Overseas student's health care struggle

Sylvia Frain went for months without coverage for her medical condition when her health insurance...
Sylvia Frain went for months without coverage for her medical condition when her health insurance company cut off payment for her treatment. Photo by Jonathan Edwards

The University of Otago is pouring money and resources into attracting international students, but is it taking care of students once they get here?

Carla Green reports on one student's nightmare experience with a health insurance bureaucracy.

The day Sylvia Frain turned orange, she was on a Pacific island 7000km northwest of Dunedin.

She was at her mother's home, in the United States island territory of Guam.

And she was ill. So ill, in fact, that she had taken a five-month medical deferral from her PhD studies at the University of Otago.

Then, her skin turned orange. Her eyes turned orange. Her liver was failing.

''I literally felt like I was dying,'' Ms Frain (33) says.

Her doctors said she was having a rare reaction to a medication she had been taking, and she needed to stop immediately.

''They said ... 'If you do not stop this, you're going to need a liver transplant'.''

Once Ms Frain stopped, her condition worsened, briefly, and then she started to recover.

She is still recovering from the episode, more than a year later.

She is also still recovering from a gruelling months-long battle with her health insurance provider, a battle that left her destitute and reliant on supermarket vouchers to provide food to eat, before the situation was resolved.

The insurance coverage - from a company called Allianz Global Assistance - was one she had bought through the university.

And, up to that point, Allianz had been paying for her treatment in full.

But on September 4, 2014, three months after Ms Frain teetered on the brink of liver failure, she got a letter.

It was from Allianz.

''Dear Sylvia,'' the letter reads.

''Based on the information provided, it would appear that the loss you reported is not insured within the terms and conditions of your policy. Unfortunately, we are unable to cover your medical expenses or any related costs.''

Within an hour of getting the letter, she called the insurance administrator at the University of Otago for help.

Later, she would go into the office to speak to them in person.

Allianz, she told them, was saying her treatment was no longer covered because it was for a pre-existing condition.

And they were wrong, Ms Frain says.

She would go on to get multiple letters from doctors saying just that, to prove it.

But the international student office repeated the same line as Allianz, she says.

''No-one wanted to deal with it.''

Nothing happened.

And it stayed that way for months, Ms Frain says, as she sunk to using credit cards for paying debt for the mounting medical bills.

In one email, more than a month after she first contacted the international student office, she asks a university staff member what is happening with her case.

''No staff got back to you?'' he writes.

''No,'' she replies.

No-one got back to her.

Finally, in November 2014, Allianz agreed to pay for bills she had submitted in June and July of 2014.

But all of her treatment after that, which she had paid for out of her own pocket, still had not been reimbursed.

Then, in early December 2014, she found out from Allianz her coverage was scheduled to end just before Christmas.

It turned out to be a ''data entry error'' by the university, and it was sorted.

But Ms Frain says she spent the holiday break worrying whether she was covered or not.

After the break, in early January, she got a message from international student office manager Jason Cushen.

''Sorry about the delay in replying to you on this matter,'' he wrote.

''I was on leave when your email came through. My understanding is that your situation has been settled with the insurer, and the confirmation of your coverage has been made.''

After that, everything finally started to look like it was turning around.

Mr Cushen negotiated with the company on her behalf, Ms Frain says, and Allianz agreed to pay all of her medical bills up to that point, including ''alternative'' treatment Allianz had previously said was not covered.

Allianz declined to comment on Ms Frain's case for this story, saying only ''the issues raised by Sylvia were dealt with via its external dispute resolution procedure''.

''[Allianz] would like you to know that these were fully and finally resolved.''

But Otago students' association student advocate Philippa Keaney says Ms Frain is not the only international student who has had problems with insurance - or with delays dealing with the international student office.

In advocating on behalf of students, domestic and international, Ms Keaney says she has seen ''a few cases each semester where a timely resolution hasn't been reached with the university'', even when time is of the essence, such as in Ms Frain's case.

And although the issues with Allianz were eventually resolved, Ms Frain says the way the university dealt with her case violated a national code for the care of international students on several counts.

The university, which is a signatory to the code and required to abide by it, disagrees.

Ms Frain also wants to understand why it took so long for anyone at the international student office to help her.

She had hoped an independent body that deals with international students could mediate to resolve the disagreement.

Yesterday, it informed her she was considered a domestic student and declined to help.

For the most part, Ms Frain says, she is happy at the University of Otago.

She has a three-year scholarship to do research at the National Centre for Peace and Conflict studies, and says she feels ''honoured to be paid to do the research that I want to do''.

And, she says, she is grateful for ''what the university did eventually do in negotiating with the insurance company''.

''It was just the timeframe. And the amount of energy and effort it took ... to force them to do it.''

And Ms Keaney, the student advocate, says many students have positive experiences with the international student office.

But there are also students, like Ms Frain, who do not, she says.

''What Sylvia's case highlights ... is that if we're going to focus on recruiting more international students, the university needs to make sure that we have robust processes to support those students,'' Ms Keaney says.

''It's really hard to be in a different country, to try to get the help that you need, when the only place you've got to go for that help really is the institution that you're expecting to look after you and support you.

''If you don't get a timely resolution, what do you do?''

The University of Otago declined to answer any questions about Ms Frain's case, instead providing a statement from international office director Simon Chu.

''While it is not a primary role of the international office to advocate for students on insurance matters, we regularly assist with individual claims when students come to us for help,'' Mr Chu writes.

''The international office stands by its record of providing a high quality level of customer service to the 2500 international students studying at the university.''

carla.green@odt.co.nz

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