HONOLULU — A Kauai man is suing his health insurer over a $36,000 air ambulance bill.
Toby Sidlo filed the lawsuit after falling into a bonfire last year during a beach football game. Doctors decided to fly him to a Honolulu burn care unit for treatment.
There are two Hawaii air ambulance providers. The average cost for a flight is $40,000.
State Sen. Josh Green is a Kohala Hospital emergency room doctor.
He says doctors select the company that can transport the patient the quickest.
Sidlo, a tour boat captain on Kauai, was going out for a pass during a beach football game when he fell into a bonfire and severely burned 30 percent of his body.
The 35-year-old Kalaheo resident could not be appropriately treated on the island, so doctors decided to medevac him to Straub Clinic & Hospital’s intensive care burn unit on Oahu, according to reports.
The Honolulu Star-Advertiser reported Monday the case illustrates the high costs of emergency air transport, which is essential for people living on the neighbor islands.
On islands where there are limited health care services and specialists, it’s common to transport patients on flights to Honolulu.
According to Courthouse News Service, Sidlo’s insurance policy said it would cover 80 percent of the cost of medically necessary emergency transportation services.
But his carrier denied most of it, leaving him with a $36,000 balance due, according to the complaint.
“Defendants and their related entities have established and carried out a deliberate and systematic policy to deny all claims for proper emergency transport reimbursement, even though it knows that the terms of its own plan documents purport to provide full reimbursement coverage for the medical services minus a standard 20 percent co-pay applicable to the class,” the complaint states.
Sidlo, who could not be reached for comment Monday, and the suit seeks declaratory and injunctive relief, costs, interest, attorney fees and equitable disgorgement.
The class is represented by Michael A. Lilly and Valerie Kato of Ning, Lilly & Jones in Honolulu.