As we were talking about medical issues abroad this week, another story of an impaired Finnish tourist in Bali is currently making the rounds on social media and Finnish news, as he feels abandoned by the insurance company (AXA) that’s the underwriter of his Amex card policy.
We want to look at this case and take it as an example of why credit card insurance isn’t necessarily enough when traveling abroad and engaging in risky activities, especially sports.
Traveling the world comes with many pitfalls, and those aren’t all related to transportation alone, such as flight delays, cancellations, or baggage issues. Even worse is when you’re encountering a medical issue of any kind and find out that you’re underinsured or not covered at all.
This particular case caught my eye in one of the American Express groups I joined online and where they linked an Instagram post of a person who apparently has a Finnish Amex card with a travel insurance as part of the benefit portfolio.
He then traveled to Bali, where he went surfing and, in a very bad stroke of luck, broke his back. He was transported and cared for in a local hospital but there appear to be issues in terms of care and treatment. It doesn’t surprise me, Bali is an island, and while they do have hospitals there, these aren’t world-class care as you’d find it in the major cities in the region where international hospitals are truly first-class.
Read and judge for yourself based on his Instagram post:
There seem to be communication issues between the patient and AXA, which is the insurance underwriter. I checked with John, as he has a Finnish Amex as well, and he confirmed that AXA is their insurance backer for the policies offered within the AMEX Finland card portfolio.
The problem here doesn’t seem like he doesn’t get any care but more to the tune that he’s concerned about the standard of care. I’m sure the hospital staff does the best as far as their abilities go, but that might not be enough. In order to authorize a repatriation flight for a patient, insurance companies really have to be convinced that there is an immediate danger to the patient and that his condition will likely worsen at the current location. All insurance companies have their own medical staff to assess the situation, of course looking after the company’s interest as well. The parties involved (patient, insurance, hospital, third parties) don’t exactly see eye to eye in most of these cases.
Meanwhile, the guy has opened a GoFundMe page with a 35,000 Euro donation goal (already reached) which appears to be rather low for a MedEvac flight to Europe.
I’m usually not a big fan of these GoFundMe’s as there is very little accountability for how donations are actually spent, and often, these campaigns are looking for a handout. In this case, I’m willing to give him the benefit of the doubt. The guy is desperate, and he does have insurance, which has left him hanging (so far); he’s not one of these people who travel without any backup around the world and then cry wolf if something goes pear-shaped.
There was also an article in Finnish media about this case, which probably helped gather some attention with Amex and AXA in Finland:
… Palomäki has an American Express (Amex) credit card and thus travel insurance. The insurance is handled by an insurance company called Axa, more specifically Axa’s London office. Communication in Axa’s direction is handled through a company called Falck Global Assistance (Falck).
Falck is a service provider whose customers include insurance companies. During the first three days, Axa was not contacted at all. Palomäki was lying in the hospital, and according to his own words, he could hardly move his limbs.
Soon the treatment errors also started, says Palomäki. First, his hand, where the cannula was attached, became inflamed. “Probably because the cannula was too long, too much medicine was given or the equipment was unclean,” Palomäki estimates. The inflammation was followed by a three-day fever of 39 degrees and bronchitis. According to Palomäki, the warning signs started ringing when he had to ask for blood tests and X-rays, as well as antibiotics. “Later, I was also changed to a softer bed, which made the healing and pain almost return to the starting point.”
Falck consulted a Finnish orthopedist about Palomäki’s situation, who recommended evacuating the Finn to at least Singapore or Bangkok for better treatment “as soon as possible”. In the end, Falck also managed to get in touch with the insurance company Axa. On Tuesday, he received information about the evacuation to Bangkok. On Wednesday evening local time, however, crushing information arrived.
According to Axa, Palomäki is not yet ready to fly and is receiving “appropriate treatment” at the current hospital in Bali. In Bali, however, the doctor had given him a flight permit for a medical flight, says Palomäki. “It is common knowledge that hospital care in Bali is not at the level it should be.”
HS has seen the message Falck forwarded to Palomäki containing Axa’s decision to deny the flight. Palomäki describes how he felt crushed and broken after the news about the cancellation of the evacuation flight came. “Let’s give a call that I can leave and then it will be withdrawn. Yes, I would be surprised if an Amex customer gets insurance as an automatic service, and then it’s like this,” describes Palomäki.
At the moment, Palomäki’s fate is to wait in a Balinese hospital until his condition allows him to fly on a regular flight. “Of course, it is frustrating information if I have to wait in the hospital for two or three weeks. I would like to go home for Christmas.” He emphasizes that he specifically blames Axa for the situation. According to him, Falck has done everything he can.
As a last resort, Palomäki decided to publish an update on his situation on Instagram and start fundraising himself. He is trying to collect the money on his own initiative for the medical flight. …
I can imagine it to be very frustrating when the only hospital at your disposal isn’t in a position to treat you adequately, even if everything is fully covered by insurance. Maybe it’s a training issue, or the equipment simply isn’t available. A hospital in Bali isn’t a world-class facility like an international hospital in Jakarta (and even the wealthy people from Jakarta usually fly to Singapore or Bangkok for important treatments).
It’s not exactly clear what Amex card the patient has. John forwarded me the insurance conditions of his Platinum card, and the insurance coverage depends on at least 75% of the trip being covered with the Amex card. During the claim process, they will ask for receipts to make sure these conditions were met.
Travel insurance is usually quite cheap in Finland (or Germany and other EU countries). You can buy a separate policy for like 15 Euros and it would be roughly the same coverage as via Amex and other cards. The caveat is that these insurances usually max out at 30 days (Amex Finland apparently allows 120 days for the Platinum Card). But are these policies really enough to cover you?
As far as hospital, clinic, and maybe a GP visit costs are concerned, yes, I don’t doubt that they will cover you properly. But repatriation by Air Ambulance or MedEvac is a different story. Insurance companies do everything they can to avoid this because of the enormous costs associated with such a situation.
If coverage for medical evacuation is important to you, there are specific providers such as MedJetAssist that cover you specifically for evacuations (in addition a health policy). I met someone on a cruise who told me about it, and he mentioned they are EXPENSIVE ($300-500/year), but if push comes to shove, they will get you home.
Conclusion
This situation shows once again how complex it can be when traveling overseas and getting caught up in medical problems, especially in remote locations such as islands or – god beware – a cruise ship. In this particular case, the Finnish tourist has coverage through American Express, but their underwriter AXA appears to be difficult.
It’s impossible to judge the situation that’s currently going on (especially as a non-medical professional), but I just hope that the insurance finally comes through for him and organizes transport to an environment where he’s properly cared for. Amex and AXA did cover Henri here in terms of medical expenses, just the repatriation appears to be a contested issue. I definitely wish him well and hope he gets home soon!
The essence of the story here is that basic insurance might not be enough, and oftentimes, these policies attached to credit cards are complicated, especially when there is a spending requirement attached, and the insurance requires receipts of how much you paid on the respective card for this trip. Can you imagine the paperwork for a multi-month trip? Sometimes, a separate policy is much easier and more comprehensive.
Have you ever claimed through your credit card backed travel insurance?
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