EHIC - is it enough when travelling?

Who remembers the famous late Max Bygraves catch phrase .... "I want to tell you a story" - well so do I!
When going on holiday you are constantly reminded to take out travel insurance as an EHIC card alone is not adequate. The European Health Insurance Card will cover any necessary emergency treatment required as part of a reciprocal health care agreement between all EU member states.  However, it will not cover the cost of repatriation etc if deemed necessary. Many people take out the cheapest and hope for the best - in these economically strained times understandable, assuming that the "medical insurance" part of the policy will cover all eventualities.

It has been well documented the need to disclose ANY pre-existing medical conditions, otherwise your claim may be null and void.  But when you take out the travel insurance you assume that in the case of a medical emergency you automatically go to the private hospital and you will be taken care of.... well have I got news for you!

This is not a fairytale with a happily ever after, but a true and honest version of events which unfortunately ended tragically. I have personally spent many many hours speaking with the various people directly involved and everything which I am about to tell you is factually correct.

A group of 7 friends booked a package holiday with Thomson, staying at Medplaya´s Regente hotel in Benidorm, arriving Tuesday 1st May. The couple I am going to tell you about took out a separate travel insurance, which they researched via the internet and satisfied with the cover offered went ahead a booked it. On Friday morning the husband woke the wife at around 7am to complain that he was having chest pains and trouble breathing. In a panic and not confidant how to call for an ambulance she ran downstairs to the reception in her nightie and asked him to call an ambulance, as she thought her husband was having a heart attack. He spoke fluent English and did so immediately, stating "suspected heart attack" to one of the towns private hospitals  .... which I cannot name for fear of bearing sued! This was all logged in the hotel diary as is procedure in such circumstances.

Villa Joyosa Social Security hospital

A second call was made for the ambulance after it had not arrived 10 minutes later, but when it did turn up there was only an ambulance driver - wearing civilian clothes and no uniform. He went up to the room with a wheelchair and NO resuscitation equipment or bag! He made no attempt to treat him but somehow struggled to manoeuvre him into the chair and literally dragged him to the lift .... his feet were catching under the bed in the process much to his wife´s distress. Downstairs he realised that the patient needed to be placed on a stretcher and on seeing this the man behind reception quickly went to assist him... acting out of compassion, where he was transferred onto a stretcher on the pavement.

The wife sat in the front with the driver whilst her husband was in the back of the ambulance unattended.  The ambulance arrived at the private hospital at which point the wife was told to go back to the hotel to get the passport and insurance documents - yes shocking! When she returned shortly after she was told the tragic news that after trying for some time her husband could not be revived and had passed away.

After hearing this shocking sequence of events I spoke to the widow and promised to investigate on her behalf. Initially the hospital director met with me and listened to my concerns as to why a single driver was despatched to a suspected heart attack with no backup or equipment. He promised to look into it and get back to me as soon as he had an answer.

The following week I was contacted by the "director of marketing" at which point I insisted on a face to face meeting - I must say I was rather shocked that such a serious situation had been passed onto the marketing department! We met and he had an interpreter, although his English was adequate and my understanding of Spanish is sufficient. He bought the deceased's medical file and was happy to go through it with me, but throughout the meeting kept reiterating that "all procedures had been followed"- particularly when I asked if it was normal procedure to send out one driver to an emergency. He told me that all the other ambulances and staff were out on call - bizarre so early in the morning.

I requested transcripts of the emergency call as he said it all hinged whether it was logged as a suspected heart attack. After this, and noting that I would be going further, the conversation and meeting came to an abrupt end. I heard nothing for a few weeks to then be told I needed written permission from the widow that I was acting on her behalf... funny how they were more than willing to share his notes beforehand! I received a letter of authorization, which was witnessed and signed and forwarded this onto the hospital. After no contact I again got in touch with the hospital to be told that I now needed a power of attorney....  and so it goes on. They basically do not want to talk and are keeping quiet.

Free Social Security fast response ambulance

I contacted the insurance company to ask whether the hospital had been paid for "the service" they provided and furnished them with the facts of the situation, suggesting that they hold off until I had delved further. I wanted to know whether they were claiming for a fully equipped ambulance and call out team.... as this was definitely NOT the case.  I asked the agent for the insurance company whether it mattered which hospital he was taken to and by which ambulance and he didn´t actually know. It is a fact that each hotel in Benidorm has "an agreement" with one of the private hospitals that if a foreigner needs an ambulance then they call them, receiving a commission. I know that this is 100% true having spoken with several ambulance drivers from the private sector.

Being somewhat concerned that the agent didn´t know the answers to my questions, and bearing in mind that he was advising customers I got in touch with the insurance underwriter... they are the ones that actually pay out for any insurance claim. I was taken aback to discover that despite having private insurance the policy did NOT cover for a private ambulance or hospital where there is an NHS/ Social Security hospital nearby. He should have gone to the nearby Villa Joyosa hospital and NOT to a private hospital and that the insurer would not be paying out for any invoices submitted by the private hospital. He told me it is the responsibility of the policy holder to know which number to dial in an emergency - so ensure you do this BEFORE you leave.

I also contacted a number of other companies which advertised travel insurance on the internet - one of the more popular ones being the Post Office, to ask the same question. They promised to get back to me as they too did not know the answer - to this date I have not heard back from them. It appears that when you take out a policy "everything" is covered... however, when you need to make a claim its another story!

To date the widow has not had any correspondence from the hospital and not been asked for payment for the service they provided - perhaps they realise its better to just leave alone and not stir things up in the circumstances.  I am deeply disappointed that I was not able to get back to her with a clarification of what happened and whether a similar situation can be avoided in the future for others. She said that she was more than appreciative to everyone at the Regente hotel for their help and compassion during and after this awful  experience. The insurance company were also excellent in repatriating the body quickly.

My personal advice, if you require an ambulance is dial 112, which is the 999 equivalent . Incidentally, 112 is a European wide emergency number, free to call from any fixed line or mobile and also works in the UK. In an emergency you will be sent a fully equipped vehicle, 2 paramedics and a doctor. It can only leave you wondering if this had happened would there have been a different outcome?

The conclusion to this story is this;  Do not assume that as you have taken out travel insurance, in the case of a medical emergency you WILL be covered to go to a private hospital. The agent selling the policy didn´t know, he just said "I think so" ... so make sure you get written confirmation that you will be covered even if there is a social security hospital within 10 km, otherwise you will be billed. The medical part of the policy will cover for repatriation and need to prolong your stay in the case of an emergency but not always for private care where there is adequate NHS equivalent. As insurance underwriters are looking to cut on payouts, they are checking every case more thoroughly than they use to.