Brad Watson died this weekend after a plane crash in Mozambique, after being left behind by two emergency planes, because he didn’t have the right cover. Health24 investigated.
Two emergency evacuation planes from SOS International evacuated the other two passengers who were injured. They were both insured – one by a medical scheme and the other through a corporate. Mr Watson, who was a member of NIMAS (Natal Integrated Medical Aid Scheme) was not covered for international evacuations, but only for evacuations within the borders of South Africa.
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“We would have liked to evacuate him as well,” said Dr Ian Cornish, regional manager of SOS International in an interview with Health24. “But our first duty lies towards our own clients. In both cases a single-stretcher plane was sent out, and because both the injured were stretcher patients, an extra patient could not be accommodated.”
Netcare 911 despatched a plane to fetch Watson on Saturday, even though his insurance did not cover this. He died on Lanseria airport shortly after landing.
Netcare 911, when approached by the family in the early hours of Saturday morning, recognised the dire need for the patient to be evacuated and also recognised the fact that he had valid medical cover in SA. The company therefore agreed with the family that Netcare 911 would undertake the evacuation with a guarantee of payment in place from the family and we would deal with the financial recovery at a later stage. Their first priority was to repatriate the patient, according to Dr Ryan Noach, Chief operating officer of Netcare 911.
A question of ethics
The question arises whether the doctors or paramedics who leave behind an injured patient in such circumstances are not violating the code of humanity, not to speak of the Hippocratic oath.
There is no prohibition on giving on-the-spot medical assistance to non-members, according to Dr Noach.
“We are tasked to move clients only,” said to Dr Cornish. “Insurance does not cover the costs of others, even though they may have been involved in the same accident. We will fly out those who are insured through specific medical schemes, through their corporates, or those who can pay for our services. Otherwise we wouldn’t be in business.”
He added that if the patients they are sent to fetch are not sufficiently injured that they need to be put on a stretcher, there may be space for someone else. It was not Watson’s lucky day on Friday.
Netcare 911 has a policy of resuscitating and stabilising patients on the scene of the accident and then taking them to hospital.
Watson was evacuated on Saturday morning by this organisation – even though he was not covered. Despite every effort to save him, he died shortly after landing.
"All cross-border evacuations performed by Netcare 911 require that some kind of insurance policy should be in place to cover the cost of the evacuation. These are frequently provided by medical schemes, special travel insurance, credit card travel insurance, employers, ex-pat policies, etc.," according to Dr Noach.
He also added that employers would be irresponsible to send ex-pat staff to contracts in Africa, e.g. this particular incident, without ensuring proper cover for their employees while out of the country.
“There are all sorts of issues involved with emergency evacuations – cost, insurance, ethics – you name it,” says independent medical schemes researcher, Johan van Tonder. “Often companies are also scared to treat non-members, for fear of possible court cases, for which they may not be covered. But it’s a sad day when monetary considerations take precedence over humanity, although this is sometimes inevitable.”
Are you covered?
So, next time you go on a 4X4 trip through Africa, or fly to Singapore on business, or go backpacking through Europe, make sure that you are indeed covered.
"The best way to ensure cover is to confirm the exact terms and conditions of your insurance, when out of the country, in writing from your medical scheme/credit card company. Most medical schemes do not provide cover outside the borders of SA. Affordable travel insurance is however available for purchase as a stand-alone option from multiple insurers in SA, or directly from Netcare 911's flight desk, says Dr Noach.
Johan van Tonder gives the following tips to medical scheme members who go travelling:
Contact your medical scheme, and ask them what you need to do before you go on a trip to make sure that you are covered in the case of an accident.
Send them a fax with the details of when and where you are going. Keep a copy of the fax.
Fill in any extra forms they may send you and check that they have received them before you leave.
Take details of your insurance with you so that people will know who to contact in the case of an accident.
Find out whether you have to pay for the evacuation upfront, and then be refunded by the medical scheme. Many people simply can’t afford this.
Check whether you will be evacuated back to South Africa, or to the nearest appropriate medical facility. It can make a huge difference.
Consider taking out separate travel insurance if you feel your medical scheme does not provide you with adequate cover. Find out how much your insurer will pay - R150 000 (which is the approximate amount you are covered for when you are insured through your credit card) may not be enough.
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