircraft with some seats taken out for the stretcher.

 

The insurance company has since agreed to pay for the med-evac and it is still bu air ambulance not commercial flight. I doubt they would authorize air ambulance if not really needed.

 

Flying to North  America there are issues with altitude flown esp if over the pole route is used which is always the quickest. A non-polar route takes significantly longer and that in itself would be dangerous.

 

 

[SkyFax]

Canadian man diagnosed with brain tumour in Thailand hours away from beginning long journey home

 

TORONTO -- Published Friday, December 13, 2019 1:02PM EST -- A Canadian man diagnosed with a brain tumour in Thailand is hours away from beginning the long and difficult journey back home so he can undergo surgery and further treatment for cancer.

...

The couple is expected to leave Koh Samui around 9 p.m. on Friday. They are scheduled to land in Ottawa on Saturday evening and be taken to a hospital, where a doctor has agreed to do the surgery. Jennifer said they are required to make at least three stops along the way for fuel and crew changes. 

https://toronto.ctvnews.ca/canadian-man-diagnosed-with-brain-tumour-in-thailand-hours-away-from-beginning-long-journey-home-1.4729188

[SkyFax]

Photo added as of about 9am Saturday Thai time:

[shy coconut]

On 12/10/2019 at 3:17 AM, zydeco said:

Insurance companies are a middleman who drive up costs for people who would ordinarily pay for medical care out of their own pocket. You don't just pay for your medical risk with an insurance company, you pay for that company's employees, its infrastructure, offices, equipment, advertising, etc. All entirely superfluous to medical costs.

Is travel insurance a legal requirement or just advisable?

If the latter, why are you getting so wound up about it? Just shell out

for any treatment required and don't insure.