u/Individual_Cash_3030

Hi everyone,

I’m looking for advice regarding a situation with an overseas visitor insurance claim in Australia.

My father-in-law travelled to Australia, and we purchased an Overseas Visitor Cover policy starting from the day he arrived. Below is the sequence of events:

• Day 1: Insurance policy started (same day he arrived in Australia)
• Day 4: Developed food poisoning and visited an emergency GP clinic
• Day 8: No improvement, visited GP again; ultrasound was done and results were normal
• Day 12: Condition worsened; went to the emergency department. While waiting, he had a seizure and was admitted immediately, then moved to ICU
• Hospital stay: Approximately 10 days (ICU + ward), then discharged
• Returned to home country, but unfortunately passed away very soon after that.

The insurance policy states a 14-day waiting period for inpatient treatment. Since he was admitted on Day 12, the insurer has declined to cover hospital (ICU and room) costs (~$34K), stating it falls under the waiting period / pre-existing condition clause.

They have only approved GP visits and some emergency department costs. The major portion of the bill (after ICU admission) has not been approved.

I have been in continuous discussion with the insurance company. After a long back-and-forth, they suggested I escalate the matter to the ombudsman. After the ombudsman’s involvement, the insurer contacted me again for a review, but also indicated that the outcome is unlikely to change.

I have already paid the smaller approved bills. The remaining hospital bill has now been referred to a recovery/debt department. As I was listed as next of kin on hospital forms, they are contacting me frequently, and recent calls have been quite pressuring, which is causing significant stress.

Additionally, I have other financial responsibilities and do not have the capacity to pay this large amount from my side.

My question is:

If the insurance company refuses to pay, am I legally responsible for paying these hospital bills as next of kin?

Any advice or similar experiences would be greatly appreciated.

Thank you.

Hi everyone,

I’m looking for advice regarding a situation with an overseas visitor insurance claim in Australia.

My father-in-law travelled to Australia, and we purchased an Overseas Visitor Cover policy starting from the day he arrived. Below is the sequence of events:

• Day 1: Insurance policy started (same day he arrived in Australia)
• Day 4: Developed food poisoning and visited an emergency GP clinic
• Day 8: No improvement, visited GP again; ultrasound was done and results were normal
• Day 12: Condition worsened; went to the emergency department. While waiting, he had a seizure and was admitted immediately, then moved to ICU
• Hospital stay: Approximately 10 days (ICU + ward), then discharged
• Returned to home country, but unfortunately passed away very soon after that.

The insurance policy states a 14-day waiting period for inpatient treatment. Since he was admitted on Day 12, the insurer has declined to cover hospital (ICU and room) costs (~$34K), stating it falls under the waiting period / pre-existing condition clause.

They have only approved GP visits and some emergency department costs. The major portion of the bill (after ICU admission) has not been approved.

I have been in continuous discussion with the insurance company. After a long back-and-forth, they suggested I escalate the matter to the ombudsman. After the ombudsman’s involvement, the insurer contacted me again for a review, but also indicated that the outcome is unlikely to change.

I have already paid the smaller approved bills. The remaining hospital bill has now been referred to a recovery/debt department. As I was listed as next of kin on hospital forms, they are contacting me frequently, and recent calls have been quite pressuring, which is causing significant stress.

Additionally, I have other financial responsibilities and do not have the capacity to pay this large amount from my side.

My question is:

If the insurance company refuses to pay, am I legally responsible for paying these hospital bills as next of kin?

Any advice or similar experiences would be greatly appreciated.

Thank you.