How did they know?

Recently, someone sent me an e-mail asking me if health insurance companies and hospitals in Thailand share information among themselves without permission from the patient. He asked me this because he says that an insurance company recently refused him coverage because of information they had obtained from a hospital that he had once been admitted to.

He said the reason that they gave for rejecting him had nothing to do with the information he had provided them on his application. And, he had only given them a urine sample and had taken a blood pressure test. He said his rejection was due to a "misdiagnosis" by a hospital that he had been treated at. What really bothered him, though, was "How did they know?!" How did they obtain that information?

At the time that he had received the "misdiagnosis" from the hospital he was insured with and another Thai based health insurer. This insurance company cancelled his insurance coverage "due to the hospital's misdiagnosis". The doctor reported that he had high blood pressure and hepatitis. This wasn't what he had been admitted to the hospital and treated for, though. He told me in his letter, with absolute certainty, that he does not have high blood pressure or hepatitis. BUT, he admits that he does suffer from what is known as "white coat blood pressure syndrome".

He says that his blood pressure dropped back down to normal after resting in his room. This was reflected in the nursing notes, he says "My blood test did not reflect a hepatic problem. A complete physical a year or so prior was good and showed no signs of the above. I tried to give this info to [the insurance company that had cancelled his coverage], but they declined it.

So the first company canceled his coverage because of "misdiagnosis" and then second insurer rejected his application because of the same incorrect information. How did the second insurer get this damaging info, he asks.

Realizing that Thai health insurers are somehow able to obtain medical information that he thought would be confidential, he was finally able to obtain medical coverage with an international insurer, but for a much higher cost

Do Thai insurance companies and hospitals share information without permission from the patient?

No, but you gave them permission when you signed the application.

I do not have high blood pressure or hepatitis. I do suffer from white coat bp syndrome.

I am very familiar with White Coat Syndrome. When you see a medical professional (getting ready to take your blood pressure) your blood pressure jumps up. But, this doesn't happen to most people. The fact that it happens to you means that, for whatever reason, you are vulnerable to increases in blood pressure.

How did the insurance company get this damaging info?

You told your treating physician what other hospitals you had sought treatment at. Your treating physician then noted it in your medical record. The insurance company requested a copy of your medical records from the hospital that you were just treated at. Then, they contacted all of the hospitals that you had told your treating physician that you had ever sought treatment from and they requested your medical records from those hospitals also The insurance companies then contacted those hospitals and got all of your medical records from them also, etc. etc. They could do this because you had authorized them to do so when you signed your application for insurance.

Was the above letter writer really a victim of misdiagnosis, like he claims? I don't know. "A complete physical a year or so prior was very good" was not a good response to the insurance companies. They didn't want to see it because medical conditions can change even over a period of a few months. If he really wanted to prove the insurance companies wrong, he should have had a new physical taken by a qualified physician and been able to use it to provide evidence that supports his contention that the insurance companies rejected him based on the misdiagnosis of another physician.

Then, if the insurance companies still won't listen to him, he should take his evidence to the Office of Insurance Commission (OIC)

You are welcome to contact me, Tony Dabbs, by e-mail or call me on 080-277-4445 if you have any questions. You can also skype me: einsure

Why not have a look at the Tony Dabbs FAQ for answers to common questions about health insurance in Thailand.

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