To think my insurance should cover me nearly dying?!

[octavio1996]

Posting here because I’m at my wits’ end and don’t know what to do. Currently stuck in Australia after a total nightmare and my insurance company is refusing to pay out.

Basically, I was travelling here on holiday with DH and the DC (two teens, one younger), having an amazing time. Then out of nowhere, I got really ill massive pain, collapsed, rushed to hospital. Turns out it was a ruptured appendix and I ended up in intensive care for days, genuinely thought I was going to die. DH was beside himself, kids were terrified. The hospital care was amazing but obviously, this is Australia, and the bills are absolutely eye-watering.

Here’s the kicker: my travel insurance is now refusing to pay. They’re saying it’s a “pre-existing condition” (it wasn’t), or that I didn’t declare something minor from years ago that has nothing to do with this. I’ve been on the phone to them constantly, but they’re just fobbing me off. We’ve already had to put thousands on a credit card just to get me discharged. We were meant to fly home next week, but I’m not even sure I’m well enough to travel, and obviously, we can’t afford to stay indefinitely.

Has anyone been in this situation before? Do I have any chance of fighting this, or are we totally screwed? DH is trying to stay calm for the DC, but I can tell he’s panicking too. I just want to go home and not be bankrupt.

TL;DR: Nearly died from a ruptured appendix, travel insurance won’t pay, stuck in Australia with a huge bill. Help!

Sorry if someone has already replied to this, haven’t RTFT.
There Is likely a number to call to disclose pre existing medical conditions when you have travel insurance via a bank account, they sometimes charge an extra fee for you to be covered.
The bank should have explained this to you when you signed up for the account, especially if there is a fee for it, as the product may not suit your needs if you can’t be covered and therefore you could have a claim of miss-selling…

@JasonMurrayMint we have bank account travel insurance too. I had a catastrophic bleed two days before a big pre planned road trip including expensive flights, car hire and some hotels. It was completely out of the blue and not expected by either nhs or me, but it was related to day surgery I’d had to remove bad cells two weeks before. I hadn’t thought to tell the insurance company anything, and they have no information about my medical history. They paid out with just a letter from the hospital and sent well wishes. They never asked a single thing about my medical history, and I’m not even the named person on the bank account, just the live in partner.

any update OP? Although I reckon the refused claim with good reason

In any insurance you have to declare absolutely everything. Sorry that’s happening to you. Must be awful. I just see people not taking insurance very seriously then they get into a lot of trouble. Insurers need to know everything to they can assess the risk. They can’t if you don’t tell them

You were lucky!

Surely you have to reveal everything even if your bank gives you free insurance. They won’t ask- you have to tell them!

Check the fine print. My bank account technically offered "free" travel insurance but it wouldn't my existing medical condition so was effectively worthless.

I believe it was possible to pay a surcharge to be covered, in my case it was cheaper to get better, more comprehensive insurance elsewhere!

@Badbadbunny yes I’m with you about how great the NHS app is but how difficult it can be to put something right

when I started getting the info in the app I could see they said I’d repeatingly refused any stop smoking advice and help for smoking for the last 3 years

i've never smoked in my life (well maybe a couple 30 years ago in high school). It took me ages to get my records updated.

No, that’s incorrect reasoning. The reason it’s difficult to claim on is because the acceptable conditions are on a list so you need to get one of them. Many conditions are not covered, even if they are ‘critics illnesses’ and so people assume everything is included. Also there are specific levels of severity that are required and often people don’t meet those.
if you compare it to income protection insurance, CIC is very tricky to successfully claim on and yet it’s the one that everyone takes out.

I think they do it to defraud the nhs by claiming they’ve given advice to x number of patients so they can tick boxes on funding applications as “management” of conditions. My gps have always asked if I’m depressed and looked disappointed when I said no - apparently depression was at one time a trigger for additional funding for the surgery. OH is constantly asked if he had erection problems but he’s never once mentioned anything like that. They seem obsessed to diagnose some things and ignore other things you do tell them about. I’m convinced they’re just following the money these days.

I don't have experience with health insurance but we've had issues with a car insurer and complained to the ombudsman who advised that an independent insurer review the case. They found in our favour and the ombudsman eventually ordered the insurer to fix our car after a second complaint. It took ages though as the ombudsman don't get back to you quickly so it's unlikely you will resolve the issue without paying upfront. Good luck, they will try anything to avoid paying.