One down – two to go.
Today, the Irish Independent on their website, together with the print edition of the Evening Herald (p. 10) and the Evening Herald online, printed an article by Luke Byrne: “Insurer refuses to pay medical bill for student in US coma”. Tonight, just a few hours after it went life on the Independent’s website, it has attracted 46 comments and was tweeted from that site 184 times.
The absolutely unbelievable part of the article is a statement by Ciaran Mulligan, joint managing director of Blue Insurances, who told the Herald that it was the underwriters, ETI in London, who decided against paying out on the policy. Luke Byrne quotes Mr Mulligan as saying that ‘the wording on the policy had since been changed to clarify that cycling helmets need only be worn on biking holidays.’ And, “We felt that the wording was too ambiguous, so we asked the underwriter to change it. The wording has been changed for this year,” he said.
When, after a week of trying to make contact with the insurance company from the ICU in Cape Cod Hospital, where we did hardly sleep, fearing for Pádraig’s life, in absolute shock at about what had happened to our son, having been asked to send and having sent to them the policy they had sold to Pádraig (yes, I know, it sounds unbelievable), and then being told that they would decline cover – it made our hearts stop and put us into a state of shock.
Now, almost to the day, nine months after the accident, they change the policy to cover casual cycling (with or without a helmet) because the wording of the policy sold to Pádraig was ‘ambiguous’.
Here is some very personal and very hurtful insight and memory: During our last days in Cape Cod Hospital we panicked. We were desperately trying to arrange an air ambulance for Pádraig who was barely in a condition to be flown half way around the world, who had to be fitted with a special helmet (to protect his brain) which eventually had to be taped against the stretcher on the tiny plane, after it had taken the best part of two hours to maneuver our 2.04 or 6’7″ tall son into this tiny aircraft, with his mother carrying his bone plate from his skull in a large styrofoam container on dry ice on her knees because there was no other space on the plane. We were wondering whether we would be able to pay for his hospital. How much were the operations to fit him with a PEG and with the tracheotomy carried out just a few days before he was repatriated going to cost us? He was on a ventilator, and being looked after by three staff who could not really move in the plane at all because it was so small. What if something was going to go wrong during the flight via Goose Bay Canadian Air-force Base and Iceland? It was a very risky evac operation, with Pádraig being very heavily sedated, an operation you only would consent to under huge distress.
We spent hundreds of euro on phone bills trying to talk to more than a dozen people in more than half a dozen companies all acting on behalf of Pádraig’s insurers, nobody prepared to make a decision for the best part of a week. Later, and following many email exchanges, a meeting with Go4Less and Blue Insurance, as well as an internal investigation, they would admit that there were some regrettable communication difficulties. – There still are communication difficulties, and there still is an outstanding bill from the hospital of more than US$100,000. And Pádraig has not received one penny out of his ‘five star’ €6.5m policy because of an ‘ambiguous’ wording that has now been changed: not for his hospital treatment, not for his devastating injuries, not for his family’s expenses to be with him – all of which should have been covered by his policy, had it not been for this ‘ambiguous’ wording that has now been changed. Instead, we suffered the most insane and almost unbearable – but utterly avoidable – distress: first being virtually ignored, than asked for a copy of the policy they had sold to us, then being denied cover in a situation that could not really have been any worse.
I am outraged. They take your money to sell you a €6.5m travel insurance – but they never pay a penny when you most need it.
At the same time:
Today we have achieved the first of our three goals:
No student traveling to the US on this insurance policy will ever be denied cover again for serious injuries acquired when doing
what thousands of young people do:
cycling to work.
Back to Pádraig: he is keeping ok, no major changes. However, today we were called into a meeting with an Oberärztin standing in for the Oberärztin that knows him and has been looking after him so well for the past months. We were told that there was a concern about his bone flap possibly not healing and connecting with the rest of his skull. They are going to do another CT, the first in three or four months, to check this out. While they are doing this, they will also check the condition of his brain chambers including those where cerebrospinal fluid is being produced.
Check out the cover page of Seachtain, the Irish Language Supplement coming with The Independent tomorrow, Wednesday. The crazy swim adventure in ice cold waters off the coast of every county in Ireland with a coast has made it to the Front Page!
What a day.
All your story is so unbelievable!!! And so hard that I have discovered that I really try not to imagine to what you had to go through because it hurts so much!! It is so unfair!!!
And on the other hand I am so sure that similar situations have happened before and therefore your fight is so important because, I am sure, it will help others too and it has already helped others.
Every thing has two sides, out of bad good can come. And in this case, it did. This insurance debacle will not happen to someone in a similar situation again.
Hi Reinhard – Some serious stuff there. I think you should (perhaps you have already) ask a lawyer to have a look at the ‘ambiguous’ nature of the policy, wording etc. I understand that you probably don’t have the stomach for a fight but maybe the insurers will scared of a legal battle and try to settle for something less. All the press is good for this as well.
Also re the bone flap – there was a study done years ago about the effect that TENS – transcutaneous electrical nerve stimulation (it is a physio modality used for pain relief – a lot in pregnant women) had on bone growth. The study seemed to indicate that it could stimulate bone growth. Perhaps it’s worth mentioning to the medics helping Pádraig. It would probably mean having to cut his hair around the area of the flap if they thought it was a good idea! Coinnigh an sin tine lasta! Colm
Thank you so much, Colm, for your info on TENS. We’ll certainly pass that on to the doctors and discuss it with them. – By the way, I think you got a few new fans in Germany. Some nurses play KILA in Pádraig’s room now – they enjoy it so much, they say! And so say all of us!
I haven’t introduced them to your Irish language course yet, we’ll have to do that very gentle, I think:)
This is an article about it. http://www.physicaltherapyjournal.com/content/62/6/840.full.pdf
Colm
Congratulations, Reinhard. You have put so much pressure on the insurance that they had no choice but to change their policy.
All the best especially for Pádraig from your home town Dortmund
Gisela
Thank you, Gisela. I think it will not stop here. This is an unbelievable move by them. It would have been so much easier and cheaper for them in the long run had they just paid up, and more importantly, just helped us when we really needed their help, when we were so “fix und fertig”. By the way, Pádraig is the one BVB fan this family has – because of him, we have black & yellow towels, cups, and bed linen:)
Certainly it won’t stop here! And when Padraig recovers, I hope he will find the time to watch a BVB match in Dortmund! It would be my pleasure to buy him the ticket.
Gisela
You’ll have to join him, Gisela!
Despite everything, it’s incredible that you and Pat have had the strength to speak out and affect change in this area ensuring that no other family in your position will have to deal with this added and unnecessary stress. Pádraig is of course inspirational is his determination and persistence but so are you as his family. Well done!
None of this we would have even dreamt of 9 months ago. We had different dreams. But you are right – what Pádraig is achieving ‘in his sleep’ is something else. They just wait and see what’ll happen when he wakes up! And it won’t be long.