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Trouble Claiming on Covid Insurance Policy


JohninDublin
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For those who have seen my posts about my trip to TH in Jan, you may recall that as I was about to depart for home, I caught covid. Since then I have written to the Insurer on 4 occasions trying to recover my losses and had no reply. I have also written to the Insurance Regulator twice, and also failed to get a reply. My losses are just over 20k.

Anyone have any suggestions?

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Hi John in Dublin,
It's sad to hear that you have not been able to claim from your insurer.
Although I am only a certified insurance advisor in the Netherlands, I think generally speaking all insurance companies operate in the same way.
My suggestion is to look up your insurance policy and search for the claims you can make. It should say in which cases you have the right to claim money back, what conditions you will have to meet and how you have to hand in your claim. 
If your health insurance doesn't offer any coverage in your case, maybe your travel insurance does.

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2 minutes ago, Bobby said:

Hi John in Dublin,
It's sad to hear that you have not been able to claim from your insurer.
Although I am only a certified insurance advisor in the Netherlands, I think generally speaking all insurance companies operate in the same way.
My suggestion is to look up your insurance policy and search for the claims you can make. It should say in which cases you have the right to claim money back, what conditions you will have to meet and how you have to hand in your claim. 
If your health insurance doesn't offer any coverage in your case, maybe your travel insurance does.

Thanks for your reply

Just to clarify, the policy was a covid insurance mandated by and approved by the TH gov prior to my being allowed to land in TH. The policy was purely about insuring me against any medical/quarantine costs incurred as a result of becoming infected. I cannot tell if they are operating any loopholes etc, because they have never replied to any of my correspondence. 

The same applies to the TH Insurance Regulator who have not responded to me on both occasions when I have raised the matter.

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John I am sorry to hear of your difficulties but hope you are well otherwise.

Do you have a citizens advice bureau (or equivalent ) near you? Often they have either retired or indeed active solicitors who offer their time free of charge. It may be worth discussing the matter with them.

A letter from those guys to the insurance company will likely get more of a response. 

Hope things go well for you sir. 

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3 minutes ago, Rookiescot said:

John I am sorry to hear of your difficulties but hope you are well otherwise.

Do you have a citizens advice bureau (or equivalent ) near you? Often they have either retired or indeed active solicitors who offer their time free of charge. It may be worth discussing the matter with them.

A letter from those guys to the insurance company will likely get more of a response. 

Hope things go well for you sir. 

Sorry, but I might have put things better. This is a Thai Insurance Co that sold me the policy, and it is both the insurer and the TH regulator who are not replying to any of my correspondence. 

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10 minutes ago, JohninDublin said:

The policy was purely about insuring me against any medical/quarantine costs incurred as a result of becoming infected. I cannot tell if they are operating any loopholes etc, because they have never replied to any of my correspondence. 

You need to read the terms and conditions of your policy carefully.

These policies included the treatment of Covid in quarantine facilities.
Although you tested positive for Covid and had to isolate for several days, you received no treatment.
These policies never covered for isolation only costs.

 

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7 minutes ago, JohninDublin said:

Sorry, but I might have put things better. This is a Thai Insurance Co that sold me the policy, and it is both the insurer and the TH regulator who are not replying to any of my correspondence. 

Might still be worth a try John. What do you have to lose? 

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Just now, Faz said:

You need to read the terms and conditions of your policy carefully.

These policies included the treatment of Covid in quarantine facilities.
Although you tested positive for Covid and had to isolate for several days, you received no treatment.
These policies never covered for isolation only costs.

Thanks for your reply. 

I can't say that I can even find the policy to look at the wording. But the problem is that I have written to the insurers asking for a claim form and not stated my circumstances. So if you are correct, how could they know whether my claim my claim was treatment and not for quarantine, when all I've done is ask for a claim form? 

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4 minutes ago, Rookiescot said:

Might still be worth a try John. What do you have to lose? 

Thanks Rookie. 

On a point of information, we don't have CAB in RoI. We do have a Citizens Information website which is pretty comprehensive at explaining your rights as an Irish Citizen in relation to the gov and consumer affairs.

However, if we did have CAB here, I can't see why a TH insurer or gov agency would be impressed at getting a letter from them? 

@FazHas suggested I may not be insured for quarantine risks. He may be right, but as they have failed to reply to my correspondence with them, I don't see how they can invoke this? Also why, the Regulator has failed to ask what the basis of my claim is.

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2 minutes ago, JohninDublin said:

However, if we did have CAB here, I can't see why a TH insurer or gov agency would be impressed at getting a letter from them?

Because it is composed and signed by a solicitor who will include his qualifications. That tends to get peoples attention. 

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Ahh the trials and tribulations of dealing with Insurance companies.

Happy to talk to you when you are giving them money for useless policies.

Legal low life.

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15 minutes ago, Rookiescot said:

Because it is composed and signed by a solicitor who will include his qualifications. That tends to get peoples attention. 

I get your point, but I am not sure they would be impressed by a solicitor thousands of miles away, unless they thought he could start an action.

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45 minutes ago, Faz said:

You need to read the terms and conditions of your policy carefully.

These policies included the treatment of Covid in quarantine facilities.
Although you tested positive for Covid and had to isolate for several days, you received no treatment.
These policies never covered for isolation only costs.

Just a thought in respect of both yours and @Bobbycomments.

Initially, I submitted a policy from an Irish Insurance co. This did cover me for quarantine costs but was rejected when I was making my application for an entry permit. If you are right, it appears that I was tricked into buying a far inferior product.

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1 minute ago, JohninDublin said:

tricked into buying a far inferior product.

Sounds like you were in Thailand.🤣

Been dudded myself with policies for myself , wife and mother in law, we all got Covid and were supposed to get a lump sum pay out on contracting the disease and submitting verifiable proof.  The company declared bankruptcy, we got zilch.

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2 hours ago, JohninDublin said:

Just a thought in respect of both yours and @Bobbycomments.

Initially, I submitted a policy from an Irish Insurance co. This did cover me for quarantine costs but was rejected when I was making my application for an entry permit. If you are right, it appears that I was tricked into buying a far inferior product.

So you had no other insurance besides the Thai one?

 

because that is what would have covered the quarantine costs........not the Thai one

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29 minutes ago, Marc26 said:

So you had no other insurance besides the Thai one?

because that is what would have covered the quarantine costs........not the Thai one

I had travel insurance which was supposed to cover me for Covid. My initial application to travel was rejected because of this policy, so I cancelled it. It hardly made sense to me to retain a policy that appeared not to be usable. No reason was given why it was no good, and time until my flight taking off was short. I saw no reason in querying it. Had I done so, do you think they would have justified their decision with an explanation? Or just said something like, "This not suitable".

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2 hours ago, JohninDublin said:

Initially, I submitted a policy from an Irish Insurance co. This did cover me for quarantine costs but was rejected when I was making my application for an entry permit. If you are right, it appears that I was tricked into buying a far inferior product.

I've never witnessed an Insurance policy that covered isolation costs due to asymptomatic conditions.
They'd all go bust overnight.

The policies all covered medical treatment from general accidents + Covid 19.
You applied for the Thailand Pass, the conditions for which were that any Insurance policy must be provided by the TGIA (Thai General Insurance Association).
Tune were the cheapest.

This is what you chose;
https://www.tuneprotect.co.th/en/product/travel-insurance/ONTALN

The policy wording is quite clear;
It covers medical treatment and associated costs due to Accident, Illness or sickness by any person licensed to practice modern medicine with the Medical Council who can render medical treatment and surgery within the territory he/she is licensed.
As an inpatient or outpatient receiving medical treatment in a hospital, medical facility or clinic that provides medical services, can accommodate overnight patients, has an adequate number of medical personnel and facilities and a complete range of services, particularly a major operating room, and is registered as a Hospital in accordance with the law on medical facilities in that locality.

https://www.tuneprotect.co.th/storage/product/iPass/11.Policy Wording_EN_Lite Plan (USD 10k) 2022-04-27.pdf

Staying in a hotel because you tested positive but were asymptomatic and not receiving any medical treatment is not covered.

 

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6 minutes ago, JohninDublin said:

I had travel insurance which was supposed to cover me for Covid. My initial application to travel was rejected because of this policy, so I cancelled it. It hardly made sense to me to retain a policy that appeared not to be usable. No reason was given why it was no good, and time until my flight taking off was short. I saw no reason in querying it. Had I done so, do you think they would have justified their decision with an explanation? Or just said something like, "This not suitable".

I had both

 

Travel insurance to cover any "trip delay/interruption"(hotel, flight changes)

And then the compulsory Thai insurance in case of covid care

 

I'd chalk it up to not being covered for "trip delay/interruption" as @Faz has pointed out

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9 minutes ago, Faz said:

I've never witnessed an Insurance policy that covered isolation costs due to asymptomatic conditions.
They'd all go bust overnight.

 

Many cover for isolation costs if your trip is "interrupted" (had to extend because you got covid)

 

If you test positive and can't fly home and have to extend your stay, many policies cover hotel/meals at a certain amount per day (mine is 200cad/day)

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2 minutes ago, Faz said:

I've never witnessed an Insurance policy that covered isolation costs due to asymptomatic conditions.
They'd all go bust overnight.

The policies all covered medical treatment from general accidents + Covid 19.
You applied for the Thailand Pass, the conditions for which were that any Insurance policy must be provided by the TGIA (Thai General Insurance Association).
Tune were the cheapest.

This is what you chose;
https://www.tuneprotect.co.th/en/product/travel-insurance/ONTALN

The policy wording is quite clear;
It covers medical treatment and associated costs due to Accident, Illness or sickness by any person licensed to practice modern medicine with the Medical Council who can render medical treatment and surgery within the territory he/she is licensed.
As an inpatient or outpatient receiving medical treatment in a hospital, medical facility or clinic that provides medical services, can accommodate overnight patients, has an adequate number of medical personnel and facilities and a complete range of services, particularly a major operating room, and is registered as a Hospital in accordance with the law on medical facilities in that locality.

https://www.tuneprotect.co.th/storage/product/iPass/11.Policy Wording_EN_Lite Plan (USD 10k) 2022-04-27.pdf

Staying in a hotel because you tested positive but were asymptomatic and not receiving any medical treatment is not covered.

Thanks for that. That clears that matter up. 

However, though it looks pretty near certain that I did not have a valid claim, Tune and the Insurance Regulator could not have known this without me filling out a claim form. 

Another thought also occurs to me: Had I not cancelled the Irish Policy and tried to claim on it, one of the questions that I've seen on other insurance claim forms, is something along the lines of "Do you have another policy which covers you for this event?". I understand that if you say "yes" to that question, they will tell you that you have to claim from that insurer instead. The second insurer will react similarly. So presuming that this happens, I can well imagine the scenario in this case being, "You chose not to go into a hospital when the other insurer would have paid for it. Why should that be our liability because you decided not to go a hospital ?"

FWIW, I have had a hatred of insurance companies for a very long time.

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4 minutes ago, JohninDublin said:

Thanks for that. That clears that matter up. 

However, though it looks pretty near certain that I did not have a valid claim, Tune and the Insurance Regulator could not have known this without me filling out a claim form. 

Another thought also occurs to me: Had I not cancelled the Irish Policy and tried to claim on it, one of the questions that I've seen on other insurance claim forms, is something along the lines of "Do you have another policy which covers you for this event?". I understand that if you say "yes" to that question, they will tell you that you have to claim from that insurer instead. The second insurer will react similarly. So presuming that this happens, I can well imagine the scenario in this case being, "You chose not to go into a hospital when the other insurer would have paid for it. Why should that be our liability because you decided not to go a hospital ?"

FWIW, I have had a hatred of insurance companies for a very long time.

Yes you would likely have the 2 insurance companies fighting it out but in the end, the Thai one never offered "trip interruption" so I believe the Irish one would have had to pay

 

I had similar issue when I had an accident in Thailand

I claimed my Manulife travel insurance that comes with my health insurance through my employer but I answered that I also has travel insurance through my credit card

 

And those two fought for months who would pay it, finally my work insurance did

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18 minutes ago, Marc26 said:

I had both

Travel insurance to cover any "trip delay/interruption"(hotel, flight changes)

And then the compulsory Thai insurance in case of covid care

I'd chalk it up to not being covered for "trip delay/interruption" as @Faz has pointed out

Now Trip delay/interruption is yet another matter I have had difficulties with in the past. 

I was flying to Cambodia from Dublin needing to change at Heathrow on one occasion when there was a BLM demo at London City Airport. This led to many of the flights to LCY being diverted to LHR. At the same time, British Airways had a meltdown on their computer at LHR leading to the whole system shutting down. After sitting on the tarmac for 2 hours in DUB, I still had 2 hours to catch my connecting flight. However, the computer failure put paid to that.

I looked up my rights under the EU, and if memory serves, I was entitled to claim €500 for a delay of over 5 hours. The actual delay was 19 hours. When I returned home, I tried to claim, and BA invoked "force majeur" citing the event at LCY as the cause. They denied that the computer problem was related, even though I still had two hours to catch my flight when I arrived at LHR.

I spoke to a solicitor, who told me that the problem I faced was that it was I who had to prove that it was the computer and not the BLM demo that was ultimately responsible for my delat, and BA were hardly likely to help me with that. 

Never mind. I had travel insurance. I looked at the list of benefits, which included "Delays of 12 hours or more: €250". Tried to claim. It turns out that this only applied if there was a mechanical failure of the plane lasting 12 hours or more.

I hate insurance companies.

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22 minutes ago, Marc26 said:

Yes you would likely have the 2 insurance companies fighting it out but in the end, the Thai one never offered "trip interruption" so I believe the Irish one would have had to pay

I had similar issue when I had an accident in Thailand

I claimed my Manulife travel insurance that comes with my health insurance through my employer but I answered that I also has travel insurance through my credit card

And those two fought for months who would pay it, finally my work insurance did

I suspect that being part of a block policy was why your work insurance paid out. I am pretty sure that in my case, they would still be blaming each other.

I recall seeing an episode of "Big Trouble in Thailand" where a Brit made a claim for leg injuries he received on a motor bike. The insurers tried to deny his claim three times. In the first case, it was because he wasn't wearing a helmet. Turned out he was. I can't remember the second reason, but that was also wrong. Finally, they refused the claim because although he was driving on a UK license, he did not have Compulsory Bike Training. So they applied UK law to a Thai situation where CBT was not necessary and avoided the payout. I presume that if the Policy was from TH, there would have been no such requirement.

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