Injury on piste - the hidden costs

A snowHead

For anyone travelling to VT this winter. If you are unlucky enough to be injured on the slopes the following may apply to you as it did to me. The ambulance will not accept your insurance or credit card. Only cash. The Cabinet Medical will not accept your insurance or credit card, only cash. You will have to arrange for someone to obtain enough cash for your use before you will be released and your treatment completed. The piste patrol will not accept your insurance details, but will accept your credit card payment which means that you can recover your skis which they will take from you. In this case they skied off on them without permission. The lift company will not refund your lift ticket unless you buy their supplementary insurance sold at their ticket office (so they say). Before this accideny I carried my insurance card, plus c.c's. Now I will add 500 Euros in cash (small denominations) to the list of essentials. Costs. 160 Euros for 150 metres of on slope recovery, Ambulance 140 Euros for 0.5 kilometer, Doctors 240 Euros, inc. 2 small xrays, painkillers and strapping. Crying or Very sad

A snowHead

snowbunny, it's normal to have to pay for medical treatment in France and then re-claim from your insurance company, I must admit the insistence on cash is something I hadn't heard of before. What you've described are the reasons we suggest to our guests that they purchase Carre Neige along with their lift pass, irrespective of the amount of insurance cover thay hold. Every pisteur understands what Carre Neige and Carte Neige are, I've never heard of anyone carrying them to be refused recovery

Well, the person's real but it's just a made up name, see?

Cash it is, and to pay them all I had to hand over my cashpoint card and pin no. (fortunately to someone I trust). I was left shivering sitting on a metal table with a broken collar bone until sufficient money had been handed over. Until that took place, around 2x per 5 minutes an ambulance attendant would come in and ask when he was going to be paid. The on slope recovery took 15 minutes to arrive and sledge me the 150 yards to their offices. I was aided by a Spanish skiing Doctor until they turned up. The piste patrol put a neck brace on which impinged the break, then the ambulance crew banged my head and shoulder against the seat in the back of the vehicle 2x. By this time the piste patrol had removed my helmet, pity really. And no this was not my fault, a woman hit me from above on the nursery slope area so hard that my collar bone broke before I hit the ground. So David, you are suggesting that in France it is necessary to buy insurance on top of insurance to get treated humanely? Evil or Very Mad

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No, I'm what I saying is that you could be expecting too much to expect pisteurs, who are the first to arrive at an accident to understand UK insurances. Carre Neige is universal throughout France, you carry a card alongside your ski pass and it ensures recovery from the mountain, it also covers ambulance costs, unused portion of a ski-pass and ski-hire costs. These are often not covered by UK insurances or you have to do what did and pay first and claim later.

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Ouch - makes me wonder if it is wise to go to France for a skiing holiday?
If that is the way they treat tourists in distress i'm surprised people don't go elsewhere.
If a French tourist visiting somewhere like the Nevis resort or Cairngorm was in distress would be interested to know if they would be treat the same?
I have visions now of injured tourists telling French piste rescue to sod off and dragging themselves down the mountain and making their way back to blighty injured and in distress. Sad

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rockyrobin, In my experience this is not typical. When I was hurt the pisteurs and ambulance drivers could not have been more helpful - the Cabinet Medical was another matter. The hospital was very good.

However it is a good idea to buy the French insurance (Carre or Carte Neige) and/or the insurance with the liftpass. Our costs €2.30 per person per day and covers evacuation from the piste, medical treatment and if necessary repatriation. Very good value I think, and not a great price to pay for peace of mind. Of course British TOs try to get you to buy theirs because they make money on it.

After all it is free

poo-poo. Sorry to hear about that snowbunny. I have to say that I'll definitely be getting a Carre Neige in future.

What a shambles of a system and I'd be staggered if that happened here. Obviously I've been labouring under the misaprehension that having an E111 for reciprocal medical treatment and a high level of insurance cover would suffice - as, I suspect, many others do also.

Lesson learned - thanks for the warning, and bad luck. Did the woman stop, help or accept any responsibility?

thanks for the reassurance easiski Smile

Can't beat a bit of old blighty knee jerk reaction Laughing

Just goes to show how the actions of a few plonkers can spoil it for the masses Crying or Very sad

I've only ever skied in Austria as a child and always had my hand held by the organisers.
I now ski on my own and have no ski buddies so is of concern to me.
I'll have a search on here for "Carre Neige" and will definately look at getting this - thanks Smile

Do the Swiss and Austrians have an equivelant to Carre Neige?

snowbunny - Thanks for the heads up. Hope you get well quick and are back carving them turns real soon.

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Mark Hunter, Yes she stopped, she was extremely upset, bordering on hysterical (so I'm told). Maybe she did'nt have Carte(Carre) Neige either. The Gendarmes asked me if I wished to bring charges. I am not sure who called for assistance, but the Spanish Dr I owe a "mil gracias" to. I am not sure of the extent of the woman's injuries, but she did receive some treatment. My insurer is a French company AXA, well recognised, but if it does'nt say Carte Neige Val Thorens you get a big NON (well I did). Perhaps they were having a bad day, I know I did. And a big non for the E111 too.David@traxvax, My insurer would have covered my costs, was surprised not to have been contacted, but all those French professionals mentioned in earlier posts were unwilling to make contact (short word 3 letters). I did observe that the number of administration staff in the doctors seemed to outnumber the medical staff. All that cashflow perhaps. I have survived, it is not apparently a serious break, though quite painful,and I will be fit in a month or so- call it a learning experience! 21 winters, my 1st bloodwagon, off the nursery slopes!! Will I ever live it down. Embarassed

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Anyone holidaying in Courchevel should note that the medical centre in C1850 only accepts cash.

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David@traxvax, For skiing in France do you recommend that I should take out Carte Neige cover in addidtion to my UK cover?

Where/how do I obtain the cover?

Does Carte Neige cover off-piste?

You know it makes sense.

snowbunny, what an all round awful experience. I hope that you soon recover.

Does anyone know what is the difference between Carre Neige and Carte Neige? Do you need both or either? With them, do you still need to carry any cash? How do they work for families/children?

Otherwise you'll just go on seeing the one name:

snowbunny, sorry to hear of your experience and hope you make a quick and full recovery.

Overall this sort of report makes me glad I'm not skiing in France

A snowHead

Answering some of my own questions, I found this on pistehors.com

A snowHead

spyderjohn, I'd always recommend Carre Neige or Carte Neige, we have Carte Neige because we have seasons passes. You buy it at the same time as getting your lift pass, it's only about 2.5 Euros a day. It gives you that extra assurance that if anything happens you don't have to worry, fortunately I've never had to test it.

Well, the person's real but it's just a made up name, see?

Dreadful experience by the sound of it. Only serves to reaffirm my Francophobia. The Swiss will always get your money in the end, but they'd never be so crass as to demand it while you're still on the treatment table.

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snowbunny, I'm sorry for two reasons; firstly the pain of the accident but also because you found out the hard way why France is such basket case of a country. There's a certain type of Brit who regards French disdain, arrogance and xenophobia as an endearing trait. It's not, it's simply disdain, arrogance and xenophobia. If anyone wishes to know, I speak from experience. I lived there for some years and well know the national characteristic.

David@traxvax, , you said

" ... what I saying is that you could be expecting too much to expect pisteurs, who are the first to arrive at an accident to understand UK insurances."

That's not good enough. Each year hundreds of thousands of British skiers put tens of millions into the French economy. Either they are aware of UK insurances and simply try to screw the hapless when they think they can get away with it or aren't aware, which simply confirms their appalling standards of customer service. The sooner all Brits abandon the country the better.

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4thefunofit, the irony is that you demonstrate the very traits you criticize by condemning, unjustifiably, an entire nation on the strength of snowbunny's very unfortunate incident. The characteristics you mention are common to a minority of individuals in countries throughout the world, not least in the UK.

You may well have spent some time in France, but I have lived around Europe for a large proportion of my 48 years and I can reassure anyone who might take this kind of stereotyped comment at face value that for every unpleasant incident, I have witnessed a hundred examples of spontaneous kindness, goodwill and respect. Those of us who make an effort to integrate into the local community, having regard for local customs and sensibilities, are made to feel perfectly at home.

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I remember a case in Val D'Isere where one of our party was injured. His insurance was good enough for him to be helicoptered off the piste. More recently there I had a bad knee injury - but somehow got myself down the cable car to the bottom and bus back to Val (from Le Fornet) under my own steam (unwise). Went to the British doctor there. Found I had to go to the pharmacy in icy conditions, to get prescription stuff, including crutches with crampons - without the benefit of said crutches and crampons. There I had to pay - but I collected little sticker things that came with the prescriptions, and presented these and the E111 to my insurance company, who lowered (may be waived) the excess charges, because they themselves were able to claim back some or all of the costs. About 6 years ago.
The French system does seem quite different in detail from ours. I think you should: be insured (Carre and Carte Neige does look interesting), have your E111 (remember you need a new one this year), proof of insurance, and means of payment with you. Cash looks to be good. Also, if possible, have someone with you at the doctor and pharmacy - preferably someone who speaks a little French. PG would be good!
Taking up PGs point on courtesy, in Provence last summer I saw the British occupant of a wheelchair topple backwards. The immediate response of the French around her was concerned, considerate and practical.

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David@traxvax, with Carre Neige or Carte Neige would all the parties concerned still require payment in cash before your treatment is completed?

After all it is free

"Bashing" the French sometimes seems to be a popular "sport" in the UK. And for every criticism of the French, I dare say there is a justifiable criticism of the British.

However, PG's assertion that

Ray Zorro, As far as I am aware, the Carre Neige is accepted as proof of insurance and that charges will be met, up to the point of treatment. Fortunately, I've never had to test it myself. As a matter of interest, I've accompanied guests to our local Cabinet Medical, where even if the guest hasn't had the means of payment with them, treatment has never been refused. I guess that's another advantage of being in a smaller village.

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Mark Hunter, this incident is very strange, and I shall find out more. The French health system is in my opinion superior to the British equivalent in many ways (I have proposed reasons for this elsewhere), but I can tell you for a fact that a public hospital cannot refuse treatment under any circumstances. Private clinics and surgeries are another matter, as they operate under the system of payment up front with reimbursement to follow (100% in many cases) of the patient/accident victim.

The British are not familiar with this system, but it is one that works very well indeed and standards of care are very high in the majority of cases. Waiting lists over here are virtually nonexistent, GPs give you a full 15 minutes of their time whatever you came in for, you can make your own appointments direct with specialists and in virtually all cases within a week or two.

I agree that the events as described would be indefensible, (ie not the request for payment per se but the alleged lack of treatment until payment in full had been made).

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PG, the French sytem of healthcare may well be superior, but the British one isn't up for examination here. Suffice to say that there is private healthcare here as well and the waiting lists are practically non-existent. No great surprise there.

What does fail scrutiny is the ability in this and other documented cases for emergency health care, on an elementary basis, to be provided first!

Don't get me wrong. I am not an advocate of the arguement that the state should pick up the whole healthcare tab for it's people and visitors. People should take some responsibility for what they do, particularly when engaging in activities that carry some risk. But, we supposedly live in a civilised society and the example of snowbunny's treatment and plenty others, I daresay, is not acceptable. Whatever the circumstances.

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I certainly agree, and as I wrote above, refusing to treat someone in pain would be indefensible. Although I hesitate to say it until I have fully checked my facts, it verges on malpractice as I understand the French system and an obvious failure in duty of care. I have never heard of a story like this before, and I have seen numerous examples of emergency care over here, and in none of them did I encounter anything approaching the circumstances/attitude as described by snowbunny.

As the ambulance service is private, there is no comeback on the state if a patient fails to pay. They stand to lose a lot of money if they don't obtain immediate payment and invoice holidaymakers from other countries once they return home. A large percentage simply wouldn't pay. Same applies to doctor's fees. A lot of these problems/misunderstandings develop because of foreign visitors' lack of awareness of the constraints under which the French medical service providers work.

The insurance business is another matter. In my experience, insurance companies seem to make it their business to contest and delay payments, and small ambulance businesses/doctors practices cannot afford to give several months credit, not to mention the time involved, chasing all and sundry, often based abroad, for payments. They know that with the Carré Neige there is no problem. From bitter experience with many other insurance companies, they know of the delays - or worse - that are often involved.

Living in France, if you need an ambulance, are you expected to pay up-front? If not, what is the system for their remuneration?

You know it makes sense.

It is worrying that a British insurance card is not considered proof of payment. I can understand it though, The Val D'Isere doctor told me that payment was often sluggish, though my company (Premier from the SCGB) wasn't bad. The helicopter I referred to earlier was called in on the basis of the Britsh insurance (again SCGB, I think), but only after the pisteur had checked that it was there. He siad that otherwise the helicopter would not be used - though rescue would still have occured.

This cash up front thing would become very interesting if you have to fork for a helicopter rescue with notes in your wallet.

When I broke a fibula at Fernie, rescue off the mountain was prompt and free (by Skidoo). First aid at the bottom of the mountain was free. The doctor at the medical centre charged for his consultation.

Anyone with experience of rescue/medical attention in Austria, Switzeralnd, or the US?

Otherwise you'll just go on seeing the one name:

Mark Hunter, the "pompiers" do a lot of the emergency runs, foc. Ambulances tend to do the booked runs, and these are often on prescription. Some people with registered conditions are 100% state reimbursable, so they wouldn't pay for the trip, others (including me) would pay. You then send off the receipt to the Sécurité Sociale for reimbursement.

We have a medical ID card these days, the "carte vitale". When I pay the doctor his 20 euros he sticks the card in his machine and the state reimbursement goes into my bank account, very little delay involved. Same at the chemists. The percentage that is not reimbursable is covered by a supplementary insurance policy, a "mutuelle", which many people have in France.

A snowHead

PG, so I guess the next time someone has an accident on the slopes, shout Feu, Feu. Joking aside, surely if an ambulance is required in an emergency and duly arrives to take an injured person to hospital or wherever, if the injured party can demonstrate they have (in our case) a valid E111, that ought to be enough for the ambulance driver to claim through state aid payment for the service.

Obviously this doesn't seem to be the case and highlights yet another big difference within the European "Community" that is discovered only when it's too late. Perhaps we should start charging nasty foreigners who use our ambulance service. Useful funding for an overstretched service.

Incidentally the fireservice here is under huge pressure to provide primary emergency treatment at accident scenes as they're usually the first on site. Many firemen are already undergoing the training.

A snowHead

Mark Hunter, Well, I would like to see if this is primarily a problem with skiing in France, rather than elsewhere. If so, it seems that the solution is the Carre Neige - or ski in another country, of course.

Well, the person's real but it's just a made up name, see?

Not an isolated incident I'm afraid.

When I broke my leg in Courchevel 1850, the mountain crew and the ambulance crew were more interested in my credit cards as their first priority. Then they had a real problem as they could not get the credit cards to work on their new system which had been implemented with little regard to how the rest of the world's credit cards worked. In bed in the hospital in Chambery, the ambulance crew called twice, having travelled from Courchevel each time, to try to get cash - in the end the the hospital assisted, on my suggestion, by putting them in touch directly with my insurance company, which was of course my credit card company.

With regard to late payments - the surgeon who did a great job on my leg asked for a cash payment as it would take months for the French health service to reimburse him.

A friend had a leg injury in La Plagne and again the priority for getting him off the slopes and for giving treatment was his credit cards. When these cards would not work I paid in order to ensure that he had treatment.

I can understand the problem of the individuals about getting paid when they are working in a system which expects them to give a service without ensuring that they will be paid.

Sorry PG but bottom line is that the priority should be to get the customer off the slopes and treated. The system run by the French authorities to look after these people spending good money is very poor indeed. Individuals are fine, they always are, but the attitude of the people running the system is hopeless and will be a problem long term.

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PG, I make an effort to integrate into the local community wherever I am, and was certainly made to feel at home in France. However the country has a serious problem in getting along with foreigners/foreign institutions where French and foreign practices don't accord. I'm sure the many drivers deprived of their money on the roads outside of Calais, without receipt, may sympathise. There are many airline pilots who have had arguments with French air traffic controllers who refuse to speak English who may sympathise also. I'll explain; you may be aware that English is the only accepted language for internatinal air travel. As such, French air traffic controllers must converse in English with pilots overflying or landing in France. My girlfriend is an airline pilot, she can tell you of numerous instances when they simply do not and refuse to speak anything but French. When sitting in the cockpit with her I witnessed an argument between an American pilot and a French controller. All of his requests for a routing through French air space were met with a dose of French. The pilot was obviously worried yet they simply would not speak English. Hey, what are 300 lives when French pride is at stake? By the way, all this talk of the carte and carre neige is beside the point; the E111 is the document that suffices. French health authorities are obliged by treaty to honour it. We have read above of an instance where they don't. It's not good enough.

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The E111 becomes an electronic card later this year - it's a proof of entitlement to welfare services throughout the EU. Perhaps it'll help.

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In Courchevel a few years ago, I was in a chalet with someone who had broken their ankle there the year before. She was very pleased with the outcome of her treatment, and decided to pay the clinic a visit to show the doctor how well it had turned out, and to say thank you. On the way out of the doctor's office, she was handed an envelope to give to the receptionist. It was a bill for the time incurred in saying thank you to him!

After all it is free

PG said.

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For longer stays in hospital there is usually enough time for insurance companies to come to an agreement. A British visitor was hospitalised when I was in Provence, and this was what happened. However, payment is made by French nationals/residents on leaving hospital if the guarantees haven't come through from their complementary insurance - the same system affects all, indiscriminately, resident or foreign visitor.

For the initial emergency it makes sense to have the carré neige for on piste rescue and emergency treatment at the clinic - private or state. Sufficient cash for the ambulance trip is a good idea. Some ambulance companies can accept credit cards, but there are no guarantees. Of course, if the UK had joined the euro system a cheque might have sufficed! wink

Hannah's best friend's mum runs the "Ambulances Bérard", one of the biggest in the Bourg St Maurice area. I'll get the lowdown on the system, problems etc from the horse's mouth next time she pops round.

Help!!

Injury on piste - the hidden costs

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