I don't get anything for it, but submitted my case story as I'd already written it for my clients in a monthly newsletter I send out.
Here's the story (it is a little jazzed up for dramatic effect - perhaps that's why I won
)6 months ago I received a call from Neil, a client I’ve been looking after for 8 years who at the age of 44 suffered a heart attack on the 17th of May.
It came as a massive shock as I’d only spoken with him 2 weeks previously, sharing stories of the difficulties of working through a global pandemic.
Neil is the last person I thought would have heart issues as he’s never smoked, doesn’t drink, is in good shape and plays tennis 3-4 times a week.
But it get’s more complicated. The consultant he saw explained he needed emergency stents fitted to his arteries, but could only do this at The Wellington Hospital as his local hospital wasn't doing this procedure at the time.
Problem was, The Wellington couldn’t take this as an NHS procedure and his health insurance didn’t cover 'The Wellington' (most don’t as it’s an expensive option to include being one of the most costly hospitals in London).
His insurer said they would cover 60% of the cost, so Neil contacted me to see if there was anything I could do. With a bit of pleading from me they eventually agreed to cover the whole cost. The proviso being only for this one procedure, seeing as nowhere local was offering it.
Happy client, procedure was booked for that Friday afternoon.
However, at about 9pm of Friday, I get a panicked call from Neil saying it hasn’t gone to plan. The consultant said his arteries were worse than they first thought and even putting the maximum number of stents in wasn’t going to work.
Apparently he’s a ticking time bomb for a major heart attack and needs a triple heart bypass surgery ASAP. Actually they booked it in for the following Tuesday at 730am (it was a bank holiday that weekend).
Neil was shocked as he said his symptoms weren’t actually that painful. He very nearly didn’t bother getting checked at all as he had a tennis match booked. Apparently the consultant explained that if he had played that game, he would never have left the court!
He also said that Neil can’t leave the hospital because of the risk of getting Covid-19 which would mean not being able to have the life saving operation. Neil's main concern now is his insurer saying they would only cover the cost of one procedure (which he already had) and he doesn’t have the funds to pay for a 5 figure operation.
We spoke at length that evening, mainly to reassure him I will do everything I can. We left it that I would speak with his insurer in the morning and see what can be done.
On Saturday morning I explain the situation to his insurer and asked if it’s possible to transfer him to another hospital that would be covered on his plan. Apparently nowhere close is offering it on such short notice. This being the case I put forward why the should honour his claim being an exceptional situation and I'm told I can't get a definitive answer until Tuesday (the same day his operation is booked for).
I’m told they’re closed for the bank holiday, but not to worry as this being a special case, they will likely pay it.
I call Neil and explain he’s basically got three outcomes here. Either we continue to try and find another hospital during a Pandemic on a bank holiday weekend, or he stays put and his insurer will pay it in full, or he stays put and they don’t. He decides to stay where he is and accept whatever happens.
So Neil is left at The Wellington for 3 days taking copious amounts of blood thinners to reduce the chances of a major heart attack before his surgery. And all the while try not to get stressed out by the potential cost of the procedure, that they will need to remove his heart, stop his heart and use an artery from his leg as a replacement.
Fortunately the consultant reassures Neil that if he does have a heart attack before Tuesday, he’s in the right place!
At 9am on Tuesday I call his insurer to explain the situation again and see if by some miracle they will pay it. I’m told to leave it with them and they will come back to me. I then make a call to Neil's wife and explain the situation as calmly as I can. She's grateful for the update and happy to await my call.
By 2pm, the insurer calls me to say they’ll pay it. Thank God for that! When I call his wife to tell her the good news, she tells me that just 10 minutes prior to that, the consultant had called to say the operation was a success!
