Certainly it was partly his fault for not reading the policy.
> “This is a general exclusion and doesn’t apply to you specifically. Our decision still stands with curtailment. No further medical input needed.
Why do you feel that he shares any part of the blame here? Why do you expect him to be an expert in reading and interpreting insurance policies in the middle of a medical emergency?
And not the one specifically dealing with broken bones?
>I wasn't going to ignore the advice of a DR who was holding my X-rays to appease an insurance company who doesn't give 2 shits about my health.
Which is not something anyone is going to argue about with you. Except, of course, those that have to write the $15K check. They are going to want more documentation that a one liner when standard medical advice says you can fly.
With all the responses you've generated here and the way you go about your argumentation I wouldn't be surprised to find out that you work for the insurer.
That's not how insurance works. They aren't going to pay for stuff on the say so of one doctor. The expectation is that they pay for treatment according to published and accepted standards of care. In this case, those say that you can fly with broken bones.
>With all the responses you've generated here and the way you go about your argumentation I wouldn't be surprised to find out that you work for the insurer.
Of course I don't work for the insurer. I am just an experienced backpacker that understands the concept of travel insurance.
> It's crystal clear from the way they conducted themselves that the insurance company would find any excuse to deny his claim
I see no evidence of that. What they offered was exactly what travel insurance is there for. That is, travel home for further treatment after a patient is stabilized. OP wanted to argue he wasn't stabilized. In response, they told him specifically what he needed to get from his doctor in order to justify his claim. As far as I know OP, for whatever reason, never bothered to get that.
IMHO, it's debatable whether or not you should be travelling with unset broken fingers. However, if all you bring to your side of the debate is a single sentence, you're going to lose.
We also don't know what their reaction to paying for the emergency services would be. OP, for reasons that are clear only to him, has decided not to claim ~$6,000 worth of covered expenses.
We will not cover the following:
2. Any treatment or surgery which we think you do not need immediately and can wait until you return home. Our decision is final.
That's what travel insurance is. It's there to pay for care until you can fly home. Accepting their flight home isn't voiding your insurance. It's getting the coverage you paid for.
Furthermore, the policy says clearly, until I CAN fly home. My DR had explicitly told me I could not. I wasn't going to risk my health for the sake of my arsehole insurance company and their bullshit attempts to wriggle out of paying.
Ask yourself, would YOU have ignored the advice of your DR, who knew your case personally, in favour of the "opinion" of a private company whose sole motivation is financial?
Basically, every service provider provides custom contracts with different exclusions, because that's the environment.
We need to get to a common set of expectations - like in a restaurant. Those expectations differ between countries/regions (is tipping expected? is water free?) but you have a common set of expectations that aren't governed by individual contracts for each restaurant.
On the other side: a random non-expert who needs some insurance, among a thousand other things going on in their life.
How much fault should assign to the second one?