Australian Tourist Secures Compensation for Air Ambulance From Bangkok

9

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

Share this news item:

Insurance News

Clear

QBE Highlights the Importance of Adequate Landlord Insurance 15 Jul 2025: Paige Estritori Landlords in Australia have been advised by QBE Insurance Group to reassess their insurance coverage, following survey findings that indicate many could encounter financial hardships if their rental operations are interrupted. According to QBE's data, 38% of landlords might face financial challenges should their properties become uninhabitable or rental payments cease for a duration of two to six weeks. - read more

Court Denies E-Scooter Negligence Allegation Against City Council 14 Jul 2025: Paige Estritori An Australian court recently ruled in favour of the City of Joondalup, rejecting a negligence claim lodged by an injured e-scooter rider. The Western Australia District Court found the city not liable for an accident involving insurance broker Kirstin Leibbrandt, who collided with a fence post while riding an e-scooter in the Perth suburb of Hillarys. - read more

Mental Health Surpasses Other Causes in TPD Claims, Doubling Payouts Over Five Years 14 Jul 2025: Paige Estritori Recent findings from the Council of Australian Life Insurers (CALI) reveal that mental health issues have become the primary cause of Total and Permanent Disability (TPD) claims. Insurers disbursed nearly twice the amount for such claims in 2024 compared to five years prior. This data originates from the CALI and KPMG's Cause of Claims Results Report, highlighting a significant shift in the nature of insurance claims. - read more

Impact of Trump Tariffs on Global Insurance Industry 11 Jul 2025: Paige Estritori According to Swiss Re’s latest Sigma report, the growth of property and casualty premiums is moderating in both Australia and globally. This moderation is primarily driven by a slowdown in rate hikes. Additionally, the Trump administration's America First trade policy is putting further pressure on the insurance sector. - read more

Navigating Changes in Australia's Life Insurance Advice Landscape 10 Jul 2025: Paige Estritori The conversation on the shifting dynamics in Australia's life insurance advice sector featured Zurich Australia's head of adviser channel, Kieran Forde, and Hayes & Co director, Katherine Hayes. They engaged with editor Chris Dastoor to spotlight the current market conditions and future prospects for financial advisers in this domain. - read more