Medical Cover?

[Albert the Frog]

This is a story in the Manchester Evening News today-I've never heard of this before but blimey it makes you think!

Holiday mum in pay-out wrangle

Kathleen Ackers.THE family of a critically-ill woman who fell on a holiday in America have been told her insurance policy will not cover her treatment - because she had been drinking.

Kathleen Ackers, 63, slipped and hit her head at an apartment in Orlando.

She suffered bleeding to the brain and is now in intensive care at a Florida hospital.

She has already been treated at two hospitals and was airlifted between them by helicopter.

Her family fear the medical bills will run into thousands and flying her back to Britain would cost £10,000-£20,000. The Halifax told the family the insurance policy is invalid because Mrs Ackers had been drinking on the night of the accident.

It was only after the intervention of the M.E.N. that the Halifax offered to pay up to £20,000 to fly her home as a goodwill gesture.

Mrs Ackers, from Ashbourne Avenue, Wigan, was sharing the apartment with husband Ted, son Mark and his two children.

Speaking from Florida, Mr Ackers said: "I found Kathleen lying in a pool of blood. We phoned 911 and she was rushed to Celebration Hospital, but they wanted her to see an expert neurologist at Florida Hospital.

"We were told the policy would cover the cost so Kathleen was taken by helicopter to Florida. It also said it would cover my accommodation.

"Kathleen was talking initially, but has since deteriorated rapidly and I have been told the prognosis is bad. She might not make it, but if she's going to die I want to take her back to the UK."

Mrs Ackers, a mother-of-two, had about 300 milligrams of alcohol per 100 millilitres of blood in her system - equivalent to about eight to nine vodkas.

The family's travel insurance policy has a clause invalidating payment if she is under the influence of alcohol. It says: "Your policy does not cover you for any claim directly or indirectly resulting from... the misuse of alcohol or you being under the influence of alcohol."

Mr Ackers said: "We have never hidden the fact we'd had a fair bit to drink, but who doesn't while on holiday? The alcohol clause is buried in the policy. The company should warn people."


Mrs Ackers' condition was complicated because she has a heart valve fitted. She was unconscious and has been given a tracheotomy to help her breathe.

Carol Wright, a spokeswoman for Halifax Travel Insurance, said: "Insurers are guided by the opinion of the medical carers of the holidaymaker. In the case of Mrs Ackers, it was the opinion of the medical carers that she was seriously under the influence of alcohol and that this directly contributed to the incident."

The Association of British Insurers said the clause was standard with travel insurance.

Spokesman Kelly Ostler said: "If you are drunk and something happens, you are responsible for the state you have put yourself in. Travel insurance is there to protect against the unexpected. We would encourage people to be responsible."

[LiesaAnna]

crikey, sounds awful!!

[Katys Grandad]

<blockquote id="quote" class="ffs">quote:[i]

Mrs Ackers, a mother-of-two, had about 300 milligrams of alcohol per 100 millilitres of blood in her system - equivalent to about eight to nine vodkas.

Mr Ackers said: "We have never hidden the fact we'd had a fair bit to drink, but who doesn't while on holiday? The alcohol clause is buried in the policy. The company should warn people."





[/quote]

Why should the responsible people who pay premiums to insurers have to sustain claims from those who ignore the conditions and behave in this way? What is it about so many of our fellow countrymen that they have to be drunk to enjoy themselves wherever they are?[msnmad]

If this family want to over-indulge THEY should take the risk.

[Macka]

Would you say the same if she had only had one small sherry then Phil?

[Katys Grandad]

<blockquote id="quote" class="ffs">quote:Originally posted by Macka
Would you say the same if she had only had one small sherry then Phil?


[/quote]

If it was a causal factor in what happened - most definitely 'Yes'.

It's nothing to do with the amount, it's about the effect the amount has, surely?

The only diffeence between 8 vodkas and a small sherry is that 8 vodkas are more likely (probably certain) to be a factor.

[florida4sun]

Macka,
they judge 'under the influence' as being over limit. Nearly all insurance policies will have this exclusion.

<blockquote id="quote" class="ffs">quote:Originally posted by Macka
Would you say the same if she had only had one small sherry then Phil?


[/quote]

[E. Cosgrove]

Several years ago a collegue of mine went skiing with family and friends.
In the evening they were walking home after a couple of beers when her husband slipped on a patch of ice and fell. He sustained a head injury and sadly died.
Her insurance company wanted nothing to do with the claim as he had been drinking and the only way she was able to get his body repatriated was, as luck would have it she had completed an E111.
She never denied that he had been drinking but has always maintained it was no more than 2 pints max.[msnsad]
He certainly wasn't drunk.

[florida4sun]

E111 does not cover repatriation, it only covers emergency medical care. I used to rock climb (long time ago) and we were out in France doing some pretty tricky routes. The lead climber took a nasty fall breaking various parts of his body. We only had E111 cover, which git him stabalised (he lloked like a mummy) but he got the bill for flying him home, this was well over 10,000 pounds. The E111 cover is very limited and you have to pay upfront and then claim it back through the NHS.

<blockquote id="quote" class="ffs">quote:Originally posted by E. Cosgrove
Several years ago a collegue of mine went skiing with family and friends.
In the evening they were walking home after a couple of beers when her husband slipped on a patch of ice and fell. He sustained a head injury and sadly died.
Her insurance company wanted nothing to do with the claim as he had been drinking and the only way she was able to get his body repatriated was, as luck would have it she had completed an E111.
She never denied that he had been drinking but has always maintained it was no more than 2 pints max.[msnsad]
He certainly wasn't drunk.
[/quote]

[wrpac00]

Insurance companies will do anything not to pay out (I know from bitter experience), I do sometimes wonder if it is really worth it.

A friend of ours was hit by a baseball whilst watching a game (this was three years ago) and the saga is still going on between the hospital and the insurance company. The insurance company say they didn't get permission from them first, the fact that she was whisked away in an ambulance seems to be irrelevant with them.

[george]

I think it is scandalous the way insurance companies try to wriggle out of everything! If you are on vacation and have a few drinks it is perfectly normal I'm sure the British are not the only race who do this. As somebody else says it makes you wonder if it's worth paying for insurance year after year.