British student’s harrowing balcony plunge

[reader]

Job One for all insurance companies: figure out why your policy doesn’t cover you.

From The Thaiger

A British student is fighting for his life in hospital after a harrowing fall from a hotel balcony in Thailand.

The 21 year old Teesside University student is unconscious in a Thai hospital suffering from major internal and external injuries following a plunge from a balcony in Chiang Mai.

Jack Heathcock had been on what his sister Chloe described as a ‘dream backpacking adventure’ around Thailand with two friends when the unfortunate incident occurred on June 17.

The nursing student was due to return to Middlesbrough in the North-East of England on June 19 but he fell from a third storey balcony in the northern Thailand city of Chiang Mai, where he is now fighting for his life.

Heathcock was immediately rushed to a nearby hospital, where he underwent multiple surgeries to address damage to his spleen, liver, and kidneys, as well as injuries including a lung bleed, brain trauma, and fractures to his neck and pelvis. Despite the passage of more than two weeks, the British student remains in critical condition, and his family is desperately seeking a way to bring him back home, reported the Teesside Gazette.

Upon receiving news of the accident from their son’s friend, Jack’s parents, Ian and Joy Heathcock, wasted no time and flew to Thailand to be by his side. Although Jack had travel insurance, the family claims that the insurance company is refusing to cover the costs associated with his treatment.

 

[PeterRS]

Just out of curiosity, does any form of insurance over this dreadful form of accident? I assume that if the balcony railing had given way, there could be a lawsuit against the hotel. But that's not insurance and the cost of suing in a country like Thailand 9,000 kms away from home could easily outweigh any award the Court might consider reasonable. I suppose there might be a case to be made for Personal Accident but my experience of such clauses in Travel policies, the amounts tend to be quite small, they are hidebound by conditions and they rarely cover very high medical costs.

It's too early to speculate that he might have been pushed or even jumped. In neither case can I imagine insurance companies offering coverage, though. I only hope the family has started a crowd-funding site, although past experience of even these seem rarely to cover the huge costs of repatriation of a patient with serous medical injuries.

[reader]

Most travel policies I’ve seen don’t cover pre-existing conditions but do cover unforeseen events such as accidents and this certainly sounds like one.

Many policies are not primary coverage and won’t pay if you have primary coverage with another carrier. 

I took out a required policy when I made my first post-Covid trip. I had to use emergency room after a fall that resulted in scalp and face lacerations. When I presented proof of coverage from the Thai issued policy I was informed (at Bangkok Christian Hospital) that coverage only applied to care sought in public health hospital. Upon return home I learned that my US private policy did cover unforeseen events anywhere and was reimbursed less $50 deductible.

 

 

[PeterRS]

19 minutes ago, reader said:

Most travel policies I’ve seen don’t cover pre-existing conditions but do cover unforeseen events such as accidents and this certainly sounds like one.

Can I ask what was the amount for Personal Accident? Seems I should consider your insurance company if that's possible.

[reader]

It was issued to all retirees as part of pension benefit by insurer that supplied coverage for active members of pension system. It supplements what Medicare doesn’t cover. It can’t be purchased by individuals outside system.

 I was unaware of the international provision until I took time to read through entire policy when I returned home. Had I known about it, I could have used it in place of the Thai policy I took out. 

I recall some news accounts in Thai press that reported how profitable those Covid-era polices turned out to be for insurers.

[khaolakguy]

Any decent standalone travel insurance policy should cover emergency medical costs arriving from accidents like this and repatriation if necessary/feasible. It's the purpose of the policies.

[forky123]

10 minutes ago, khaolakguy said:

Any decent standalone travel insurance policy should cover emergency medical costs arriving from accidents like this and repatriation if necessary/feasible. It's the purpose of the policies.

Is there a different article to that linked? The one linked is very careful in its language and doesn't call it an accident saying it remains unclear what happened and who was with him. 

[reader]

4 hours ago, reader said:

Upon receiving news of the accident from their son’s friend, Jack’s parents, Ian and Joy Heathcock, wasted no time and flew to Thailand to be by his side.

 

24 minutes ago, khaolakguy said:

Any decent standalone travel insurance policy should cover emergency medical costs arriving from accidents like this and repatriation if necessary/feasible. It's the purpose of the policies.

Wholeheartedly agree that a decent policy should. But it’s not until you read all the exclusions many insurers put in their terms can you appreciate how indecent some of these policies can be. 

[Mavica]

Accident, or suicide?

[fedssocr]

I guess there are also provisions in insurance policies that say they won't cover incidents that happen when the victim is intoxicated or has drugs in their system.

[a-447]

12 hours ago, fedssocr said:

I guess there are also provisions in insurance policies that say they won't cover incidents that happen when the victim is intoxicated or has drugs in their system.

Recently CCTV showed a woman tripping on some steps and falling flat on her face in Bali, 

She ended up in hospital with serious injuries but her insurance company - one of the biggest in Australia -refused to pay up,  citing the fact that she was drunk. How do they know that? Because they checked the bar tab and saw that a lot of alcohol had been consumed.

But as she said, how does the insurance company know who drank what? She could have been drinking Coke all night.

[reader]

Pay with cash to beat the bastards.

[Thomas_88]

It could be "balconing", some call it "Raining Brits":

https://www.bbc.com/news/newsbeat-38115232

"Your travel insurance may not cover you for incidents that take place while you're under the influence of drink or drugs"

 

[vinapu]

11 hours ago, a-447 said:

 

But as she said, how does the insurance company know who drank what? She could have been drinking Coke all night.

and she was right, should sue unless they performed blood test and found excessive amount of alcohol there. 

I know somebody who, when in Thailand ,  has  bottle opened in few bars and yet drinks only idiotic stuff like water and sift drinks. Bottle's  contents are for boys he invites.

[a-447]

I used to run up large drink bills at the old Eros bar in Pattaya, but it was the boys who were drinking - I was usually drinking Diet Coke.

[unicorn]

Any decent insurance policy should cover an accidental fall. If he jumped over intentionally, either because he was showing off or feeling suicidal, then I could understand the insurance not paying. I don't know how things go in the UK, but if it were accidental and he were American, he could probably sue and win. I don't think the insurance company could prevail over some small-print technicality buried on page 12 that no coverage would be provided if he'd been drinking. Most people drink when they're on vacation. 

[vinapu]

2 hours ago, unicorn said:

Most people drink when they're on vacation. 

I agree. I never drink beer at home but as soon as i land in some foreign and hot land it's one bottle after another

[PeterRS]

7 hours ago, unicorn said:

. . . if it were accidental and he were American, he could probably sue and win. I don't think the insurance company could prevail over some small-print technicality buried on page 12 that no coverage would be provided if he'd been drinking. Most people drink when they're on vacation. 

Isn't the problem here the actual legal costs of suing in a country 9,000 kms away from home like Thailand where laws sometimes appear to be fluid and dependent on the verdict given by just one judge (no juries in Thailand) and whose verdicts can be, shall I say, 'odd' given the facts of a case?

In case you did not see the recent thread in which I mentioned the infamous Spice Trade trial in the rearly 2000s about the arrest of the directors of Utopia Tours, can I suggest you read the following. It is long but a fascinating - some might say horrifying - look at the Thai justice system. In all cases everything depends solely on the judge. In the Spice Trade case he clearly disliked gay magazines and based his erroneous judgement on that. If a litigant is expecting to be awarded substantial costs when the defendants will point out a clause in tiny print buried somewhere in the text in a language the judge will not fully understand, I would have absolutely zero confidence in winning the case!

https://web.archive.org/web/20050606015724/http:/www.yawningbread.org/arch_2005/yax-435.htm 

[reader]

Your opportunity to succeed in a law suit against a foreign entity depends a lot on the country in which the product or service was marketed. If, for example,  a Thai insurer marketed a policy that was sold in the US, you’d have a much better opportunity than trying to do the same within the Thai legal system.

[unicorn]

4 hours ago, PeterRS said:

Isn't the problem here the actual legal costs of suing in a country 9,000 kms away from home...

Well, I don't know about British law, but in the US, if you bought your policy in the US from a company which does business in the US, you could sue in US courts. I'm not sure if this would come under the state or federal court system, but if the company refused to pay your bills, you wouldn't have to rely on Thai courts. I think it comes under the regular, state courts, because when I've purchased travel insurance, there are pages devoted to differences in coverage depending on what state you're in. 

[forky123]

28 minutes ago, unicorn said:

Well, I don't know about British law, but in the US, if you bought your policy in the US from a company which does business in the US, you could sue in US courts. I'm not sure if this would come under the state or federal court system, but if the company refused to pay your bills, you wouldn't have to rely on Thai courts. I think it comes under the regular, state courts, because when I've purchased travel insurance, there are pages devoted to differences in coverage depending on what state you're in. 

Even if UK courts could get jurisdiction, good luck getting it through the legal system in any timely manner to help in this circumstance. 

[PeterRS]

1 hour ago, unicorn said:

Well, I don't know about British law

I've been discussing Thai law, as I stressed in my post. If as @forky123 points out a British court would take the case, which in itself must be doubtful in the absence of a mountain of paperwork about the event itself, witnesses affirming the state of upkeep of the hotel and the stability of its balconies, any previous similar cases, the activities of the young man and his friends througohut that evening, whether they had been drinking and what the young man's blood alcohol level was on arrival at hospital, in addition to calling several expert medical witnesses which it might be impossible to pay for from Thailand, the family might perhaps have a case, I expect. Under Thai law, though, the family could find itself very much deeper in debt. They'd be spinning some form of roulette wheel with the chances of it stopping at the right number all but zero. Unless you know a bit more about Thai law than I.

Then there could be a secondary but equally important issue. If their number did in fact come up and it was proven beyond a reasonable doubt in a UK court that the hotel was at fault, the chances of the family actually getting the monetary award out of Thailand would be quite another matter. All but impossible, alas!

[forky123]

Under all jurisdictions I suspect you'd need a lot more evidence than are contained in the articles I've read here. Out of interest, i've just checked the exclusions for my last holiday. The main ones I would see catching people out are excessive alcohol consumption and not wearing a helmet while riding a motorcycle which is another big cause of insurance not paying out. Again though, the articles are very carefully written and avoid allocating blame for what happened. 

[reader]

4 hours ago, unicorn said:I think it comes under the regular, state courts, because when I've purchased travel insurance, there are pages devoted to differences in coverage depending on what state you're in. 

Good point. One avenue to pursue that would avoid legal expenses would be to get the state consumer protection agency or state secretary of state to initiate the action (not uncommon in many jurisdictions). 

The biggest thing an insurer can lose is not the cost of paying the claim. It’s the loss of the right to market their product in that state going forward.

[khaolakguy]

If the UK national purchased a travel insurance policy in the UK, from a UK registered company then, regardless of where any accident took place, the relevant jurisdiction for the settlement or legal action is the UK.

In the event that the insured, or his family, felt they had had a claim unjustly refused, then the first recourse in the UK would be to the Financial Ombudsman. Most insurers are signed up to a code of conduct to abide by the ombudsman's decisions.