Expat defeats insurance company in medical bill row

An expat has won a two-year legal battle against a Spanish insurance company who refused to cover his medical bill

After suffering an emergency heart condition in Mijas, Andalucia, retired IT director Graham Otter, 58, took it for granted that his insurance company, Groupama, would pick up the bill.

Despite having no history of heart problems, he was surprised to learn that they'd refused to cover the medical costs on the grounds he was suffering a pre-existing complaint.

He supplied the insurance company with an assurance from his doctor that it was his first heart-related illness, yet Groupama refused to budge, leaving him €4,000 out of pocket and no option but to take them to court.

“Their response was just to ignore me and block any further cover for heart-related treatment.
“Thankfully for the last two years I have only needed consultations and simple procedures, but I have had to pay for these myself.

Now, after two years of fighting, he has had the money reimbursed.

“But it would not have been achieved without a huge amount of effort and emotional stress which is exactly what you don’t need when dealing with a heart condition", he said.

Mr Otter, originally from Buckinghamshire, has spent the last seven years in Mijas and always relied on private Spanish healthcare because he doesn't qualify for the country's national healthcare cover.
“In total I have been forced to pay around 4,000 euros.”

He has now recouped his losses after the judge ruled that Spanish insurance company were liable for his costs.

He said: “I just hope that my experience may be a warning to others.”
Groupama declined to comment.

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