Posted on Oct 13, 2015 by Alex Nellist
Alcohol is synonymous with expat-centric areas all around the world, and with liquor often the favoured lubricant in the social scene of many foreigners, hosting cities and countries seem to be increasingly happy to supply their new locals with ample amounts. Particularly in South East Asia, where the last decade or so has seen an influx in alcohol focused events and festivals, the popularity of a pint has turned businesses around and even witnessed a blossoming industry of home-brewed concoctions.
The continuing increase in consumption has undoubtedly seen pressures on local authorities as they deal with higher rates of intoxicated street wanderers, and it might be prudent to consider how this can not only affect the society that has welcomed you, but how much risk you are also personally at. Attending any event should heed awareness from patrons, but it is clear to see where a liquor themed festival may have a disadvantage in mitigating cases of impaired judgement. Anything from alcohol poisoning, slipping on somebody’s spilled drink, or losing your surroundings at a critical moment, can lead to a host of medical concerns, some prolonged and others alarmingly immediate.
If you are relying on whatever health insurance you own to pick up the pieces in the morning, please make sure you know exactly what your cover includes. Many health insurance providers do not provide coverage for injuries that happen while under the influence of alcohol. In fact, almost every plan has a provision in its terms and conditions that is worded under similar to the APIS (Alcohol Policy Information System), “The insurer shall not be liable for any loss sustained or contracted in consequence of the insured’s being intoxicated or under the influence of any narcotic unless administered on the advice of a physician.”
Identifying alcohol related injuries under your insurance plan
At a glance this policy wording may appear comprehensive, yet in reality there is an ambiguity in determining how exactly health insurance and accidents as a result of alcohol intoxication are affiliated. Some pertinent questions would need answering, such as how an insurer would know the claimant was intoxicated, and the how the process confirms this.
To help clear things up, we put a few questions to Sales Manager at Pacific Prime, Aurora Chan, about how insurers view alcohol related injuries and claims. Chan commented, “Every insurer will have provisions related to alcohol and claims in their policy documents, this wording can be quite confusing or ambiguous. Of course, the easiest recommendation would be to not drink in situations where you can potentially hurt yourself. This is simply not going to happen for many, so it would be beneficial if you knew more about how insurance companies view claims that can be linked to intoxication.” She also provided three pieces of advice:
1. Determine how the insurers decide on your level of intoxication
Because the wording in some policies is not always clear-cut, there could be difficulties when defining the degree of intoxication. Ms. Chan explained how most insurers first look to a doctor’s report, and that if conclusions assign the injury as a cause of alcohol or intoxication when you received care, the insurer will reject the claim if their policy wording excludes alcohol related injuries.
A police report has similar consequences. For example, if your blood alcohol level is tested to be above the legal limit in order to drive a vehicle, you may see the claim outright rejected.
2. Fully understand the terms and conditions of your plan
This is important because every provider will have a different policy wording regarding the exclusion of alcohol related medical claims. For example, the policy under Bupa’s Global Select plan states the exclusion of “Treatment for or arising from the harmful, hazardous or addictive use of any substance including alcohol, drugs and/or medicines.”
From another provider, AXA PPP, whose position is to not pay for, “Treatment of, or treatment which arises from or is in any way connected with, alcohol abuse, drug abuse or substance abuse.”
Allianz policies affirm that, “Care and/or treatment of drug addiction or alcoholism (including detoxification programmes and treatments related to the cessation of smoking), instances of death, or the treatment of any condition that in our reasonable opinion is related to, or a direct consequence of, alcoholism or addiction (e.g. organ failure or dementia).” are excluded.
If any of the policy wordings or advice from insurers is overwhelming, or you feel is simply incorrect or incomplete, make sure to take the third piece of advice.
3. Get an expert to explain your position and options
There are few plans that refrain from excluding everything related to being under the influence of alcohol. However, a knowledgeable insurance expert will be able to assist in finding a plan that does accommodate treatment for alcoholism or other related medical conditions. They will also be able to guide you through any potential to claim insurance on the liability of the vendor, organiser or any other immediately involved parties in the case of events of festivals.
As ever, drinking safely and responsibly will reduce the need ever to worry about these issues, or the chance of being denied a claim when it matters most.
If you have any questions about how Pacific Prime can help you secure the best health insurance in the market, pleasecontact us today to see how we can help.