Laya Medical emergency or death abroad

Hi All,

It is a long post but please bear with me. This is about an issue that most of us care about: safe return from holidays back home in Ireland, alive or not, and insurance cover.

I am in the process of shopping around for a travel insurance. I want my safe return to Ireland, in case of medical emergency or death abroad, to be covered. We all have heard stories about how stressful and costly it can become.

So first I started checking what exactly my partner and I are already covered for under our existing Laya private health insurance schemes Essential Assist & Flex 500 Explore in this respect.

Below are my findings.

1. Death abroad/ repatriation of remains: Not covered under any of the two Laya schemes.

Is anyone aware of any Laya scheme that would cover such an eventuality? If not - I guess travel insurance.

2. Medical emergency:

Laya General Rules – Policy Booklet reads as follows:

p.22 under ‘Treatment Overseas’: Emergency hospital admission overseas ‘limit allowed on a members scheme applies to each episode of illness or injury. An episode means a continuous period of illness or injury. Periods of illness separated by less than 28 days shall be treated as continuous.’

‘Your membership of the scheme will end immediately if you stop living in Ireland for a consecutive six month period.’

p.22 under ‘Repatriation’: ‘This is benefit of up to €2,000,000 towards the cost of medically evacuating a person to the nearest medically appropriate country (…)’

p.23: ‘(…)We will only pay the costs of repatriation or evacuation which is arranged by a laya healthcare approved overseas provider.’

I understand that Laya will cover medical evacuation of a person only to a nearest medically appropriate country, which may not be Ireland at all. Hospital stay may turn out to be longer than 6 months. So this person, possibly able to travel,

- may be left without medical cover before the 6 months are up, as there is a limit per ‘episode’,

- will be left with no medical cover at all after 6 months, as they have 'stopped living in Ireland',

- when back in Ireland, will most likely be unable to resume membership of Laya as it was before going abroad.

Is my interpretation correct? How to ensure return back home and family, to a hospital in Ireland, if Laya representative says 'no'?

Your comments and advice will be most appreciated.

Many thanks!

Mona

I think you are seriously overthinking this.

In the very unlikely event that you are in a foreign hospital, and medically cant be moved to a hospital in Ireland,even for 6 months , you are still a resident of Ireland.

Thank you huskerdu for your reply.

I agree with you re residency. However, Laya's policy wording does not refer to residency. It refers to 'living in Ireland'. And this is open to interpretation and does not have to mean residency as defined for tax purposes in Ireland. Being in a hospital abroad means living outside Ireland, regardless of residency or citizenship status. This is in my view an obvious interpretation.

I agree with you - moving to Ireland from a hospital abroad may be possible before the 6 months are up. But - who is going to pay for this? Laya only commits to a payment towards the cost of medically evacuating a person to the nearest medically appropriate country. Decision what country it would be is in the hands of the Laya's healthcare approved overseas provider. There is no mention in the policy that Laya would ever bring a person back to Ireland. At least I did not find it.

My experience with public works contracts taught me first hand how important use of words and their meaning and possible (mis)intepretation is. Also, many issues discussed on askaboutmoney come down to understanding and interpretation of policy documents.

What I found in my Laya's policy document alarmed me. Am I the only one who finds it worth looking into?

You are over thinking it. When you spend a number of months in a hospital you are not living in a hospital, you are staying in a hospital. The general thesaurus definition, if you want to get technical on interpretation, of the verb to live would be to make one's home, one's residence, to be settled. Which you would not be in a hospital and what you would remain to be in ireland.

Also the rule of contra preferentum would apply to Laya's wording so it would favour you as opposed to them in a court. But that is always why they are being so casual as to say "living in Ireland". Because they are trying to keep their wording uncomplicated. Not so everyone needs to forensically examine each word.

The general point that needs to be made is that the travel insurance which comes as part of a Health insurance policy is very limited
and should not be relied on if you want to feel secure that you have adequate insurance in the event of something going wrong.

If you are concerned, Get proper Travel insurance.

Thank you for all the replies, they are most helpful.

Huskerdu, you may have noticed from my original post that the reason why I started looking into details of the private health insurance cover I already have is because I am in the process of shopping around for travel insurance. So it seemed reasonable to check what I am covered for already before I decide on the type of travel insurance cover next.

Travel insurance offers a discount to people with a private health insurance. I would think it is a good idea to understand what each one of them covers. And since I don’t know the nitty gritty of how it works and what matters when checking and choosing insurances, I asked my questions.

Thanks to all your replies I understand some things better now. Most appreciated!

"Travel insurance offers a discount to people with a private health insurance."

Yes, but usually because the Health Insurer will be involved if there is a claim. Health insurer will not repatriate a dead body, any more than they will arrange transportation in Ireland from place of death to undertaker.

Do the family pay for repatriation of remains then? I know the Kevin Bell Trust have helped quite a few families who have found themselves in this awful situation...

This subject along with other questions regarding of what we are really covered for in any insurance policy have been discussed on various threads on this forum. Seems to me that when you read all the small print the customer is insured for very little. We all buy annual travel insurance; we extend our health insurance; we have our broker get a deal. But, whatever way we look at our travel insurance - we're covered for all eventualities until something happens. When you claim the insurance company circles its wagons and builds their case to pay as little as possible. The Irish Insurance Industry as been getting away with such situations for years.

It is about time that they come up with written policies explaining in simple terms what the customers are covered for and stop hiding behind small print etc. Remember the word-of-mouth from your insurer or broker is useless.