Emergency in a cash based system even with Travel Insurance

[Ashland]

7 hours ago, GeezerCouple said:

 

 

Is the patient admitted to a hospital as an inpatient?

Is there an airfield nearby for fixed wing aircraft?

And of course, is the patient stable enough for a full medevac aircraft?

 

If yes, then why not?  They let the client select the hospital, but it might need to be in home country... but if one has MJA, isn't that what one would want?

 

GC

Thanks...I was just wondering if the OP (rimmit) would have had MJA if this would have been possible.

[rimmit]

On 7/1/2022 at 5:46 PM, Suzanne123 said:

I was wondering if MedJet would have been able to rescue OP’s wife from the first “hospital.”  MedJet’s Emergency Medical Cash Advance is $60k.

NetCare Millpark ( the good hospital) in Johannesburg is on GeoBlue’s list of providers.

Also, it seems like the family all used Capital One which wasn’t much help.  Would Chase or AmEx have been any better?

Lots to consider about visiting any third world country, for sure.

The company didn’t take American Express so that was no help.

 

We tried any and all cards to make payment and her uncle was the one who finally got the payment through.  He was initially denied, but made some calls and got it through, which is impressive as we tried everything.  When asked what he did differently, he simply said, “I’m a big deal.”  Which he actually is but he has not told me what he did to get it approved.  I am just grateful it did.

[rimmit]

On 7/1/2022 at 6:05 PM, mauimary said:

Good to know Millpark is on the Geo Blu list. Thanks. 

Millpark was great.  We got great care there.  The only negative and this is likely a cultural thing, is that physicians in South Africa do not communicate with the patient.  In 14 days in the hospital my wife talked to a doctor 6 times and I talked to them 4 times.  We were in the dark the entire time as to what was happening.  It was maddening.  There is no post surgery talk from the surgery.  I went 36 hours after the first surgery without talking to a doctor.  It was maddening and incredibly frustrating.  The hospital was very clean though.  Not the best part of Joburg, but I stayed 10 min. Away in melrose arch at a Marriott autograph hotel which was gorgeous.

[rimmit]

On 7/1/2022 at 6:20 PM, Jersey42 said:

Unfortunately, unless I am totally misinformed, the answer is pretty much NO.  Travel insurance is normally reimbursement only, with the exception of the GeoBlue network being discussed.  Now, if I were in that situation I would definitely call the insurance company and plead my case.  You have nothing to lose. Perhaps a provider might take a deposit and bill the balance if the insurance company could provide something to show medical coverage up to $X.  But I am only speculating and I would not count on it.

 

If you have the time, you might want to pose this question to your safari company and their insurer.  I am sure they have run into this before.  I would be curious if they give you any good insights.

Actually, in a situation where a large amount of cash is involved, the travel agency can submit a letter of guarantee of payment and the hospital will use that without you fronting large amounts of cash.  For some reason we couldn’t get that initially when we got to Netcare Milpark in Joburg, and I lit up 38k just to get her a bed.  They did call my insurance in Joburg but they could not get the letter at the time.

 

Once admitted the local agents for the insurance took over and sent a letter of guarantee and supposedly they will now pay the hospital directly for the care and the hospital will refund my 38k.  I am still waiting on this to happen.

 

The repatriation was a debacle, but long story short we paid nothing for it and we’re able to get business class back to the US from JNB-EWR and then an air ambulance back to Columbus oh since narrow body jets do not have space for her to keep her leg elevated.  A med jet was on the table for a bit as the biz class seats were all sold out, but some space opened up, but at one point we were looking at a medjet to get back.

[rimmit]

On 7/5/2022 at 4:43 PM, Hlitner said:

I finally got around to reading the OP's link (saga in Africa) and I could almost cry imagining the frustration of the OP.  When we had our own major medical situation (in Vietnem) we were lucky that we were able to get decent emergency care on our ship (South African physician) and get her to Osaka, Japan in two days where DW could get worldclass care/outpatient surgery.   We did not face anything nearly as horrid as the situation in Zimbawe.

 

But reading some of the posts just reinforces my belief that most folks have little clue when it comes to dealing with Travel and related travel medical insurance.   The reality is that very few insurance companies are going to authorize direct of immediate payments.  And in a situation like the OP where he could not even communicate with the insurance company the situation is even worse.

 

The way most travel insurance works is that you must first handle the payments (or at least have available credit) and then later resolve the financial end with the insurer.  To do this you must be able to document everything including having detailed medical records.  This is not always easy to get and folks need to often become somewhat assertive in their demands for copies of records.  In nearly all cases, Medical Evacuation insurance requires the ability to communicate, and the cooperation of the attending physician, insurance company, claimant, and often a receiving hospital.   This can be very complicated and having an insurance company that truly acts in good faith is very helpful.  The best insurance companies will have medical case managers that can get immediately involved and help (or hinder) resolution.  The injured or ill claimant's life and/or future health may well depend on having a capable advocate on the scene.  In the case of the OP the advocate was a physician which is very helpful.  In the  case of DW she had me who had once been a Paramedic and had spent over 30 years working in the medical insurance industry.  Like with the OP, it was my background that really helped work through the many problems.    I have long wondered how folks manage without a capable (and calm) advocate.  Many folks do not function well when under lots of stress and in a medical situation.

 

As we have previously posted (back when we told our tale of medical woe), we think a very important step is to contact the insurance company and open communications and a case file.   The earlier this is done the better.  In fact, medical evacuation reimbursement is often dependent on getting approvals before evacuation (or you may never get reimbursed).  

 

In our case we did have GeoBlue and they did earn my thanks for their professionalism, case management help, and relatively fast reimbursement.  But expecting assignment (direct reimbursement from GeoBlu to the hospital and physicians) is one of those things that does require some luck and the agreement of the hospital/physician.   There is never a guarantee that a foreign entity will accept immediate assignment and in a medical emergency you will not often have the chance or opportunity to choose participating folks.  You will generally go to the nearest provider or, in our case, to where arrangments could be made by the ship's Agent in Osaka.  DW was taken to the best teaching hospital in that large city and it turned out they had no agreement with GeoBlu.  My goal was to get her the best care and money/assignment was low on my list of priorities.  I suspect that the OP would say the same.  When you have a real medical emergency, you do what you must do to get the best treatment as fast as possible and worry about the money later!

 

Hank

 

Hank

Yes.  Pay now, money later.  No amount of money can replace a lost life or limb.

 

We tried to get the insurance involved early on but the evac companies didn’t care.  We activated the local agent the day after arriving in Joburg and at that point we’re instructed to stop making payments and to refer all future bills to them at that point.  I obviously was already knee deep in payments but at least the medical repatriation and some other separate bills were deferred to the local agents for payment as they were then responsible for all future payments.  
 

i am now in the process of submitting receipts and documention for reimbursement of the evac, care in Zim, and trip interruption.

[rimmit]

On 7/7/2022 at 9:08 PM, Hlitner said:

An awful scenario for which I doubt anyone has a good answer.  You do everything possible to deal with the situation, somehow manage to keep your cool, and then pray.  I know this is really a non-answer but traveling to third world countries always involves some extra risk.  And carrying a lot of cash comes with its own risks.  For those of us who are long time independent travelers (we try to avoid group tours like the plague) it is even worse.  If you are part of a tour group there may be other resources (within the group) that can be very helpful.  If on your own it is more of a challenge and the outcome may not be good.  Like many experienced independent travelers, we try to anticipate problems and have some ideas in the back of our minds.   At times the options are so bad one might decide not to even go forward with their trip.  

 

I do not think you can ever depend on an insurance company to come to the rescue in a situation where time is of the essence.  Insurance companies are not set up for that kind of quick decision making.  And if you do not even have communications that is not even relevant.  Without good communications your options are all lousy.  If you do have a phone connection, having a very good friend or family member who can become an advocate and work on your behalf can be a lifesaver.  You do the best to make your own luck and sometimes all the luck runs out :(.

 

Hank

 

This is all accurate.  We fell through the cracks as we were part of a privately chartered safari.  We had some free time that was arranged in Vic Falls and CPT, but in the middle would have been under the operator umbrella.  All the tours were arranged in Vic and CPT but the issue was while we had arranged tours we did not have a “guide” at this time.  It would have been better to have been injured on safari as then the tour operator would have been able to assist as I assume they have some protocols for this as I have no doubt people have been injured on safari before.  We would also not have been evacuated to a small local “hospital” but to a real hospital with facilities and meds.

 

We hit every hole I  Swiss cheese model of when safety protocols fail.  I honestly don’t know what we coulda done differently as I have gone over it in my head 100s of times.

[Hlitner]

4 minutes ago, rimmit said:

Yes.  Pay now, money later.  No amount of money can replace a lost life or limb.

 

We tried to get the insurance involved early on but the evac companies didn’t care.  We activated the local agent the day after arriving in Joburg and at that point we’re instructed to stop making payments and to refer all future bills to them at that point.  I obviously was already knee deep in payments but at least the medical repatriation and some other separate bills were deferred to the local agents for payment as they were then responsible for all future payments.  
 

i am now in the process of submitting receipts and documention for reimbursement of the evac, care in Zim, and trip interruption.

Good luck with the claims process.  A good friend like Tequilia can help you deal with the claims processor folks :).   I can imagine the feelings of helplessness with not having any decent communications and seeing medical care that did not meet your standards.  

 

Hank

[rimmit]

On 7/9/2022 at 9:14 PM, Ashland said:

Thanks...I was just wondering if the OP (rimmit) would have had MJA if this would have been possible.

I just took the suggestion of the doc in Zim on where to go.  Since I paid out of pocket we coulda picked anywhere.  We coulda gone to Christian Bernard in Capetown if we wanted.  I picked Joburg as it was only 2 hours and I wanted a surgeon on her foot as soon as possible as I was very concerned if it went to long it may need amputation.

[rimmit]

1 minute ago, Hlitner said:

Good luck with the claims process.  A good friend like Tequilia can help you deal with the claims processor folks :).   I can imagine the feelings of helplessness with not having any decent communications and seeing medical care that did not meet your standards.  

 

Hank

Yes.  Although I go for bourbon myself. 🙂

The communication from the physicians was non existent.  They don’t even round on WEEKENDS!!!!   What physician doesnt round on weekends!  They never answer the pages as After the first surgery I desperately wanted to talk to someone about prognosis, recovery, what they did in the OR.  It was absurd.  Like 1950s level physician communication as in NONE.

[Jersey42]

28 minutes ago, rimmit said:

Actually, in a situation where a large amount of cash is involved, the travel agency can submit a letter of guarantee of payment and the hospital will use that without you fronting large amounts of cash.  For some reason we couldn’t get that initially when we got to Netcare Milpark in Joburg, and I lit up 38k just to get her a bed.  They did call my insurance in Joburg but they could not get the letter at the time.

 

Once admitted the local agents for the insurance took over and sent a letter of guarantee and supposedly they will now pay the hospital directly for the care and the hospital will refund my 38k.  I am still waiting on this to happen.

 

You say "travel agency", not insurance company.  Is this a service travel agencies usually provide?  Assuming it is not a personal friend, what guarantee does the travel agency have for repayment?

 

This whole thread is an eye opener, thank you for sharing all of the details.  Hopefully it helps others in the future.

[rimmit]

46 minutes ago, Jersey42 said:

You say "travel agency", not insurance company.  Is this a service travel agencies usually provide?  Assuming it is not a personal friend, what guarantee does the travel agency have for repayment?

 

This whole thread is an eye opener, thank you for sharing all of the details.  Hopefully it helps others in the future.

Mistyped.  I mean travel insurance.  Thanks for catching that.

[KMMaui]

Just finished reading these messages and WOW what an ordeal.  Thank you for sharing your experience.  I don't know how anyone could have done better under the circumstances.  Hope you quickly get fully reimbursed.  .

[GeezerCouple]

How is your wife now?

That's ultimately the most important concern!

 

This was indeed a nightmare come true... 

A few years ago, we decided that there were a few "wish list" trips that we probaby were not ever going to do after all.  We sort of waited too long, although unfortunate events could occur at any age and regardless of medical condition, as your experience illustrates dramatically.

 

I can't even imagine........

 

By the way, your situation did cause me to double check about travel insurance that will arrange to send money or guarantee payment in situations such as where that is required before a hospital will admit someone.  But as your situation demonstrates all too well, that only works if the facility will accept such a guarantee or have a way actually to receive the payment.  And, of course, if one can contact the insurer from <wherever>!

 

GC

[rimmit]

7 hours ago, GeezerCouple said:

How is your wife now?

That's ultimately the most important concern!

 

This was indeed a nightmare come true... 

A few years ago, we decided that there were a few "wish list" trips that we probaby were not ever going to do after all.  We sort of waited too long, although unfortunate events could occur at any age and regardless of medical condition, as your experience illustrates dramatically.

 

I can't even imagine........

 

By the way, your situation did cause me to double check about travel insurance that will arrange to send money or guarantee payment in situations such as where that is required before a hospital will admit someone.  But as your situation demonstrates all too well, that only works if the facility will accept such a guarantee or have a way actually to receive the payment.  And, of course, if one can contact the insurer from <wherever>!

 

GC

She’s doing ok.  Some days are better than others. Her wound is still open, but we are hoping it will be ready for a skin graft this Wed.  The pain comes in waves, and some lights are better than others.  She can get up and get to the bedside commode without assistance and get to the bathroom with a walker and assistance so that is good.

 

All things considered it is an all out miracle how well she is doing.  She should make a full recovery aside from a foot that will look like Frankenstein and some scars on her legs and arms.  Considering she was run over by a car we truly consider it a win and I just keep reminding myself that whenever she has a bad pain day.  The fact she didn’t break any bones and didn’t hit any major arteries is truly a miracle.  If she was actively bleeding she woulda died as they dont have blood in Vic Falls.  Also a miracle she didn’t get an infection and go septic.   
 

The issue is that the air evac company just wouldnt take a guarantee of payment.  They wanted payment NOW and wouldn’t schedule it till they had a receipt in hand.  Netcare Milpark Hospital did do some irrigation of the wound and some pain meds and some labs in the ED before I paid, but to get the OR and bed I had to make a payment.  We did call our insurance company at the hospital in Joburg at the time but at the time for some reason I can’t remember they wouldn’t guarantee the payment. I didn’t push the issue as at the time I was still under the assumption my only option was to pay out of pocket and file a claim later,  I did not realize that for admissions of this level the insurance company can get directly involved just like if we were in the US.  The next day when I went to the international patient liason we called the insurance company together in her office and they then agreed to send a letter of guarantee of payment and I was finally absolved from future payments.  In actuality,  the insurance company I think prefers to be involved so they can get some control of the situation and reduce cost. Every single email from my insurer after they were directly involved always stated at the end anything beyond basic labs and tests (X-rays, cbcs, etc) must now be preapproved.  Surgeries must now be preapproved before they could be done.

[GeezerCouple]

37 minutes ago, rimmit said:

She’s doing ok.  Some days are better than others. Her wound is still open, but we are hoping it will be ready for a skin graft this Wed.  The pain comes in waves, and some lights are better than others.  She can get up and get to the bedside commode without assistance and get to the bathroom with a walker and assistance so that is good.

 

All things considered it is an all out miracle how well she is doing.  She should make a full recovery aside from a foot that will look like Frankenstein and some scars on her legs and arms.  Considering she was run over by a car we truly consider it a win and I just keep reminding myself that whenever she has a bad pain day.  The fact she didn’t break any bones and didn’t hit any major arteries is truly a miracle.  If she was actively bleeding she woulda died as they dont have blood in Vic Falls.  Also a miracle she didn’t get an infection and go septic.   
 

The issue is that the air evac company just wouldnt take a guarantee of payment.  They wanted payment NOW and wouldn’t schedule it till they had a receipt in hand.  Netcare Milpark Hospital did do some irrigation of the wound and some pain meds and some labs in the ED before I paid, but to get the OR and bed I had to make a payment.  We did call our insurance company at the hospital in Joburg at the time but at the time for some reason I can’t remember they wouldn’t guarantee the payment. I didn’t push the issue as at the time I was still under the assumption my only option was to pay out of pocket and file a claim later,  I did not realize that for admissions of this level the insurance company can get directly involved just like if we were in the US.  The next day when I went to the international patient liason we called the insurance company together in her office and they then agreed to send a letter of guarantee of payment and I was finally absolved from future payments.  In actuality,  the insurance company I think prefers to be involved so they can get some control of the situation and reduce cost. Every single email from my insurer after they were directly involved always stated at the end anything beyond basic labs and tests (X-rays, cbcs, etc) must now be preapproved.  Surgeries must now be preapproved before they could be done.

 

Thank you for the update.

 

I think this sentence of yours captures the essence:

"All things considered it is an all out miracle how well she is doing."

It seems like a miracle that she is even alive, much less doing reasonably well!

I hope they aren't being too "cautious" with pain meds... (That's a pet peeve of ours, both personally and a bit professionally, but I'll stop here about that...)

Is she home now, or still in hospital?

 

How are your children?  That's a terrifying thing to see, and then the situation didn't get better for way too long... probably seeming like an eternity from their perspective.

 

Thanks again for sharing.

It's still *very* sobering to think about how all the planning that one can do... etc.... but nevertheless.......

 

GC

 

[rimmit]

9 hours ago, GeezerCouple said:

 

Thank you for the update.

 

I think this sentence of yours captures the essence:

"All things considered it is an all out miracle how well she is doing."

It seems like a miracle that she is even alive, much less doing reasonably well!

I hope they aren't being too "cautious" with pain meds... (That's a pet peeve of ours, both personally and a bit professionally, but I'll stop here about that...)

Is she home now, or still in hospital?

 

How are your children?  That's a terrifying thing to see, and then the situation didn't get better for way too long... probably seeming like an eternity from their perspective.

 

Thanks again for sharing.

It's still *very* sobering to think about how all the planning that one can do... etc.... but nevertheless.......

 

GC

 

It really is.  If you were at the scene, you'd for sure thought she was dead, given what happened.  I definitely did as did my mom.  Kids are ok.  A little traumatized and my youngest who is 7 is definitely a little anxious about cars and being on streets, but she seems to be getting more comfortable walking around cars again over the last week.  My son who is 11 doesn't have the same level of anxiety about cars, but is still anxious.  My youngest still gets concerned that she's gonna be in bed forever, but we've assured her that's not the case and she's gonna get better and it'll just take time.  It definitely seems like an eternity from their perspective that she's been down and not able to do much and in pain. 

 

She is home now, as she is just managed by wound care and oral pain meds until she is ready for the graft.  She inadvertently got addicted to some pain meds right prior to the pandemic for some back pain, and didn't even realize it until her script ran out at the beginning of the pandemic and she didn't bother to refill it.  Little did she know her body had become reliant.  Took us several days to figure out she was withdrawing as we couldn't figure out why she was so sick given we had contact with practically no one.  She toughed it out for 7 days of misery as she withdrew and swore she'd never get on opiates again and would rather take the back pain before being on an opiate.  This is obviously an exception, but for that reason after 3.5 weeks on some Oxy, we stopped it before she has the skin graft to try and keep her body from getting addicted again as she'll need some pain management obviously after the skin graft.  It's a fine line to walk between pain and avoiding addiction.  

 

Yes, you can plan all you want, but you can't plan for everything.  We do a ton of travel and this was the most logistically complex trip we've ever planned.  By the end my kids had been on 10 plane flights ranging from A350's, 787's and 777's to small puddle jumpers.  They had done more border crossings than I can count, and excluding the US had been through 6 countries.  There were endless car transfers, house boats, and nights in a safari camp and hotels.  It was all meticulously planned, but one mistake (leaving behind my contact solution) led to everything unraveling in seconds and it all came crashing down.  I am definitely glad they got to complete the vacation, despite there being a cloud over the remainder which was still 12 more nights, but man plans and god laughs. 

[GeezerCouple]

Hi rimmit,

 

Someone posted a link to your thread, about possible difficulties with payments, etc. (to put it mildly!).

 

So... how is your wife doing now?

We certainly hope that there has been good progress.

 

And your children?

 

Best wishes,

 

GC

[cruiselvr04]

I really appreciate your taking the time to post your story.  Hoping your wife is back on her feet by now.  As an RN I’m a horrified by your story but also not that surprised.  Its a good example of why to always purchase insurance even if you’re young and healthy and don’t do crazy things like rent mopeds in foreign countries.  
 

We always get insurance but in this case that wasn’t even the issue which is eye opening.  I’m not sure we’d have enough on one or two cards to cover $55k at the time.  We don’t carry a lot of cash ever.  You’ve given us more to consider before our next international trip.  

[The-Inside-Cabin]

I called Med Jet and ran your scenario past them - they said they would have covered it .....They would arrange and pay for the medevac themselves.   If you bought their higher level plan - they would wire money to a hospital for care - up to 60K - and then charge your card. 

 

Limitations - need a 5000 foot runway - no war zones 

Cash advance only M-F - USA business hours

 

$678 - 2 people - 12 months 74 and under

 

Of course saying they would cover it to some random phone inquiry and actually delivering - could be two different things - but encouraging that they seem to offer an option to make a single phone call and they will handle the rest.

Edited September 12, 2022 by The-Inside-Cabin

[rimmit]

On 9/11/2022 at 6:16 PM, GeezerCouple said:

Hi rimmit,

 

Someone posted a link to your thread, about possible difficulties with payments, etc. (to put it mildly!).

 

So... how is your wife doing now?

We certainly hope that there has been good progress.

 

And your children?

 

Best wishes,

 

GC

Hi!

 

Well,  it’s been a looon road.  Where to begin.

 

So we got back to the US, July the 5th.  Getting out of Joburg was a nightmare and the travel insurance screwed up our repatriation so bad I can’t even begin to start.  There are a lot of moving parts to a medical repatriation, the actual patient and family, a local agent that is assisting you, and then the travel insurance agency somewhere far away.   There is a lot of politics between the local agents and the actual agency and needless to say it was a total disaster getting out of Joburg,  but we made it out… barely.

 

So here’s the cliff notes version.  After 5 surgeries in Joburg, and 1 more in A Level I trauma center right when we got back to the US she got home for two weeks as she waited for her skin graft to heal.   She the got her skin graft.  5 days later spiked a fever.  Took several days to figure it out but she had osteomyelitis (bone infection) and she had 7 different bacteria growing.  She had to go back to the OR 6 more times to get rid of the infection at which one point they thought she was gonna lose her foot.  She got discharged after 2 weeks and 6 surgeries with a PICC line, 6 weeks IV. Abx, 6 months po abx, hyperbaric oxygen therapy, and a wound vac.  
 

She has had multiple complications with the abx and due to their being 7 different bacteria has now been on 15 different antibiotics.  She is now 2 days from the end of her IV abx course, 7 days from the end of hyperbaric, and her wound is almost closed.

 

Due to being non ambulatory for 10 weeks she lost a massive amount of ROM.  She was cleared to bear weight 2 weeks ago and has been killing herself in PT.   She is a fighter and it’s been hard but we’re getting there.

 

Thats the SHORT version.

[rimmit]

On 9/11/2022 at 10:30 PM, cruiselvr04 said:

I really appreciate your taking the time to post your story.  Hoping your wife is back on her feet by now.  As an RN I’m a horrified by your story but also not that surprised.  Its a good example of why to always purchase insurance even if you’re young and healthy and don’t do crazy things like rent mopeds in foreign countries.  
 

We always get insurance but in this case that wasn’t even the issue which is eye opening.  I’m not sure we’d have enough on one or two cards to cover $55k at the time.  We don’t carry a lot of cash ever.  You’ve given us more to consider before our next international trip.  

The weekend was the big issue.  The first evac company would only take cash or wire transfer and walked off when I said that was impossible.  The second thankfully took CC, but was 6000k more (not that I care or that it mattered), but there systems just refused to process our payment.  And for reasons I don’t understand to this day,  they REFUSED to let us either tap or insert the card into a machine to make a payment which is much more likely to go through than an internet link.  We begged them to try it on their machine but they REFUSED.
 

All I could think about this whole time was if you were a solo traveler you were screwed.  The physician is not an advocate.  Unlike in the US if I have a patient that I am not equipped to handle, I am transferring it out as fast as possible.  The physician here didn’t care.   If I didnt demand a transport she woulda laid there until she died, or ran out of money and they kicked her out.

 

due to the money situation in Zimbabwe, the physician will do nothing for you.  If you dont have someone who’s health advocating and making payments for you, you are screwed.  

[rimmit]

12 hours ago, The-Inside-Cabin said:

I called Med Jet and ran your scenario past them - they said they would have covered it .....They would arrange and pay for the medevac themselves.   If you bought their higher level plan - they would wire money to a hospital for care - up to 60K - and then charge your card. 

 

Limitations - need a 5000 foot runway - no war zones 

Cash advance only M-F - USA business hours

 

$678 - 2 people - 12 months 74 and under

 

Of course saying they would cover it to some random phone inquiry and actually delivering - could be two different things - but encouraging that they seem to offer an option to make a single phone call and they will handle the rest.

That is good to hear,  this situation as a unique “slipped through the cracks” situation.  From the timing of when it happened, our CCs not being accepted,  not being under the care of a guide or operator for that portion of our trip, etc.  

 

I’d be impressed if a single phone call would do it,  but once We got to Joburg, and got settled and finally got a hold of our travel insurance company,  they activated a local agent, who then sent a GOP (guarantee of payment) to the hospital and all future bills were billed to the local agent.  Once we activated that, I didnt make one further payment.  I filed my travel claim on July 11th, however, and still hasn’t been processed…..  ugh.

 

unfortunately,  the GOP was not good enough for the air evac companies.  They wanted the money NOW.

[Hlitner]

Thanks for posting "the rest of the story" and we pray she has a full recovery.  Certainly, a saga from hell and a lucky lady that she had a capable advocate who was able to keep things moving in the right direction.   I am not sure what lesson to learn from your experience (and our own prior experience in VIetnam).  Having a capable advocate, on the scene, who is able to think clearly and work through all the options, can truly be a matter of life and death.  You mentioned the single traveler, but I would add couples where the healthy partner is not up to the task!  

 

By the way, just between us (everyone else can move on to another post), when my DW also had a large open wound (lower leg anterior of the tibia) we thought a skin graft was in her future.  When we got her back to the States, I immediately got her to a local Urgent Care physician who quickly referred her to an excellent General Surgeon.  The surgeon was thinking skin graft (the open wound was about 4 inches long with substantial adjacent tissue damage) but wanted DW to first see her Orthopedic Surgeon who had previously done a total knee (same leg).  The Ortho (who is a very special guy) took one look at DW and said, "I will personally deal with this!"  He was opposed to a skin graft because there are often residual problems.  Instead, he used a technique he had learned (as a resident in NYC) from an Aussie physician.  He ran a line of staples along both margins of the open would and then threaded a thick piece of elastic (like a shoelace) back and forth between the margins.  Then, over about 3 weeks he kept tightening that elastic which gradually pulled the wound together so that he could finally staple it shut.  The result is a nasty scar, but the none of the skin graft issues (like when it would rub against jeans).  When he did this technique (in a teaching hospital) he said many residents crowded into the OR to see this procedure.

 

Hank