Australian Tourist Secures Compensation for Air Ambulance From Bangkok
Australian Tourist Secures Compensation for Air Ambulance From Bangkok
9
The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.
A recent decision by a dispute resolution body in favor of a 74-year-old Australian traveler has emphasized the importance of clear communication and precise terms and conditions in insurance policies.
This comes after the individual engaged in a tug-of-war with an insurance company over a $195,223 claim to cover emergency medical transportation from Thailand.
The traveler found himself in a life-or-death situation while in Bangkok when he suffered from necrotizing pancreatitis and heart failure. Despite initial improvements, a deterioration in his condition led his family to pursue an air ambulance to return him to Australian care. Lloyd's Australia was contacted, but confusion and lack of confirmation regarding coverage left the family to decide on the man's urgent evacuation on their own.
Despite absence of a formal nod from Lloyd’s, the family proceeded on the pretext that the window for safe transfer was rapidly closing. Following the move, the patient incurred over a four-month stay in an Australian hospital, a period likely mirrored if he had remained in Thailand, but with potentially higher medical costs.
The insurance provider, Lloyd's, weighed the case against their policy terms and initially favored partial payment, rebuffing the high cost of emergency evacuation due to an apparent lack of pre-approval. Their stance was that the provided medical updates suggested an improvement that negated the need for air ambulance services. However, they conceded that there was a communication oversight on their end.
The Australian Financial Complaints Authority (AFCA) oversaw the wrangling and ultimately ruled in the traveler's favor. A compelling case was constructed around medical documents including a key letter from the Bangkok hospital and a consultant gastroenterologist's report that underscored the necessity of urgent repatriation to Australian medical facilities via ambulance plane.
While acknowledging Lloyd's deviations, particularly their failure to secure detailed medical reports, AFCA held that the insurer's proposed alternate paths would not have significantly altered the situation. Therefore, the cost-saving argument did not stand. The adjudication elevated the patient's immediate health needs over procedural discrepancies. AFCA's final judgement resonated with a fundamental ethos of insurance: serving the policyholder's dire need, which in this case, was a safe and swift return to home country medical treatment.
In AFCA's adjudicator's concluding remarks, it was underscored that the insurer could not exhibit that costs would be mitigated had the policyholder sought their express consent. Moreover, the nature of the medical emergency and the insufficiency of information did not justify the exclusion of expenses. Consequently, Lloyd's was instructed to cover the evacuation expense claim in full, reinforcing AFCA's role in ensuring the protection and rights of insurance consumers.
Published:Saturday, 11th May 2024 Source: Paige Estritori
Please Note: If this information affects you, seek advice from a licensed professional.
Australia's life insurance sector is witnessing a significant transformation, with mental health conditions emerging as the predominant cause of Total and Permanent Disability (TPD) claims. Recent data from the Council of Australian Life Insurers (CALI) indicates that mental health-related TPD claims now constitute nearly one-third of all such claims, highlighting a profound shift in the factors leading Australians to exit the workforce permanently. - read more
The Australian life insurance industry has reported a remarkable financial turnaround in the fiscal year 2025, with earnings more than doubling to $360 million, according to the latest figures from the Australian Prudential Regulation Authority (APRA). This 210% increase in profit after income tax marks a significant recovery from previous years' losses and underscores the sector's resilience and adaptability. - read more
Australia's general insurance sector has reported an unprecedented after-tax profit of $6.1 billion for the year 2024, according to KPMG's General Insurance Insights report. This figure is three times higher than the five-year average of $2 billion, marking a significant milestone in the industry's financial performance. - read more
The Australian general insurance sector has reported a remarkable after-tax profit of $7.3 billion for the last financial year, marking its most substantial earnings in over ten years. This significant increase is primarily attributed to a decrease in catastrophe-related losses and robust investment returns. - read more
The Australian general insurance market is on a trajectory to see direct written premiums (DWP) exceed $144 billion by 2029, according to projections from data and analytics firm GlobalData. This anticipated growth is largely fueled by heightened demand for coverage in response to the increasing frequency of natural disasters. - read more
An income insurance policy, often referred to as income protection insurance, is a financial safety net designed to provide you with a steady income stream if you're unable to work due to illness or injury. It ensures that you can still support yourself and your family, even when unforeseen medical conditions prevent you from earning a salary. This policy typically covers a percentage of your pre-tax income, helping to alleviate the financial burden during recovery periods. - read more
When illness strikes, the impact on your finances can be as significant as on your health. Maintaining continuous income flow during such times is crucial for financial stability. - read more
Income protection insurance serves as a financial safety net for countless Australians, offering a replacement income when unforeseen circumstances such as illness or injury impede their ability to earn. For the self-employed and entrepreneurs who may not have the safety nets offered by corporate employment, such protection is particularly important. - read more
Income protection insurance is a safety net that many Australians rely on to secure their financial future in the event of illness or injury preventing them from working. It's a type of policy that provides a replacement income if you are unable to earn your regular income due to a health-related absence from the workplace. - read more
Insurance is a crucial component of financial planning. While many Australians understand the importance of life insurance, there's another vital type of coverage that often gets overlooked: income protection insurance. - read more
Start Here !
Apply now for your free Insurance assessment and price comparisons!
