Thread: Thailand holiday horror: $30K medical bill

Example of a rider clause on NZ travel insurance.

When the unexpected happens

8.
You, or someone acting on Your behalf, must contact Southern Cross Worldwide Assistance under the following circumstances during Your Journey:
(a)
if You require hospitalisation or surgical treatment; or
(b)
in the event of Your death.

9.
We are not responsible for the medical standards or services overseas and You acknowledge and accept that different places, countries, facilities and tour operators may have lower medical standards and services than in New Zealand.
10.
Loss, theft or damage must be reported to police, security, or appropriate authorities within 24 hours of the discovery of the loss, theft or damage and a full written report obtained and provided to Us, otherwise Your claim may not be paid.
11.
Claims must be submitted to Us as soon as reasonably possible after the event giving rise to the claim. If We require additional information, We will advise You of this.
12.
All currency mentioned in this Policy is in New Zealand dollars. All sums insured include any applicable taxes or duties.
13.
Original receipts and documents must be provided to substantiate Your claim. Photocopied, faxed or scanned documents will not be accepted. You must provide full evidence of any Unexpected Event to Our reasonable satisfaction.
14.
We may, at Our cost and in Your name, take any action available to recover a claim. You must assist Us in providing information about any third parties who We may recover a claim from and/or in any legal proceedings.
15.
If any information is falsely given or You make a fraudulent claim, this Policy shall become void and no claims will be payable.
16.
The law of New Zealand shall apply and the courts of New Zealand will have exclusive jurisdiction in respect of any litigation in relation to this Policy.
17.
Additional travelling and accommodation expenses for which You make a claim must be of the same nature and class as originally purchased and may not be upgraded without Our prior written approval.
18.
If all or part of any valid claim is covered by another source, including any travel, sickness, accident, health, or income protection insurance policies, banks and/or a credit card providers, or You are eligible to receive any refunds, credits, rebates or discounts, then You must provide Us with those details and We will only pay the difference. If You can claim against anyone else, You must claim against them first before We will consider covering the difference. This condition does not apply to section 5.
19.
Your right to make a claim is subject to, and conditional on, You providing all authorisations which We are required to obtain to comply with privacy laws and codes of practice applying in New Zealand and elsewhere, relating to the collection, holding, use and disclosure of information, which We require to investigate and verify Your claim.
20.
If You do not hold a return ticket to New Zealand at the time of an Unexpected Event We will deduct from any claim, which may include Your evacuation back to New Zealand, an amount equal to Your original carrier’s one way economy class fare for the route used for Your return, as published on the date Your claim is finalised by Us.
21.
The right to any payment which remains unclaimed by You for 5 years after the payment was made available by Us shall lapse at the expiry of such period and such amount may then be applied for Our own use.
Terms of cover

22.
To be eligible for this Policy, You must be:
(a)
a New Zealand citizen or permanent resident; or
(b)
an Australian citizen or permanent resident who resides in New Zealand; or
(c)
on a work permit which allows for a continuous stay of at least two years in New Zealand.
You are not eligible for this Policy if You:
(d)
do not intend to return to New Zealand on the completion of Your overseas travel; or


(e)
are travelling with the intention of obtaining medical or dental treatment, cosmetic surgery, or related advice, overseas; or
(f)
have been advised by a registered medical practitioner that You are not fit to travel; or
(g)
have already departed New Zealand; or
(h)
are not travelling outside of New Zealand.

23.
Cover commences under sections 2 – 1 and 2 – 4 on Your Start Date of Insurance. Cover for all other sections of the Policy commences on Your Start Date of Journey and ceases on Your End Date of Insurance.
24.
The maximum length of Journey covered under a Single Trip Policy is 12 months. The maximum length of each Journey covered under a Multi Trip Policy is 90 days.
25.
You must select the plan that covers all destinations You will be visiting. If You are visiting more than one destination during Your Journey, or during multiple Journeys (if You have a Multi Trip Policy), You must select the plan that covers all such destinations.
There are three plans available:
•
‘SuperWorld’: covers all destinations and is mandatory for visits of more than five days in total over Your Journey to the United States of America, Canada, Japan, Antarctica, Sub Antarctic Islands and the Arctic Circle.
•
‘World’: covers all destinations, excluding the United States of America, Canada, Japan, Antarctica, Sub Antarctic Islands and the Arctic Circle, except for visits to these destinations for five days or less in total over Your Journey.
•
‘Australia/South Pacific’: covers American Samoa, Australia, Bali, Cook Islands, Fiji, French Polynesia, Lombok, New Caledonia, Niue, Norfolk Island, Samoa, Tahiti, Tonga and Vanuatu. This plan also covers visits to ‘World’ and ‘SuperWorld destinations for five days or less in total over Your Journey.
For example:
•
If You intend to travel to Australia and Europe (and Your visit in Europe is more than five days) You must select the ‘World’ plan.
•
If You intend to travel to Fiji and Canada (and Your visit in Canada is more than five days), You must select the ‘SuperWorld’ plan.
If You select a plan that does not cover all the destinations You are travelling to, You will not be covered for events which occur in the destination that is not covered by Your selected plan.

26.
There are two cover types available:
•
‘Individual’: applies to one person, or one adult and any of his or her Dependent Children, all of whom are named on the Certificate of Insurance and are travelling together on the same itinerary.
•
‘Family’: applies to two adults, or two adults and any of their Dependent Children, all of whom are named on the Certificate of Insurance and are travelling together on the same itinerary.

27.
The issuing of a TravelCare Policy shall be at Our sole discretion. We may decline to offer cover or choose to offer cover on different terms and conditions, regardless of whether cover has been offered previously.
28.
You may claim for either Your prepaid costs or Your additional costs, but not both. You cannot become ‘better off’ financially due to a claim.
29.
Any special terms and conditions that You receive in writing from Us will apply in addition to the terms and conditions contained in this Policy Wording.
30.
The terms and conditions contained in this Policy Wording can only be changed by Our written notice to You.
31.
Your Period of Insurance will be extended at no charge if Your return to New Zealand is delayed due to an Unexpected Event, subject to any limitations set out in this Policy Wording.
32.
If You choose to extend Your Journey, You can request an extension of Your Policy by emailing us at info@scti.co.nz prior to Your End Date of Journey. If You have a Single Trip Policy, no extension will be granted once the initial Policy has expired. If You have a Multi Trip Policy, no extension will be granted once the 90th day of a Journey has passed. Any extension to a Policy will be at

Our discretion. Any extension to a Policy will comprise a new Policy and a new premium will be payable. Any events that have occurred prior to the date this extension is issued will not be considered an Unexpected Event under the new Policy.
33.
If any provision of this Policy is held by any court or administrative body (including the ISO) to be illegal, void or unenforceable, such determination does not impair the enforceability of the remaining parts of this Policy which will remain in full force.
34.
The use of the words ‘includes’ or ‘including’ in this Policy Wording does not limit what else is included.
Premium

35.
Payment of the premium is acceptance of these Policy Wording terms and conditions.
Cooling-off period

36.
If You are not completely satisfied with the terms and conditions of Your Policy, You may cancel Your Policy within 14 days of Your Start Date of Insurance but prior to Your Start Date of Journey, and receive a full refund. If You cancel later than 14 days after Your Start Date of Insurance but prior to Your Start Date of Journey, You are still entitled to a refund, less a $35 cancellation fee, or Your entire premium, whichever is lower. To cancel your Policy, visit Travel Insurance New Zealand : Southern Cross Travel Insurance | 35% off on TravelCare. If You cancel Your Policy We will not pay any claims made by You. No premium is refundable once a claim is made or after Your Start Date of Journey (except to the extent that You may be entitled to a refund under the Consumer Guarantees Act 1993).
General exclusions of this Policy applying
to all sections

We will not pay for any claims under any section of this Policy arising directly or indirectly from:
1.
Pre-Existing Conditions.
2.
Mental conditions, nervous disorders, depression, stress, anxiety or travel exhaustion.
3.
Acquired Immune Deficiency Syndrome (AIDS), Human Immunodeficiency Virus (HIV), a sexually transmitted infection (STI), or chronic alcholism.
4.
Pregnancy, except for Illness or emergency medical treatment up to and including the 20th week of pregnancy (providing the pregnancy was without complication prior to Your Start Date of Insurance) and only for medical complications.
5.
Conditions for which You require, are on a waiting list or scheduled to receive, a medical procedure (including overnight or day surgery).
6.
The breakdown or dissolution of any personal or family relationship.
7.
Events relating to animals that belong to You or a Relevant Person.
8.
Intentional self-inflicted Illness or Injury, suicide or attempted suicide, or voluntary abortion.
9.
The influence of alcohol or drugs (other than a drug administered or prescribed by a registered medical practitioner).
10.
Persons invited to Your accommodation or You visiting the accommodation of persons unknown to You.
11.
Participating in any prostitution.
12.
Participating in any gambling.
13.
Hitchhiking.
14.
Your unlawful activity.
15.
Elective or cosmetic treatment, including any complications that arise from any such treatment.
16.
Consequential loss of benefits, including loss arising from the use of frequent flyer points or similar loyalty programmes (except as specifically covered under ‘Sub limits applying to Section 2’), or as part of a prize for a promotion or an employee incentive scheme.
17.
Your loss of enjoyment, amenity or other non-financial loss.
18.
Air or sea travel except as a fare paying passenger on Scheduled Transport services (or aboard charter vessels where crew are included, which are operating within coastal waters, or sightseeing air tours from one location back to that location). We consider for the purpose of this clause that a fare paying passenger includes the utilisation of Your ‘airpoints’, ‘flybuys’ or similar loyalty programme, or as part of a prize for a promotion or an employee incentive scheme.
19.
Activity as an aircraft crew member. This includes anyone in control of a device that leaves the ground.
20.
Touring on a motorcycle with an engine capacity of more than 200cc.
21.
Participation in, or training for, the following activities at any time during Your Period of Insurance:
•
Professional Sport, or individual and team sport competitions which involve monetary prizes over $500;
•
Contact Sport;
•
racing of any sort (other than on foot);
•
motor sports;
•
riding a moped or motorcycle with an engine capacity of more than 200c, or riding a motorcycle with an engine capacity of 200cc or less without a helmet;
•
hunting of any sort;
•
pot-holing or caving;
•
rodeo;
•
downhill snow skiing or snow boarding which happens outside of designated commercial ski areas, or in areas which have been closed for any reason, or competitive downhill snow skiing or snow boarding in any area;
•
microlight flying or kite surfing;
•
ocean yachting 12 nautical miles or 22.2km or more away from populated land, or in a Remote Area;
•
parachuting, paragliding, parasailing, hang gliding, bungy jumping, whitewater rafting, blackwater rafting or whitewater kayaking, unless participating with a licensed operator;
•
abseiling, mountaineering or rock climbing necessitating the use of ropes;
•
Remote Area touring, except as part of a licensed organised tour; or
•
underwater activities involving the use of an artificial breathing apparatus unless You hold an open water diving certificate or are diving with a qualified instructor.

22.
Work undertaken, including volunteer work, other than attendance at a conference, trade fair, business training course or business meeting (provided that no manual activity or manual work is involved).
23.


Events related to a governmental or official authority directive, restriction, prohibition, quarantine, or detention, including border closures and seizures by government authorities.
24.
Riot or civil commotion unless You have already left New Zealand prior to the riot or civil commotion, and You promptly take steps to avoid related risks.
25.
Events where a travel advisory risk rating of ‘High’ or ‘Extreme’ has been published on the New Zealand Ministry of Foreign Affairs and Trade website (Official New Zealand Travel Advice - SafeTravel.govt.nz), prior to Your Start Date of Journey, except for cover as provided under section 2-1 if the travel advisory risk rating ‘High’ or ‘Extreme’ was published after Your Start Date of Insurance but prior to Your Start Date of Journey.
26.
You travelling to a country engaged in war, invasion or civil war whether declared or not.
27.
Acts of foreseeable violence or involving military operations.
28.
Acts of Terrorism (except for cover as provided under section 1-1).
29.
Nuclear weapons materials or ionising radiation or contamination of radioactivity from any nuclear waste or from the combustion of nuclear fuel. For the purpose of this exclusion combustion shall mean any self-sustaining process of nuclear fusion or fission.
30.
Intentionally or recklessly placing Yourself in circumstances, or undertaking activities, which pose a risk to Your personal safety (except in an attempt to save a human life) or the safety of Your baggage or personal items.
31.
Your refusal to return to New Zealand after the date when You may, in the opinion of Our medical adviser, have safely been evacuated to New Zealand at Our cost.
32.
Any claim where Our directions or instructions or those of Southern Cross Worldwide Assistance have not been followed.
33.
Services provided by a family member or friend including but not limited to accommodation or health care.
34.
You having lied or been less than truthful in the application or claims process when answering questions and/or proving statements, relating to Your application or claim.

Read it all, I did and spotted the missing coverage. Nemo, my wife was the agent, but she had me go through all the fine print as it was in English.

The bike should have insurance and that covers to a certain amount of hospital treatment. One of the bikes I had was hit by pickup that drove off. The standard insurance paid their bills of about 15,000 baht each with just a photocopy of the insurance receipt.

If the van driver hit them surely it has insurance as well ?

If they are stuck contact the Australian Embassy they may be able to help at least get the treatment enough to get back to Australia.

Mark