Sarah's story - huge private medical bill

May I thank you for the way my accident claim has been handled, after my accident my confidence was very low indeed but the sympathetic handling of my case restored my confidence.

John, Sheffield

When Sarah decided to give birth in a private hospital she expected to be able to cover the medical bill with her private medical insurance. A host of complications left Sarah and her husband with a medical bill of £160,000, which her medical insurance did not cover.

Sarah's pregnancy
Sarah was pregnant for the 3rd time, and had been told she was expecting twins. She had undergone a caesarean section for the delivery of her first baby, but had given birth naturally to her second baby at a private hospital. Sarah was very keen to give birth to her twins naturally if at all possible.

When Sarah visited her GP he advised her that, because she had previously given birth by caesarean section, she would be unable to have a natural birth at an NHS hospital under current NHS policy.

Private medical care
Sarah therefore decided to return to the private hospital where she had given birth naturally to her 2nd child. Under the terms of her health insurance policy, her insurance company would pay up to £6,500 per delivery. She felt sure this would cover the cost of giving birth to her twins at the private hospital, as her pregnancy had progressed normally and there were no concerns.

Complications during labour
However when Sarah was admitted to hospital things did not turn out as she had expected. After she had been in labour for 10 hours the doctors advised her that they would in fact need to perform an emergency caesarean section as there was evidence that her babies were in distress. In the course of the caesarean procedure the obstetric team found that Sarah had actually been expecting 3 babies and delivered a set of triplets.

As a result of the unexpected complications Sarah's babies had to be rushed to the intensive care unit where they remained for the next 10 days. Meanwhile Sarah was severely haemorrhaging following the caesarean procedure and the doctors had to perform an emergency hysterectomy.

Private medical bill - 12 times more expensive than expected
Fortunately Sarah and her triplets all recovered and suffered no health problems following the dramatic delivery. It was accepted that the hysterectomy could not have been avoided and that in the circumstances the doctors had saved Sarah's life. But on the down side Sarah and her husband were left with a huge problem - private hospital medical expenses bills. The £6,500 per delivery provided by their insurance company was not nearly enough to cover the bills which soon arrived, which came to a total of around £160,000. Sarah and her husband, now with 5 children, could not afford this amount of money. Sarah contacted Alexander Harris for specialist advice.

When Sarah contacted us she explained that she would have done things differently if she had been told that she was expecting triplets and that there was a risk of complications. She told us that she would definitely have chosen to give birth at an NHS hospital with expertise in multiple births, and where no hospital expenses whatsoever would have been incurred.

We established that the treatment provided to Sarah had fallen below an acceptable standard because the hospital should have known from antenatal scans that Sarah was expecting triplets rather than twins. However it appeared that Sarah may not be able to succeed in a clinical negligence claim, as there was no element of personal injury and she had suffered purely from financial loss.

Breach of contract claim
After careful review we advised Sarah that she may have a potential claim for breach of contract. We contacted the private hospital's legal representatives and made it clear that unless the hospital agreed to a reduction in the medical expenses bills which they were claiming, Sarah would bring a counter claim in breach of contract for the financial loss which she had suffered as a result of the hospital's failure to provide treatment of an adequate standard.

Settlement
In the space of a few months we were able to negotiate an amicable settlement. Sarah had to pay £30,000 in full and final settlement of all outstanding bills, which was a considerable reduction from the sum of £160,000 which she had been billed previously. Her insurer paid £19,500 of this and fortunately Sarah and her husband were able to pay the remaining £10,500 from their savings.

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