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Travel insurance loophole devastates B.C. couple
Topic Started: Mar 10 2012, 01:46 AM (1,698 Views)
Darcie
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Skeptic
The travel health insurance that millions of Canadians buy may offer no protection at all if they answer a single question incorrectly — no matter how innocent the error — on a medical questionnaire full of convoluted language, confusing clauses and tricky definitions, the CBC's Marketplace has learned.

For some people, the result can be financial ruin when their claims are denied.

That’s what happened to Bill Jennings, 67, and his wife Tracy, 48, of Gold River, B.C., who bought travel insurance from Manulife before leaving on a trip to Fort Walton, Fla., in December 2010.

They filled out the application, including the medical questionnaire, online and thought they were covered in case of illness during their trip.

In Florida, Bill had chest pains and numbness in his arm. He discovered he had suffered a heart attack and needed emergency surgery to remove five blockages in his heart.

The surgeon explained that Bill could not be flown home because a change in altitude could bring on another heart attack


Which is why we bought insurance in the first place — unexpected emergency," Tracy said. "This was unexpected."

Recovering back home, Bill was stunned to receive a letter six months later, saying his travel health insurance claim was denied and he owed $346,000 US in medical bills.

"I was just in shock," he said. "I’ve always had travel insurance whenever I’ve left the country. Just in case something happens."

Added Tracy: "We're in financial ruin."

The problem, according to his insurer, Manulife, was the way the Jennings filled out the medical questionnaire.



Manulife says Bill should have answered yes to this question about two conditions:

"In the last two (2) years, have you been prescribed or received treatment for and/or been hospitalized (as an in-patient or seen in the emergency department) and/or been prescribed or taken medication for any of the following conditions: diverticular disorder or gastrointestinal bleeding?"

Bill insists that he didn’t know what was spelled out in his medical file or that he’d been diagnosed with those two conditions. He thought all his symptoms were related to the colon cancer he’d had surgery for 19 months earlier.

"Most importantly to me would be the question, 'What does anything, what does anything related to this have to do with Bill’s heart?'" Tracy said. "Absolutely nothing. Absolutely nothing."

Susan Eng of CARP, a Canadian advocacy group for people over 50, says the system is set up for claims to be denied.

"Ordinary people are out thousands and thousands of dollars because they did not get the protection they thought they had — only because they made a mistake on the form that they could not possibly have done correctly," she said.

While people do have the responsibility to fill out the medical questionnaires correctly, the bar is set too high, she said.

"They have to do their best. But as we’ve looked at some examples, the best is not good enough. They simply have all the cards stacked up against them."

http://www.cbc.ca/news/canada/story/2012/03/08/travel-insurance-marketplace.html

Never realized that people trusted insurance companies. Carp is right on about them.
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Darcie
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goldengal
Mar 11 2012, 06:31 AM
You still are not comprehending ohmy 03 when one lives in a long term care/nursing home, they are not a patient but a resident - resident being the key word.

Take care,
Pat
ALL private and not for profit nursing homes have their rates set by government, none are above the law when it comes to rates. They cannot avoid this and charge more no matter how much money you have.

The rate is based on the individual's income tax assessment.
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campy
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goldengal
Mar 11 2012, 06:31 AM
You still are not comprehending ohmy 03 when one lives in a long term care/nursing home, they are not a patient but a resident - resident being the key word.

Take care,
Pat
I am comprehending. You are not.

Private care is available. The richer you are the better care you get.

That's not the case for other health care in Canada.

You can't jump the line no matter how rich you are (practically speaking but i know that's not entirely accurate).

And I also told you I am not against the private care. Just setting the record straight for our American posters as to what Universal health care is like in Canada.

Once you get old it's no different than that of the U.S.

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campy
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Darcie
Mar 11 2012, 06:34 AM
goldengal
Mar 11 2012, 06:31 AM
You still are not comprehending ohmy 03 when one lives in a long term care/nursing home, they are not a patient but a resident - resident being the key word.

Take care,
Pat
ALL private and not for profit nursing homes have their rates set by government, none are above the law when it comes to rates. They cannot avoid this and charge more no matter how much money you have.

The rate is based on the individual's income tax assessment.
Don't be naive.

The private care is much more expensive than the public care and the service is much better as well regardless of the rates.

The rate is based on the individual's income tax assessment?

I have already stated that and if you check the rates what senior on OAS can afford any of the rates quoted?
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wildie
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campy
Mar 11 2012, 05:18 AM
What I was surprised at in a nursing home was how few visitors some of the residents get from family.

So if you do transfer assets make sure there is a visitation clause.

Elderly patients used to get visits from family when the OAS cheque arrived. The cheque had to be signed.
Now that the cheques are deposited directly, the OAS reciprient will get fewer visits.
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campy
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wildie
Mar 11 2012, 06:39 AM
campy
Mar 11 2012, 05:18 AM
What I was surprised at in a nursing home was how few visitors some of the residents get from family.

So if you do transfer assets make sure there is a visitation clause.

Elderly patients used to get visits from family when the OAS cheque arrived. The cheque had to be signed.
Now that the cheques are deposited directly, the OAS reciprient will get fewer visits.
Well now the Casinos are getting the money before they go into a home.

The families complain but one senior told me.

"If they visited me more often and took me out once in a while, I wouldn't have to go to the Casino for company".





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Darcie
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campy
Mar 11 2012, 06:39 AM
Darcie
Mar 11 2012, 06:34 AM

Quoting limited to 2 levels deep
Don't be naive.

The private care is much more expensive than the public care and the service is much better as well regardless of the rates.

The rate is based on the individual's income tax assessment?

I have already stated that and if you check the rates what senior on OAS can afford any of the rates quoted?
Well if you know all about it I would appreciate the name, address and phone numbers of nursing homes that do not have their rates set by government.

You appear to be knowledgeable so I imagine the information will be available soon.
Edited by Darcie, Mar 11 2012, 06:45 AM.
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campy
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O my gosh.

What do I have to do to convince you? Beat you over the head with a stick?

The government sets the rates but check the rates of private homes as compared to public ones and tell me if a senior on OAS can afford to go into a private home.

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Darcie
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campy
Mar 11 2012, 06:47 AM
O my gosh.

What do I have to do to convince you? Beat you over the head with a stick?

The government sets the rates but check the rates of private homes as compared to public ones and tell me if a senior on OAS can afford to go into a private home.

:sign10:

Read this:

http://www.nursinghomeratings.ca/understand-the-nursing-home-system/ontario
Edited by Darcie, Mar 11 2012, 06:50 AM.
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campy
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O my gosh!

I am not arguing the fact that government set the rates.

That's not the point.

The point is the rates at private homes are much higher than the public ones.

Get it now. If it were the other way around and the rates were the same for all homes, we would all go into the private ones if the service stayed the same as the are now.

Do you not Capeece?

Edited by campy, Mar 11 2012, 06:58 AM.
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Darcie
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"In the province of Ontario, the Ministry of Health and Long-term Care determines the fees for private, non-profit, and government run nursing homes, and fees are the same regardless of the owner."

Copied from the site I told you to read Campy
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Darcie
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campy
Mar 11 2012, 06:55 AM
O my gosh!

I am not arguing the fact that government set the rates.

That's not the point.

The point is the rates at private homes are much higher than the public ones.

Get it now. If it were the other way around and the rates were the same for all homes, we would all go into the private ones if the service stayed the same as the are now.

Do you not Capeece?

Not at all true the rates are the same no matter who the owner is.
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campy
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Darcie
Mar 11 2012, 06:34 AM
goldengal
Mar 11 2012, 06:31 AM
You still are not comprehending ohmy 03 when one lives in a long term care/nursing home, they are not a patient but a resident - resident being the key word.

Take care,
Pat
ALL private and not for profit nursing homes have their rates set by government, none are above the law when it comes to rates. They cannot avoid this and charge more no matter how much money you have.

The rate is based on the individual's income tax assessment.
This is what I am talking about.

Private Nursing Homes

Also an option in BC, some seniors choose to reside in private homes that determine their own pricing, admission procedures and wait lists.
Room Type

Provincial Range
Semi-Private

$4,200.00-$6,300.00
Private

$4,000.00-$8,200.00
One-bedroom Suites

$5,100.00-$8,640.00

Quoted from:www.sunlife.ca

http://www.senioropolis.com/article-general.asp?ID=41
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Darcie
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campy
Mar 11 2012, 07:04 AM
Darcie
Mar 11 2012, 06:34 AM

Quoting limited to 2 levels deep
This is what I am talking about.

Private Nursing Homes

Also an option in BC, some seniors choose to reside in private homes that determine their own pricing, admission procedures and wait lists.
Room Type

Provincial Range
Semi-Private

$4,200.00-$6,300.00
Private

$4,000.00-$8,200.00
One-bedroom Suites

$5,100.00-$8,640.00

Quoted from:www.sunlife.ca

http://www.senioropolis.com/article-general.asp?ID=41
I do not know about BC, if this is the state of things there at present it certainly has changed since I lived there. Later this weekend I will check out the nursing home policy of that province.

The largest province in Canada, Ontario has the same rate for all nursing homes and one can apply for a rate reduction depending on your income to ALL nursing homes.
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goldengal
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Mistress, House of Dogs
This is the not for profit charitable 100 bed long term care home in Woodbridge, Ontario which, while Latvian applicants would likely get first choice, they do admit others. The price here is exactly the same as in the other nursing homes that come under the umbrella of CCAC.

http://www.kdlatvianhome.com/rates.html

I queried my friend about giving away assets in the U.S., and this is her reply:

"Medicaid performs a very indepth audit into people's finances and they cannot have transferred any funds within 5 years."

Take care,
Pat
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goldengal
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Mistress, House of Dogs
In this site you provided, I do not see any private long term care homes listed for Ontario. Am I missing something?

http://www.senioropolis.com/article-general.asp?ID=41

We have been discussing long term care homes in Ontario under the umbrella of CCAC with government funding. Now you provide us with a site to prove your point, and I do not see any listing for Ontario.

Take care,
Pat
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