<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by jja34-1:
It's a benefit...but J379pa, did you read the whole letter? The argument in the Ombudsman column was that Amex refused to pay for many of the evacuation costs (this was eventually resolved).
I have never read all the T&C's of this benefit, but it seems to me from the content of the CNT letter, that if the idiot who answers the phone at Amex thinks the cardholder is in a country where the treatment is fine, you're screwed. I'm sure that a lot of countries in this care have comparable or better care than the US, but I'd rather be home if I have to have anything done.</font>
I'm not familiar with how AMEX handles medical evacuations, nor have I read the CNT article but I can tell you a little about the process that another company that writes this coverage uses. I worked for them as a flight physician, flying people back home after mishaps. We would take commercial flights (obviously in FC) to bring people back or send them home. I have flown people from US to Taiwan, Europe, and India.
First, remember that travel can be very stressful on an injured person. Getting to the airport is bad enough. Getting to the lav on a long flight is also a problem. Plus you're at altitude, another physiologic stress. On top of this, there are no good studies of how well (or poorly) people do when evacuated.
Second, if you have any problem that needs to be treated soon, it's usually better to get done what you can locally, even if the care isn't the same as the US. You don't want a mishap at 30,000ft. Sure, it may sound safe, being accompanied by a personal physician. But consider the stuff you see on ER and TLC. Do you think one lone physician could do 1/10th of what happens in a hospital ER when a patient goes South while flying? Pain control, sure, but without help there is little one can really accomplish.
Third, these commercial trips were VERY expensive. I often found myself carrying around $15,000 air tickets just for myself (and then there is the injured). An air ambulance is REALLY expensive, and can easily cost $30-40-60K for a few hours.
Fourth, it's usually not some jerk on the phone who makes any of these decisions, because they are medical decisions and there are plenty of lawyers who like to sue deep pockets like AMEX. At Worldwide, the people who answered the phones were usually knowledgable translators who then reported to the medical director (an emergency physician who worked at a local academic hospital) who made all the decisions about who got to go and when. The medical director had NO financial incentive to move or not move people, it's all based on what is logistically possible and medically safe. And believe me, this can often take several days to arrange. Just trying to get an accurate picture from the local healthcare team can be impossible!
Overall, these are always extremely stressful events on family involved. Most people don't plan on having a heart attack on vacation, are frightened to be in a hospital where they don't speak the language, and don't realize that most US insurance (including Medicare) does not pay for care outside our boarders.
Just some thoughts...
PDX