We have seen several instances in the past where air ambulance service is denied for a particular patient or the coverage is denied once an air ambulance service is availed. The result most of the time is that the patient has to bear the entire expense out of pocket. The reasoning behind the decision is usually the actual need for an air ambulance evacuation. Health insurance companies tend to make their own decisions based on their in-house expert opinion. It does not matter what the attending physician of the patient has to say. There have been many cases where people have gone bankrupt because of such decisions to deny air ambulance coverage.
Court Rules in Favor of the Need for Air Ambulance
Recently, a plastic surgeon was in a foreign country, trying his hand at an adventure activity. Specifically speaking, he was trying his hand at zipline. Unfortunately for him, there was an accident and his knee was dislocated. The doctor insisted on being treated in the United States. At the time, he was in Mexico. The insurance company had argued that he had acted against the advice that the patient must have sought treatment for two days in Mexico itself.
The Patient Lost his Limb
Because the patient did not receive the appropriate treatment within time, his leg had to be amputated, leaving him with a permanent disability. The patient, in turn, sued the insurance company for denying him access to appropriate care. In a case that is quite different from what has been happening regularly, the insurance company was held liable for this mishap. Further, it was ordered by the court to pay almost USD 25 million in damages to the patient. The award is viewed as one of the biggest in the state of Minnesota. The incident is a wake-up call for health insurance providers.
