Travel insurance nightmare: 'I don't think I'd leave the country again' 

Costly travel insurance may give you peace of mind in case you fall ill abroad, but one Cork woman found using her European Health Insurance card would have been so much easier and less stressful

PJ Lynch, recuperating with his dogs.

A Cork woman is advising holidaymakers to rely on their European Health Insurance cards rather than costly travel insurance after fears that a €20,000 hospital bill for her partner would not be covered.

Kate Durrant says the stress of the experience has made her and her partner reluctant to ever travel overseas again for a holiday.

Ms Durrant took out a comprehensive travel insurance policy through her travel agent, before going to Palma for a two-week break at the end of September.

PJ Lynch, pictured with his partner Kate Durrant, became very ill on holiday.

The 53-year-old, who lives in Blarney with her partner PJ Lynch, aged 71, said she wanted full peace of mind on her holiday.

“I was so careful to ensure we had the all-important travel insurance, taking out a medical extension and calling them carefully to list out his ailments; paying the price of a cheap holiday for the insurance alone but we’re at that age, and he is medically very vulnerable, you don’t take chances,” she said.

After three days in Palma, PJ became extremely ill and required an ambulance. The driver asked Ms Durrant if they had cover and so they went to a private hospital called Quirónsalud.

She said the majority of people in the hospital were tourists in similar situations, and that it seemed to be the hospital to go to if you had travel insurance.

“There was a guy wandering around the hospital after his wife had been knocked down and she had been in intensive care for weeks and I think one-week costs €60,000 and already this poor man of 86 was wandering around not sure whether the bill was going to be covered or not,” she said.

Intensive care

PJ was subsequently diagnosed with sepsis and required urgent extensive care, which Ms Durrant said saved his life.

After the hospital advised her to ring her insurer, Ms Durrant was initially put at ease following the call during which she was offered a hotel to stay in, which she declined.

However, she said this sense of ease evaporated once she realised they had not requested a medical report from PJ’s GP until day 11, and when doing so sent the request to the wrong GP entirely.

Ms Durrant said she was then subjected to constant worrying phone calls, emails, and delays.

While the claim was being discussed, the hospital bill — in excess of €600 per night — was mounting and Ms Durrant did not know if the insurer would cover the cost.

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“We have our European Health Insurance cards and realistically life would have been much simpler if we had used them because we would have had extremely good treatment in a public hospital without any of the stress.

“I just presumed if you were honest and did it right as much as you could, you would be covered,” she said.

“With anybody with complicated medical issues, the way I feel at the moment I don’t think I’d leave the country because the experience was so stressful that there was no holiday,” she said.

Despite PJ having sepsis, the insurer queried the fact that he had had a kidney removed more three decades ago. They then began to question the fact that he had a catheter. They then questioned a heart condition which Ms Durrant said he does not have.

It seemed they were going to keep on going until they found a reason not to pay out on a legitimate claim.

Ms Durrant booked flights home without the medical assistance they needed on the flight and was due to pay half of the bill before leaving the hospital as they could not leave without doing so.

“They were supposed to repatriate him and — in the end — we came home on our own because all the time they were fighting about paying the claim, which went on for a period of about eight or nine days, they hadn’t even started to make repatriation arrangements,” she said.

PJ was still in the hospital eight days after he was given the all-clear to go home, due to the fact the claim had not been resolved.

Finally, 20 hours before they were due to leave the hospital, the insurance company paid the bill which came to €20,000.

Ms Durrant said the experience made her realise just how vulnerable you can be when abroad in a medical emergency.

Speaking about Mapfre, the underwriters who dealt with PJ’s claim, Ms Durrant said: “They need to remember that they’re not dealing with potatoes or lumps of coal, or commodities. We’re not stock and share to be sold and made money out of.

They’re dealing with people’s lives.

"I rang to ensure he was covered and gave them every medical condition and still we were let down by people who should have been in our corner when we needed them but instead made our very bad situation worse."

“He’ll never leave the country again,” she said.

Insurer's response:

A spokesperson for Mapfre said they cannot comment on individual cases but added: “As a responsible travel insurance provider we have to follow specific, well-defined processes in dealing with any oversees medical emergency assistance claims.

“Often there is engagement needed with various GPs, hospitals, and other stakeholders throughout the assistance process, which can make them more complex. We always aim to manage communications of this nature as soon as possible.” 

Executive director of McCarthy Insurance Group Paul Kavanagh said he has heard several stories similar to that of Ms Durrant.  

He described travel insurance as a “luxury,” one that the McCarthy Insurance Group stopped providing at the outset of the pandemic due to uncertainty.

Travel insurance can be added on to cover “incidentals” but should never be used to cover essentials such as healthcare, according to Mr Kavanagh.

“Once you have your European health card, you can walk into any hospital in Europe,” he said before adding that those with private health insurance can access any hospital in the world while abroad.

Experts say travel insurance should not be used to cover essentials such as healthcare.

The European Health Insurance Card (EHIC) allows access to medically necessary, state-provided healthcare during a temporary stay in the EU or EEA.

Among Irish Life Health, VHI and Laya, the cheapest private health insurance plans cover between €55,000 to €100,000 for emergency hospital admissions abroad and between €1m to €2m for repatriation costs.

“What’s going to happen? Your baggage will go astray? We saw that happen in Dublin, Schiphol and Heathrow, people never got their bags back. If that’s what you want to cover, that’s what travel insurance is for in my book,” Mr Kavanagh said.

“I wouldn’t be relying on it for my medical care,” he said, adding that his first port of call in a medical emergency abroad would be his EHIC.

Mr Kavanagh said that those without an EHIC or private health insurance have little or no choice but to seek travel insurance. However, he urged those in this cohort to purchase premium cover. “Not a policy for €15,” he said.

750 complaints since 2019

The Financial Services and Pensions Ombudsman (FSPO) said it has received 91 complaints this year to date — and 750 since 2019 — concerning travel insurance.

The most common reason for the complaints is the wording of terms and conditions of policies which results in misunderstandings amongst policyholders and subsequently, claims being declined.

MaryRose McGovern, Financial Services and Pensions Ombudsman (acting), said better clarity of the wording in travel insurance policies would lead to fewer complaints.

“The FSPO has previously highlighted that the clarity of the wording in insurance policies could be improved. Consumers looking to purchase a policy that is suitable to their needs, should not have to struggle to understand the terms and conditions of a policy.

“Insurers should therefore ensure that these terms and conditions are comprehensible and as easy as possible for their customers to understand,” she said.