Clinical Negligence & Catastrophic Injury Solicitors
Travel insurer to pay compensation after man's death.
One of Britain’s biggest travel insurers is being forced to pay thousands of pounds’ compensation to the family of a policyholder who died after being denied a medical evacuation flight.
The Financial Ombusdman ruled against Travel Insurance Facilities, the company behind brands, including Holidaysafe, Alpha, and Boots, for leaving Martin Blake, 72, in a hospital without the facilities to care for him after he suffered a heart attack on one of the Canary Islands.
The ruling is crucial for travel insurers because it shows that they cannot renounce their responsibility to policyholders to overseas hospitals. The insurer, which spent 18 months disputing the family’s complaint, claimed that it was not obliged to move Martin Blake to a hospital that could treat him.
The Ombudsman found that, while the level of care in a foreign hospital isn’t something insurers have control over, or responsibility for, they must still exercise their discretion to repatriate, or move, policyholders fairly and reasonably.
Mr Blake, who was insured with Flexicover, which outsources claims to Travel Insurance Facilities, fell ill on Lanzarote in February 2018. He was admitted to a local public hospital that identified that he needed a coronary angioplasty. As it was unable to perform the procedure, Mr Blake was put on a waiting list for transfer to a larger public hospital on Gran Canaria.
Spanish doctors told the insurer that Mr Blake would have to wait about a month and that there was a risk of complications if he was not evacuated sooner, either to the UK or a private hospital elsewhere in Spain.
Even so, the insurance company’s medical director refused to arrange an air ambulance, insisting that Mr Blake was not well enough to fly. It also declined to transfer Mr Blake to a private facility claiming it was concerned about practices at that hospital group.
In the ruling, The Financial Ombudsman said the insurer did not arrange for Mr Blake to be moved even after being told that his condition was worsening.
On one call to the insurer, a Spanish doctor said: “Look, the air ambulance is so much better than here. He is not even being monitored here as I do not have a monitor for him. Not even his saturation levels are being monitored; I don’t know if you are understanding what I am saying. We live next to Africa and do not have catheterisation.”
After six weeks, Mr Blake’s daughters paid for an ambulance which cost £22,000 to bring their father home but he died two days later in Wrexham Maelor Hospital after suffering a stroke in the Spanish hospital.
When the family complained to the Ombudsman, an initial investigation concluded that the insurer had failed to act “fairly or reasonably” in “such grave circumstances” but Travel Insurance Facilities disputed this, claiming that the Ombudsman did not have jurisdiction to question the clinical judgment of its medical director.
However, the Ombudsman dismissed this and highlighted that the Spanish doctors had made it “very clear” that it was in Mr Blake’s best interest to be moved. The Ombudsman’s ruling also noted that Mr Blake would have been treated in the UK “within a very short period of time” had he been transferred.
It was likely Mr Blake had suffered “extreme distress” because of the insurer’s inaction, the Ombudsman said.
She wrote: “I think Mr Blake was there for approximately four weeks after he should have been moved to the UK, suffering from a life-threatening condition, and feeling as if his insurer had abandoned him.”
The Ombudsman also dismissed the insurer’s argument about why it refused to transfer Mr Blake to a private facility. She pointed out that it left Mr Blake to receive medical care under the reciprocal health agreement, which was “something he’d be entitled to anyway as an EU citizen who had travelled without insurance.”
She added that selling travel cover for the Canary Islands while operating “an undisclosed company policy that shut out a major healthcare provider there” left policyholders exposed in a way that they would not have known when they bought the insurance.
She concluded: “I don’t think Travel Insurance Facilities has justified why they thought the risk of leaving Mr Blake untreated in Lante was more acceptable than the risk of bringing him home, or sourcing an alternative hospital, where he could access, at least, proper monitoring, if not treatment.”
The Ombudsman ordered URV, the German company that pays for claims insured by Travel Insurance Facilities, to pay Mr Blake’s estate £7,000 for his distress and inconvenience. Mr Blake’s daughter, Michelle Sullivan, said: “Losing our father under such circumstances has been unbearable. My sister and I are exhausted with the distress this has caused.”
Travel Insurance Facilities offered its “deepest sympathy” to the family but pointed out that part of the delay was because of a backlog of cases at the Ombudsman and that the case gave rise to “difficult issues concerning the way in which insurers deal with medical advice.”
The insurer added that it acted on the advice of experienced medical professionals, which considered a flight to the UK too dangerous.
It said: “The Ombudsman has previously accepted that this type of medical advice could not properly have been ignored. In this case the advice was that repatriating Mr Blake at the time requested by his family, or transferring him to another hospital, was against his best interests.
“However, the Ombudsman has now made her decision. We will review our policies and procedures in the light of this to identify improvements we can make. The desire to do what is in the best interest of our customers is at the heart of all of our decision making.”