In spring 2021 I. purchased PVZP Plus insurance. Later this summer she had to travel to her home town in the Ukraine in order to extend the validity of her passport – unfortunately this could not be done in the embassy. Thanks to the direct orders of the Czech Ministry of Health, long-term residents with private health insurance weren’t entitled to COVID-19 vaccination for the first 6 months of vaccination campaign (even paying out of pocket was not an option) – so I. wasn’t vaccinated at the time of her trip. I. was traveling by car and according to travel restrictions in place she didn’t need a COVID-19 test to show upon return – she had to undergo one in the Czech Republic the earliest 5 days after her trip.
4 days after she was back in the Czech Republic I. got diagnosed with COVID-19 (delta mutation) and hospitalized in Fakultní Thomayerova nemocnice. 3 weeks later PVZP declined paying for I.’s COVID-19 treatment, at the same time they refused to provide any explanation but the cryptic reference to “exclusion from coverage according to Oddil B Čl. 2.1 KZPCP 1/20″.
The hospital took the patient’s side and sent a request to PVZP to reconsider the case. At this time the medical bill has already reached 130.000 czk.
3 weeks later I. finally managed to get a formal explanation from the insurance company – according to it PVZP denied paying for COVID-19 as I. didn’t prove that she was healthy upon leaving the Ukraine. By mere chance I. underwent an antigen test a day before her trip as she needed one to attend a local event, and she still kept the result. Only after this evidence was introduced PVZP finally recognized the claim as valid and started to fulfill their obligations.