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| Travel insurance loophole devastates B.C. couple | |
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| Topic Started: Mar 10 2012, 01:46 AM (1,697 Views) | |
| Darcie | Mar 10 2012, 01:46 AM Post #1 |
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Skeptic
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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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| LuvSouth | Mar 11 2012, 10:15 AM Post #46 |
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I am not aware there's different rates for private nursing homes in Ontario, they all follow the rates set by CCAC. To clarify the confusion, I called a private nursing home and asked them their rates, they told me all nursing home in Ontario have the same rates set by CCAC, no matter where you go. |
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| LuvSouth | Mar 11 2012, 10:31 AM Post #47 |
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Back to the topic: Travel insurance. Now we know some people were left with the medical bills as insurance companies found ways to deny claims. How are we assured that this won't happen again ? Any check list ? |
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| campy | Mar 11 2012, 10:34 AM Post #48 |
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Handyman Extraordinaire
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I said Canada not Ontario only. |
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| erka | Mar 11 2012, 10:36 AM Post #49 |
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Gold Star Member
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Back to the "off topic". In BC, there is a two tier system (public and private) and the disparity in fees is unbelievable as indicated in Campy's post. We have friends in a "private" nursing home and any extras are paid by the resident (i.e. help with feeding, dressing, personal care. I believe it was $20,000 more per year. The help is from unqualified staff as evidenced from this link: http://www.nsnews.com/Coroner+says+home+lied+senior+death/5643312/story.html |
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| LuvSouth | Mar 11 2012, 10:45 AM Post #50 |
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Wow, BC has a 2 tier system re nursing homes. I only learned it today ! Speaking of choking to death, it almost happened to one of our family members. He was fed by an in home healthcare worker, and he was choked in a way he couldn't talk, his faced turned pale, his eyes were wide open but no responses. Fortunately one of us was around and we immediately tapped his back and there came the culprit: A piece of banana ! People need to take precaution when feeding patients. |
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| campy | Mar 11 2012, 04:47 PM Post #51 |
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Handyman Extraordinaire
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Simply don't pay those outrageous bills. What can the insurance company do.? |
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| goldengal | Mar 12 2012, 12:36 AM Post #52 |
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Mistress, House of Dogs
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On the 'off topic' subject ...... It has occurred to me that where there are private long term care homes that charge exorbitant rates, it would not be causing people to go in the poor house. They are more likely to be the 1%ers we talk about so often who can well afford all the frills most of us cannot. That IMHO has nothing to do with our universal health care, but rather the rich who can afford more. Take care, Pat |
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| friendshipgal | Mar 12 2012, 12:51 AM Post #53 |
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Guess everyone wants their own Trudashians
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I don't think we have any assurance at all, but a check list and some advice on how to answer the questions, if there's doubt. |
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| LuvSouth | Mar 12 2012, 12:56 AM Post #54 |
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Now I think why the Ministry of Health in BC allows different rates for private nursing homes, and I suppose it's only in BC. It was for those 1%ers in Canada (not just BC) who could afford to pay. Let's say those 1%ers each has 2, 5, 10 millions of asset in their final years of life, I think they wouldn't mind paying extra for accomodation (nursing home, personal care such as better feeding, more staff or nurses on the floor or even better trained staff but I don't know if the staff are better trained than other government regulated nursing home in Ontario). |
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| LuvSouth | Mar 12 2012, 01:02 AM Post #55 |
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It will never be the same anymore after I learned of this case ! I am so disappointed that private insurance companies have been trying to find reasons to deny claims. |
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| LuvSouth | Mar 12 2012, 01:04 AM Post #56 |
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But according to the news, bill collection agency has been calling the couple for the $160,000 payment. Can they go after their principle residence ? |
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| friendshipgal | Mar 12 2012, 01:12 AM Post #57 |
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Guess everyone wants their own Trudashians
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It's not new, I've met a few people who have had similar problems, most just unwittingly or inadvertently missed some info. If it's a major claim, then the insurance company will go back a long way to verify your information, you have to make sure you haven't omitted a thing, such as the correct no. of meds. Health insurance is always a topic of discussion at happy hours - we learn a lot. biggrin 04 One guy we know had a large claim rejected because he had declared 4 meds when he took 5... He said it was just an oversight, not a deliberate omission, which doesn't matter to the insurance company. In his case, the hospital also reduced the bill to about half which he had to pay. Again, this speaks to the issue of why insurance rates are so high, obviously insurance companies are gouged which causes higher premiums. This doesn't excuse their tactics and tricky questions, they should be required to make them clear, concise and understandable. The people in BC are on the hook for paying that bill, what they should do is offer a monthly payment of $50.00, I'm not a 100% sure, but I'm told that as long as you make a payment they can't seize any assets. It might be worth their while to get a lawyer, I know one guy who did because his insurance company simply outright rejected a huge bill for his wife, he won. He said his lawyers fees were very reasonable, only around $700.00 which was a heckuvva lot better than more than half a million. Which is another question, can an American company sieze Canadian assets and or garnishee pensions ? Edited by friendshipgal, Mar 12 2012, 01:17 AM.
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| LuvSouth | Mar 12 2012, 01:21 AM Post #58 |
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Here's another situation but in the opposite way. It happened in the 90's, someone that I knew told me his grand father was flying in the US, then had a heart attack, the plane had to make an emergency landing in Chicago.... I don't know the detail after that, but he told me his grand father had to take a train back to Canada. The bill ? A whopping 1 million dollars, yes 1 million dollars in the 1990's. His grand father didn't pay the bill and he was barred from entering the US. |
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| LuvSouth | Mar 12 2012, 01:27 AM Post #59 |
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It will be beneficial to find out if American hospitals can go after assets (principle residence in Canada, 2nd property, RRSP, RRIF, stocks ...) and garnish pension (CPP, OAS, GIS & GAIN) of Canadians ? |
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| friendshipgal | Mar 12 2012, 05:26 AM Post #60 |
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Guess everyone wants their own Trudashians
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As far as I know, the only people who can garnish CPP and OAS are gov't. agencies, don't know about other pensions. I did read elsewhere that an American judgment is not enforceable in Canada, so maybe all they can do is harass people wub |
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