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Seanad
‹ Order of Business

Health insurance liver operation coverage

Summary

Senator O’Brien raises a constituent’s urgent need for a liver operation in Canada, arguing that Aviva’s policy covers treatment unavailable in Ireland. He asks the Leader to seek ministerial help and hold the insurer accountable.

I thank the Leader. I wish to raise a specific case with him. I would not do this on the Order of Business but for the severity of the case. A constituent has made contact with me about a matter that relates to the broader issue of health insurance, health insurance coverage and how health insurance companies such as Aviva deal with their customers. The man's name is Mr. Colm Callaghan. He has written to the Minister for Health-----

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Paddy Burke An Cathaoirleach Fine Gael

The Senator should not name people in the House.

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My apologies. He is well known because the case is public, but I apologise for naming him. However, my constituent requires life saving medical attention and an operation that is only available in Canada. This has been confirmed by St. Vincent's University Hospital. A liver operation is required. What is galling is that this family has health insurance and the insurance policy document which I have with me clearly states "Yes" that the family is covered for benefit abroad for surgical procedures that are not available in Ireland. Obviously, the news the family received about this man's liver cancer was devastating. They made contact with Aviva at the time and were told verbally that they were covered and that the matter would be dealt with, except for the cost of flights and accommodation.

Then, a couple of weeks ago, Aviva came back to them to tell them that they were not covered and that they would be paid €22,000. The cost of the operation was €200,000. The man concerned has a young family who are distraught. I will be writing to Aviva as it is absolutely disgraceful.

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It is disgraceful.

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I worked in the insurance industry and have the policy documents. We have asked the Minister for Health, Deputy Leo Varadkar, to assist as best he can. The family wrote to him on 16 July. I will give the Leader the details afterwards and ask his office to take up the case with the Minister for Health who I am sure will be sympathetic. It may be that the State will have to step in, but Aviva cannot be let off the hook on this. The man concerned and his family have paid their premiums. It states on the policy document that they are covered and now Aviva is backsliding purely because of the cost. If the man concerned can raise the money, €200,000, he can have a lifesaving treatment in Canada that is not available in Irelan or elsewhere in Europe. It is groundbreaking surgery. Aviva needs to do the decent thing, admit the claim and allow the man concerned and his family to travel to Canada to receive the treatment and have the operation that will save his life. He is 47 years old. As the Leader knows, I do not generally raise specific health cases such as this. It is just the week that is in it because the Dáil is not sitting and we are. I will give him the details. I have written to the Minister, as have the family. I ask the Leader to take up the case with him. With the support of my colleagues, I intend to get on to the chief executive of Aviva and tell him of the Seanad's disgust at the manner in which the man concerned and his family have been treated. I seek the support of colleagues from all sides of the House on the issue.

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