Insurer breaks silence after denying payment to brain-injured woman who suffered horrific fall on holiday

An insurer has spoken out after refusing to pay out for the care of an Australian woman in a coma after a fall at a Thai hotel.

The moment Kylee Enwright fell head first was captured on film, but the insurer refuses to cover her medical expenses.

Her family are struggling to raise the cash for her medically evacuation - which could cost AU $200K (US $130K).

Kylee, from Singleton, New South Wales, has been unconscious in Bangkok Hospital, Phuket, since the incident at the Grand Mercure hotel in Khao Lak on 28 May.

Her emergency brain surgery and care has cost her family upwards of AU $50,000 (around US $33k), a total that rises with every passing day.

The insurer, Cover-More, says a clause excluding incidents involving alcohol means they won't pay out - despite Kaylee's blood alcohol level never bring tested.

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They used the couple's bar tab and calculated a blood alcohol level of 0.35 at the time of her fall - more than seven times Australia's legal driving the limit.

They'd paid for nine Long Island Ice Teas and 14 beers, but her husband claims the tab had been left open and other guests added drinks to the bill.

Cover-More told 7 News in a statement: “Cover-More is fair and reasonable in our claims processes, and we make our decisions after thoroughly assessing all available details and medical information.

“We gave Kylee’s husband, Paul, a detailed and transparent explanation for declining this claim."

They continued: “This is a sad case, and we will continue to offer Paul and Kylee and their families all the non-financial assistance Cover-More can.

“This includes help with arranging repatriation to Australia, assisting with hospital admissions and a ground ambulance in Australia, travel arrangements and making appointments with local medical practitioners overseas or in Australia.”

Kaylee's husband Paul Enwright admitted he 'didn’t read the fine print' of the policy.

“We were doing it tough and just getting by, so we thought we would have a holiday to decompress," he shared.

On the second day of their trip, Kylee went to the bathroom as the pair enjoyed drinks.

Paul remembers: “Then all of a sudden I was getting called by the hotel staff to come quickly.

“I got over there and found she had fallen off the deck, head-first, about half a metre.

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He says: “She was basically bleeding from the head and ears. Her head hit the ground very hard, from what I’ve been told.”

Paul believes she was trying to dodge heavy rain.

A guest provided first aid until emergency services arrived 15 minutes later.

Paul explains that, while Kylee has opened her eyes a few times, can move her left arm and leg and squeeze his hand, she's 'basically been asleep ever since'.

"They’re a bit concerned that she’s not more alert by now,” he shared. “They’re not sure what’s going on."

Her three adult children flew to Thailand to be by her bedside.

In some positive news for the family, a GoFundMe campaign has raised over AU $140,000 raised of $200,000 goal.

Of Cover-More, Paul said: “I am disappointed. Like most Australians, we took up travel insurance at the level of coverage that we thought was going to be adequate.

“We thought we’d done everything right. We’ve been stung by it in the most devastating way.

"We’re just at a loss. I don’t see a light at the end of the tunnel.”