Does medical insurance fully cover road accidents?
Woman left with mounting hospital bill after crash
An Uzbek woman who was severely injured in a car accident has been left without full coverage despite having comprehensive car insurance.
The 29-year-old Ilvina Khayrullina, a compliance officer at an investment bank, is currently being treated in Rashid Hospital for injuries she suffered when her car was hit by another car on August 21. But as the other car left the scene and there was no CCTV or witnesses, the accident was “deemed her fault”, with her car coverage being minimal.
Her comprehensive insurance capped personal accidents at Dh3,000 with the view to only later taking a percentage off a total limit, after a medical evaluation upon her discharge. Accordingly, Khayrullina could get a 25 per cent cut of the Dh200,000 limit (Dh50,000) due to paralysis in her leg, but that doesn’t help if her full hospital bill is Dh275,000 and mounting.
ADubai woman has been left severely injured without adequate coverage despite having comprehensive car insurance after a horrific road accident.
Ilvina Khayrullina, 29, a compliance officer at an investment bank, was travelling to work at around 9.15am along Jebel Ali Road towards Shaikh Zayed Road on August 21 when she claims another car hit hers’ and sent it spinning into a barrier.
As the other car left the scene and there was no CCTV or witnesses, she said police recorded the incident as having had no other vehicle involved.
Khayrullina, originally from Uzbekistan, was transferred to the nearest hospital with a shattered pelvis and ruptured intestines, along with what would later be discovered was broken ribs and a punctured lung, which was denying her brain of oxygen.
The fact that Khayrullina’s husband Vikram Naik has since filed a complaint against the private hospital for their alleged 12-hour delay in transferring her to the specialist trauma centre at Rashid Hospital, is a separate story.
However, the wider case of insurance has also come back to haunt the couple as not only did her medical insurance not cover road traffic accidents, but also because the other car allegedly left the scene and the accident was “deemed her fault”, her car coverage was also minimal.
Despite being comprehensive, it capped personal accidents at Dh3,000 with the view to only later taking a percentage off a total Dh200,000 limit, after a medical evaluation upon her discharge.
Mounting hospital bill
Based on this, Khayrullina could get a 25 per cent cut of the Dh200,000 limit (Dh50,000) due to paralysis in her leg, but that doesn’t help if her full hospital bill is Dh275,000 and mounting, as she is still in Rashid Hospital. (The bill from the first hospital was also Dh30,000).
“Third party liability insurance of the other vehicle would have covered her, but since it was deemed her fault by police her own insurance only covers her for personal accident, which is a percentage of a fixed amount deducted once treatment is over,” said a Dubaibased insurance specialist, who wishes to remain anonymous.
“The insurance company is paying out properly as per terms and conditions that are similar to Europe. If they knew who the other car was they would be able to get coverage on the other car’s liability, but in this case there is no liability insurance. Motor insurance does not respond to your treatment at all if you are at fault and most insurers embed a small personal accident coverage in the motor policy.
“It’s a very good example of why people should buy personal accident insurance and get good medical coverage. Standard medical insurance does not cover car accidents but depending on what medical plan you choose it will,” added the specialist, who is head of claims at a leading insurer.
Khayrullina’s husband now has to foot the bill before the insurance company will even consider evaluating that claim.
“What’s the point of having insurance then?” said Naik. “None of this was clear when we bought the coverage. There were different levels that didn’t give specific details of what they did and didn’t include. For that reason the consumer has to jump through hoops and often doesn’t get a clear picture,” he added.
“So far the insurance company hasn’t paid out anything stating that clauses in the insurance policy that she bought didn’t fully cover medical expenses, which they didn’t inform us of when we bought it,” he claimed.
The couple are now appealing for public support to help pay their mounting bills.