The daughter of a woman who suffered brain injuries while on holiday in the US has said she was told by her mother’s insurer that she must return to the UK, against the advice of doctors, or face having funding for her medical care withdrawn.

Jane Rubens, 73, from Edinburgh, is in a coma after being hit, as a pedestrian, by a large vehicle in St Louis, Missouri, at the start of November. The collision left her with severe brain injuries requiring multiple surgeries.

Her daughter Cat Rubens says insurance company Axa Partners insisted Jane be repatriated to the UK – against the advice of multiple experts.

“We have been shown zero empathy, customer care or reasonableness from Axa at one of the darkest times of our lives,” she said. The firm later backed down after a social media outcry.

Cat Rubens, a solicitor, described how she communicated the medical advice from neurologists in both the UK and US to the insurer, but was told on Sunday that the family had to agree that day to repatriate Jane by Wednesday 27 November or cover for her medical expenses in the US would cease.

“Jane has had a craniectomy where part of the skull was removed to relieve pressure in the brain,” said Rubens. “We were advised by an NHS neurologist and a brain injury charity that they would not expect a patient with my mum’s type of injury to be flown this early in her recovery.”

The family said they asked for the decision to be delayed for 48 hours so they could consult the neurology team, but this was turned down. Axa also declined to let Rubens’ neurosurgeon speak to its medical advisers, they claim, and was unable to produce a medical plan for the repatriation and ongoing care.

“The call handler accepted that we were being asked to agree to a plan we had not seen. Despite this, he reiterated that we had to agree by the afternoon or no further medical expenses would be covered,” said Cat, who has flown from the UK to the US to be at her mother’s bedside.

“We asked to speak to a manager. We were told no manager was available. We asked the call handler for a manager to call us back. He said that could not be arranged. We asked to speak to an underwriter. The call handler said that was not allowed. We asked for more time. Again, Axa said no. Backed into a corner, we had no choice but to agree to their repatriation plan, since we can’t afford to lose her medical cover.”

Jane’s neurosurgeon subsequently told the family that it would be in her best interests to fly after part of her skull had been reattached.

“That’s 3-6 months down the line,” Rubens wrote on X.

Axa changed its stance after the family highlighted their plight on social media. It has now withdrawn its deadline for repatriation pending discussions with Rubens’ medical team, and said it would continue to cover medical expenses while discussions were ongoing.

An Axa Partners spokesperson said: “We are sorry for the distress Ms Rubens and her family have experienced when making a claim and we sympathise with their situation.

“We have spoken with Ms Rubens’ family and will remain in contact with them over the coming days to support them. Our medical team and Ms Rubens’ treating doctors will agree the best course of action going forward.

“We are considering all available options, and the welfare of Ms Rubens and her family remains our priority.”

Axa’s conduct had caused the family intolerable additional suffering, claimed Rubens.

“All the time we are having to fight these battles to try to protect her is time we can’t spend in the room with her, holding her hand and talking to her and doing the things that might make her, if she has moments of greater awareness, feel less lonely and scared. We do not yet know if she will ever recover, but we are trying to give her the best chance possible,” she said.