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Phuket hospital hits back over UK claims they put money first after tourist's motorbike accident

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I thought that travel insurance doesn't cover motorbikes anyway.

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2 hours ago, Mises said:

His mother needs to take this up with the insurance ombudsman and/or a solicitor (preferably no win no fee). I am not at all convinced riding pillion on a scooter with a broken arm is reckless. Furthermore it is almost certain that the broken arm did not in anyway contribute to the second accident and hence it is irrelevant to the claim.

The insurance contract was made in England and therefore subject to English law, I very much doubt that the insurance company's position will stand up in an English court.

 

It all comes down to one's own interpretation of reckless, but the final say is with the insurance company, not with the insured or with Thai Visa forum commentators. People doing dangerous things on holiday would be wise to consider the risks and outcome before doing something that might endanger their lives or cost them dear in hospital charges. Personally, I wouldn't have gotten on the back of another bike after sustaining such an injury in a previous accident, whilst having my arm still in plaster, because it'd be reckless of me to do so. Can't blame the insurance company here, as they'd already paid out a claim from this individual 3 weeks prior. He's clearly reckless when it comes to safeguarding his own well-being. Besides, having your arm still in plaster, your grip and balance would not be as good as a person with two arms in use. Therefore it is relevant to his claim.

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1 hour ago, Tony125 said:

http://www.thephuketnews.com/all-citizens-now-entitled-to-free-emergency-services-in-first-72hrs-61662.php#XjGw1q0WMWo56c27.97

Does NOT cover foreigners unless they are under SS or their wife's civil service policeis.  It states it covers ALL citizens of Thailand for free care for first 72 hours at ANY hospital . After that they have to be taken to the hospital they are covered at under their Gov Policy scheme. Foreigners not under their wife's Civil service policy or Social Security from working here are not covered.

Yes, that's what I said.

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21 minutes ago, Lone Ranger said:

Are you [email protected]% sure of that fact?

I thought I read  anyone- be it Thai or Farang -was eligible as long as it was an emergency?

Yes, anyone as long as he is Thai. So also farang Thai.

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22 minutes ago, Tchooptip said:

I have been on a motorbike everywhere almost every day for more than 40 years without any accident  incident and have intention of ever doing so.

No offence, just showing every one's story is different 

 

Great. I think you're completely mad, but so are people who climb mountains or pursue other dangerous activities. It's not a problem for me though, except in as much as I have to pay higher insurance premiums to cover the antics of the insane.

 

If one day you are unlucky enough to have a road accident you may regret being on a bike rather than in a two-ton pickup. But hopefully it wont happen at all. I certainly dont wish it on you.

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1 hour ago, dcsw53 said:

He paid his policy and the insurance company entered into an agreement to cover him. He then had an accident where he had to claim. After that accident the insurance company should have told him that any further claims would be refused. Whether they considered him reckless or not ( he was not driving just a passenger so this is higly debatable ) they still had a contract with him and as such should pay the claim.

Not if the insured is deemed to have breached the terms and conditions of the contract, which in this instance the company believes to be the case. Would it stand up in Court? I don't know and that's why I believe the insured should contact the ombudsman or a no win no fee lawyer if he was wearing a helmet.

7 minutes ago, soalbundy said:

I thought that travel insurance doesn't cover motorbikes anyway.

Some do, some don't. This one covers riding bikes up to 125cc as long as you wear a helmet.

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1 hour ago, colinneil said:

Thank you for posting that stevenl keeps arguing about that, will not admit to being wrong.

Again, you're confusing free emergency care in life threatening situations with standard cover under civil service or SS.

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10 minutes ago, soalbundy said:

I thought that travel insurance doesn't cover motorbikes anyway.

 

Many dont, quite rightly and for obvious reasons. They also generally exclude accidents occurring whilst the insured is under the influence of drink or drugs, or participating in any particularly dangerous activity. It all makes perfect sense to me.

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6 hours ago, darksidedog said:

So his travel insurance did cover traveling by motor bike, but only once a year it seems. To my mind riding pillion with a broken arm in plaster is not "reckless".

70% of the traffic accident victims leaving the hospital do so by bike. It is absolutely normal here. Many have no other way of getting home.

I hope the insurance companies miserable argument is seen for what it is, and others spend their money with a firm who can be trusted.

 

 

whilst riding a motorbike with a serious injury that incapacitates might not be the brightest idea, depending on the circumstances, it's not automatically reckless.

 

Had he crashed the bike or fallen off then fair enough. But he didn't. According to police he was on a bike that was rear ended.

 

It's time governments looked at the little get out clauses insurance companies insert and their interpretation and implementation by teams of people whose job it is to avoid paying.

 

Did this insurance company make their stance crystal clear when approving the initial claim - i.e. you're no longer covered as we consider further riding would be reckless? If so, then he was taking a known risk. If they didn't and only thought this up due to a second claim then it stinks of avoiding their responsibilities.

 

Time some level of responsibility for actions, contractual obligations specified and implied, were imposed on insurance companies and their talent for avoiding paying.

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5 hours ago, darksidedog said:

I agree with you about the mother, and you are correct, the first 72 hours is supposed to be free anywhere.

Two accidents in 3 weeks is very bad luck, though this one can't be blamed on him, regardless of how the first one happened.

My point however was that a bike is the sole means of transport for a vast number of the population. Whether a local or a tourist. this is how people get around here.

The travel insurance was for a trip to Thailand and the insurance company must have been aware of this.

The situation in the UK is obviously very different and most people have  a car.

Where I live, I can find a motor bike taxi easy enough, but an actual taxi is not likely. And I like many others try not to use the taxis anyway, as I don't like bad manners, bad driving and being overcharged.

ever heard of a songtail? a taxi?even a samlor?  there are other ways of getting around in thailand!

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20 minutes ago, Baerboxer said:

Did this insurance company make their stance crystal clear when approving the initial claim - i.e. you're no longer covered as we consider further riding would be reckless? If so, then he was taking a known risk. If they didn't and only thought this up due to a second claim then it stinks of avoiding their responsibilities.

 

Time some level of responsibility for actions, contractual obligations specified and implied, were imposed on insurance companies and their talent for avoiding paying.

 

I suspect the insurance company screwed the pooch when they paid out the first (probably much smaller) claim, giving the guy a reasonable expectation that he was covered for that activity.  Unless he did something different (or they notified him in writing that he was no longer covered when riding scooters), his new claim should be as reimbursable as the first one.

 

I also suspect it was the amount of the newer claim that triggered scrutiny at a higher level within the company, and that a good lawyer will have them regretting that they paid out the first one.

 

Edit:  That doesn't mean I think he was wise to get back on the horse...

 

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To have got on the bike shows a scant regard for his own wellbeing so he should have took a taxi with 4 wheels end of. 

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2 hours ago, The Deerhunter said:

Where I live I might have to travel 50km or probably more to reach a town where any taxi has 4 wheels, unless you include mini busses.

You might as well wait for the hearse at that point. 

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5 hours ago, steven100 said:

Try and get treated in the US or the UK after an accident ......

of course they want to confirm how the treatment is going to be paid ..... they are a business not a charity.

 

As for his insurance ....  inclusions and exclusions will be documented in the policy I would assume,  either he is covered or he is not ...  so if it only covers an accident on a motorbike once in a year and if that is in the fine print then thats it .....  you cannot argue if it's in back and white. The problem is not all the truth is told such as what is jake saying happened ? and what really happened ?   what has he told his family happened   ?

 

I am in no way defending the insurance company as I have little sympathy for the m .... just saying how it is.

I dont know about the U.S. but you would not be required to show ability to pay in the U.K. even as a foriegn National, they would treat you automatically and you would get exactly the same treatment as anyone else yes hsopsitals in the UK are businesses but they are not required to make a profit, that is why the NHS in the UK is in financial meltdown, so many people who come in to the UK have no insurance cover and some even come to get treatment as health tourists getting treatment for things they would have to pay for at home.

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