- What was the exact reason Mr Spong’s claim was rejected? For all claims we receive, we follow a thorough process to ensure all of the facts are known and assessed appropriately to support the claim outcome as quickly as possible.
The bacteria, Staphylococcus aureus that caused septicaemia for Mrs Spong can originate from a number of sources/causes. In this case, the detailed medical reports received from the Hospital and medical practitioners did not make any mention of a trauma which could possibly be linked to septicaemia. The Accidental Death benefit is only paid in circumstance where there has been a specific accidental injury during a journey which results in death.
- If the cause of Mrs Spong’s death was not caused by the cut on her hand or her infected blisters, what does Allianz believe led to staphylococcus aureus septicaemia? Staphylococcus aureus is a very common cause of bacteraemia and can initiate from a number of sources. As the medical advice provided did not conclude what led to the staphylococcus aureus septicaemia, we cannot make assumptions as to the cause. It should be noted that medically it is not unusual for the origin of septicaemia to not be able to be definitively determined.
- Why has Allianz failed to clearly explain why Mr Spong’s claim was rejected? We had immediate and ongoing correspondence with Mr Spong as we supported his family with full medical assistance during this difficult time.
We provided cover for all medical expenses incurred overseas, including the repatriation of the late Mrs Spong. On 10th August 2015, a letter was sent to Mr Spong’s Estate, Aubrey Brown Lawyers outlining the review process and decision regarding the Accidental Death portion of the claim. It was noted that there was no medical evidence to indicate that Mrs Spong’s death was a direct consequence of an infection developed as a result of an injury to her finger.
Does Allianz consider the way Mr Spong has been dealt with to be honest, fair and reasonable?
As with all our customers, we pride ourselves on full and transparent communication and correspondence, which we believe we have delivered on in this case.
We had daily communication with Mr Spong, his family and medical practitioners, and the Allianz Global Assistance medical team were thanked for their assistance during Mrs Spong’s time in hospital.
We took the full situation under review and were able to provide non-financial and financial support for the medical assistance portion of this claim, including the repatriation of Mrs Spong.
While the cause of the septicaemia is still unknown, Allianz Global Assistance has committed to full payment of the Accidental Death Benefit, which we have confirmed with Mr Spong.