Widow in debt after travel insurance cover denied

DAVID HALLETT/The Press

DOUBLE BLOW: Pauline McGrade grieves with daughter Sarah and her husband, Glenn Hughes. The family faces a hospital bill of $120,000-plus and another bill for repatriating the body of husband Kevin McGrade after he died in France.

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An elderly Christchurch widow has been forced to remortgage her home after her husband died while on holiday in France and their insurance company refused to cover medical and repatriation costs.

Pauline and Kevin McGrade had taken their "dream of a lifetime" holiday in September last year.

However, Kevin McGrade, 74, suddenly collapsed from a heart attack.

He was in a coma for 20 days before dying, leaving not only a grieving family but a $120,000-plus hospital bill.

The McGrades bought full travel insurance with American Express before leaving New Zealand, researching the policy several times before signing up, Pauline McGrade said.

"It's something we were really pedantic about being properly covered. We would have never have left New Zealand without such cover that we were promised."

After her husband's collapse, dealings with the company had been difficult. After a week, her family received a phone call from American Express advising "all communication and support had stopped completely", she said.

American Express's insurance provider, ACE, had declined medical-insurance coverage on the basis of Kevin McGrade having a pre-existing condition.

American Express has since waived $53,000 on the couple's credit cards "as a gesture of goodwill".

Pauline McGrade was forced to pay for the week's hospital bills and to sign a guarantee that she could pay any outstanding expenses while her husband remained in hospital.

In the meantime her family battled with the insurance company.

"You never want this to happen and when it does you don't expect to have to put your energy into battling insurance companies to pay for a hospital bill overseas. It was shattering."

McGrade said that to deny an insurance claim on the basis her husband had a pre-existing condition was mind-boggling.

She said no-one not even health practitioners in New Zealand had found any "pre-existing" heart condition during several hospital and doctors' visits in the months before his death.

"An hour before my husband collapsed, he had been driving four of us around France and Italy. There is no way we would be doing that if we felt Kevin was ill."

Kevin McGrade's general practitioner of 23 years backed the family in a signed affidavit, saying he had treated McGrade for chest pain but several tests had shown no acute sign of cardiac problems.

In December 2007, McGrade was referred to hospital to rule out any cardiac or chest problems and was discharged and diagnosed with atypical chest pain being "likely muscular skeletal", as a result of painting and decorating work he had been doing at home.

Follow-up visits did not indicate acute heart problems and at no time was McGrade or his family told that he had heart disease or that his pain might be angina, the doctor said.

"If I had diagnosed Mr McGrade with angina or ischaemic heart disease I would have referred him to a cardiologist for further cardiological tests and I certainly would have advised him that he should not travel overseas on long-haul flights without first undergoing those tests and if necessary having specialist preventative measures put in place," the doctor's statement said.

The McGrade family had sent a copy of the affidavit, along with a letter from their lawyers, to the insurance company in the hope it would reconsider its position, but it declined.

On top of hospital costs, the family was confronted with the cost, and difficulty, of getting the body home to New Zealand.

The McGrades' daughter, Sarah, who lives in London, got help repatriating her father's body through her insurance company.

"It was a bloody horror. In a way, we have written off the whole cost. I feel like American Express really let us down. The only reason I'm telling this story is to warn people to check their insurance provider," Pauline McGrade said.

In a statement, American Express spokesman Todd Beavis said it "sympathised" with the McGrade family and offered its condolences.

"As a gesture of goodwill American Express waived substantial balances on the family's American Express cards following Mr McGrade's death.

"We understand that after careful consideration of the claim made under the travel insurance benefits provided with Mr McGrade's card, a decision was made by the underwriters, ACE Insurance Ltd, to decline the claim based on a pre-existing condition in accordance with the terms and conditions of the policy."

- © Fairfax NZ News