SALLY SORTS IT: My battle to get insurer to pay £150k U.S. hospital bill

While skiing with my family in Utah, in the U.S., on Christmas Eve 2021, I had a serious fall. 

I was later diagnosed with a pulmonary embolism and spent six days in intensive care.

I had comprehensive travel cover with a firm called Puffin, whose policies are underwritten by Axa.

Denied: Axa is refusing to pay out on a travel insurance claim after the policy holder suffered a serious fall while on a skiing holiday in a America

My daughter-in-law made a payment of more than $3,000 (£2,600) to the hospital, with a further $81.05 (£70) for medication. 

To date, she has not been refunded and the insurer still hasn’t settled the claim — despite me making many phone calls.

It has now decided it requires yet more medical information from my GP. In addition, a letter to the U.S. hospital confirming and guaranteeing payment for other bills has yet to be sent.

My GP has already submitted my medical history and stated that Axa has no grounds for citing non-payment because of an existing condition which could have caused the health incident.

Please can you help?

H. M., Baldock, Herts.

Sally Hamilton replies: You should be taking it easy following such a health scare. Instead, you’ve faced an avalanche of obstacles trying to have your ski accident bills met.

By the time I contacted you, in September, the situation had gone downhill. Your daughter-in-law, who lives in Las Vegas with your son, was being chased by debt collectors on behalf of the hospital that treated you, for $180,000 (£150,000) in unpaid medical bills.

This was alarming and confusing, since she had expected to be reimbursed by Axa for the more than $3,000 she had kindly paid up front on your behalf at the time of the accident.

Over many months of trying to sort out the claim, you say you’ve been cut off more than once while on the phone to Axa customer services. 

You later found out that the firm had been dialling an incorrect number for you when trying to return your calls. It had your email address, but for some reason chose not to contact you this way.

For months, the insurer was still checking your medical history. You said the GP had confirmed long ago that your emergency in the U.S. was the result of your fall on the slopes and unrelated to a deep vein thrombosis you developed on your knee following an operation five years earlier.

Your frustrations were already at a peak, but the demand from a collections agency for the unpaid hospital bills pushed you over the edge.

I contacted Axa to ask it to explain its side of events and to accelerate the claims process. A few days later it confirmed it would be settling the claim in full.

Its defence for the lengthy delays was the necessity to chase your GP several times for essential medical documents, which it says were not received until August.

You dispute this version of events, but Axa is insistent this was central to the claim’s delay.

Nevertheless, it admitted the service you received was not up to scratch and that errors were made. This includes the firm calling the wrong phone number and not attempting to contact you by an alternative method.

And the reason your son’s wife was chased for those vast hospital bills? Axa’s agents in the U.S. had put the wrong dates on the paperwork which was sent to the hospital to confirm the insurer would meet the costs of your stay.

It seems the hospital feared it might not be paid, so turned to its next point of contact — your daughter-in-law.

She should no longer receive emails demanding frightening sums. But if she does, she should direct them straight to Axa.

A spokesman says: ‘We are very sorry for the delay that H. M. experienced when claiming on her travel insurance and for the inconvenience caused.

‘We have performed a detailed review, which has highlighted that there were a number of external factors that contributed to the delay, such as late GP medical reports. We have been in touch with the customer and have settled the claim in full.’

The insurer paid you an extra £200 as an apology.

Snared by card payment firm’s auto-renewal policy 

My partner took on the catering for a golf club last November. He signed a 12-month contract with Take Payments so customers could pay by debit or credit card. 

Unfortunately, however, the arrangement with the golf club didn’t work out.

When he originally met the Take Payments salesman, he was told he would be informed when the contract was coming up for renewal so he could choose if he wanted to continue with it.

But it transpires the company operates an ‘auto-renewal’ policy, which my partner didn’t know.

As soon as he realised, he confirmed he no longer wished to continue with the contract. 

Unfortunately, his call was two weeks late for the notice period apparently required and the company is insisting his contract is renewed for another year at more than £30 per month.

It is an unnecessary outlay at a time when his business is already suffering the effects of the cost-of-living crisis.

G. K., London.

Sally Hamilton replies: It seems Take Payments has a most appropriate name — willing to take payments from its customers but less enthusiastic about stopping them when asked.

Your partner admits that his notice to terminate was late, but he believes the company could have used its discretion after he had explained the situation, including relating what the salesman had told him about a renewal reminder.

I, too, felt it could have been more flexible, and so stepped in on your partner’s behalf.

An executive got on the case immediately and I am pleased to say that within a day or so, your partner received a text informing him that his contract would not be renewed after all, saving him more than £360.

I received no explanation from Take Payments. But your partner is mightily relieved.

Auto-renewal of any service can be convenient — especially for providers — but it is good practice for customers to be reminded in advance when a contract is about to restart.

• Write to Sally Hamilton at Sally Sorts It, Money Mail, Northcliffe House, 2 Derry Street, London W8 5TT or email [email protected] — include phone number, address and a note addressed to the offending organisation giving them permission to talk to Sally Hamilton. Please do not send original documents as we cannot take responsibility for them. No legal responsibility can be accepted by the Daily Mail for answers given. 

This post first appeared on Dailymail.co.uk