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Hefty medical bills rejected by travel insurance firms
Topic Started: Jan 8 2013, 03:11 AM (984 Views)
Darcie
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Skeptic
Two Canadian seniors have been "blindsided" by $100,000-plus in U.S. medical bills, despite buying full coverage travel insurance for trips south.

“It’s just been a terribly, terribly stressful few months,” said Joanne Parr, 67, of North Bay, Ont.

“It just threw me for a loop totally," said John Toljanich, 74, of North Vancouver, B.C. “I am on anti-depressant pills now, for the first time ever … because of this claim

Both were treated in U.S. hospitals last winter. Their illnesses were sudden and unrelated to any pre-existing conditions.

Their insurance claims were denied because Parr and Toljanich each made what they call an honest mistake when answering a question on their initial application form, about past treatments for other ailments.

http://www.cbc.ca/news/canada/british-columbia/story/2013/01/04/bc-snowbirdinsurance.html

Read, be warned and weep. When filling out an application one should carry a tape recorder and go to a company representative and ask the question and record the answers. Even then I imagine they would find a way out. One of the companies mentioned is one that I personally had to go to court against, lucky I had a friend who was a lawyer as I did not have the money to challenge the legality of their decision.
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Delphi51
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Will anyone offer an opinion on this insurance which we already have
https://www.asebp.ab.ca/member_resources/faq_travel.html
It clearly says we don't need any more for our trip to Hawaii.
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swing
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swing
D.T. I was told by a lady that used to work for an insurance company, that they do indeed have people that do extensive research to avoid claims!!! It is very scary. They have access to your entire medical history and perscriptions. It's such a scam. No one makes an ommission purposely, we all want coverage, should we need it. This is why I'm in Victoria and not my beloved California!
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Deleted User
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I had once used Lloyds of London travel insurance for a cruise. I had to see the cruiseship doctor but had to pay the bill up front and then lodge the claim. When I did so, the Insurance company would only refund me in Canadian funds even though the debt was incurred with U.S. Funds. At that time our dollar was something like 50 cents to the U.S. After much correspondence back & forth, they eventually paid me in U.S. dollars but that took many months to settle.

Another angle to watch for. Re my disability claim, that is a long horrific story & without the strong backing of the bank where I worked, I would never have received any funds.
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goldengal
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Mistress, House of Dogs
friendshipgal
Jan 8 2013, 01:40 PM
goldengal
Jan 8 2013, 09:31 AM

Quoting limited to 2 levels deep
I wonder if there's anyway to get an ins.company to clarify or tell you what they want you to say. These companies set you up to fail with their questions, and worse, will not help you or clarify the question.
FSG ... I actually did get something in writing from RBC stating I did not have to click Yes for taking meds for Osteoporosis, but since my doctor did not think they would stand behind it, I have been clicking Yes. Might contact them just to have this on record - that is if they record it.

Take care,
Pat
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friendshipgal
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Guess everyone wants their own Trudashians
I would think the would have to stand behind the letter, if not you could take it to court.

I'm curious as to how far back they go in doctor's records, more than 20 years or back to childhood?
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goldengal
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The foolish thing is I no longer have the reply as I went with another travel insurance company for just one trip and thought I wouldn't need it any more. I have written again today though. While I have some coverage through my former employer, even when working, it stated one should take out additional travel insurance. I hope I never have to make a claim, but do want to know I will be covered if I ever have the need.

Take care,
Pat
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margrace
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I though maybe I should have some coverage when I travelled west but found that they wanted all my medical records from my doctor. Since I wasn't going out of the country I told them to shove it.
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friendshipgal
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Guess everyone wants their own Trudashians
Another one from last year but not the one I remembered. The part I believe to be important is the reply stating investigations are considered treatment. So, if an applicant has had a test for something it could come back to bite them, even if the results were negative. IMO this is fraud on the part of the ins. company, the questions are not that specific and as I've said, they set you up for failure.

http://www.cbc.ca/news/canada/british-columbia/story/2011/11/11/bc-travelclaim.html
Despite letters submitted since from doctors, insisting she is not receiving any treatment for her kidney condition, the insurance claim denial letter reads, "You do have a chronic kidney disease for which you have undergone investigations which is considered treatment."

Read further down to where it speaks about people being rejected for not disclosing some previous conditions, one of which was an ear infection. I've never seen the question asked 'have you been treated for an ear infection' or... hemorrhoids while pregnant, or a brother's heart attack he never knew about etc. etc.

Maybe it is time for the provinces to require more transparency and questionnaires simpler and easier to understand (or answer).

It is I believe a provincial responsibility.
Edited by friendshipgal, Jan 9 2013, 03:27 AM.
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Darcie
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Skeptic
There really needs to be adequate and effective legislation to stop these companies from scamming people who honestly pay them for coverage and then find themselves unable to know exactly what is expected of them in their application forms.

For instance, could there not be a cap legislated on how long one had to report taking a medication that you had stopped years ago?

Do I have to report that as a child of 4 I ingested arsenic which is still in my body? We need to have clear and precise rules for insurance companies that let us know the framework that we are faced with when we buy their product. In other cases if something we buy is not as presented, then we get damages. Why not with insurance companies.

If this government wanted to buy the goodwill and votes of seniors they only have to enact something which makes the insurance companies comply with clarity for their product.

They get you coming and going.

An insurance company denied my disability, but the government accepted that I was permanently disabled, so they could not actually continue to deny me. We all know how difficult it is to get that ruling by CPP and QPP.
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wildie
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friendshipgal
Jan 9 2013, 02:05 AM
I would think the would have to stand behind the letter, if not you could take it to court.

I'm curious as to how far back they go in doctor's records, more than 20 years or back to childhood?
If necessary they would likely go back to Adam and Eve, pointing out that the apple had a worm in it and as Adam had failed to remove it, this would be negligence and for this reason the claim is denied!
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goldengal
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Mistress, House of Dogs
I did receive a reply and will call today to have my answer re the use of Actonel changed to NO.

Quote:
 
Thank you for choosing RBC Insurance. We appreciate your loyalty for so many years!

Your question is difficult to answer without speaking to you to 100% clarify.

The question you are asking about reads as follows:

At ANY time during the past 12 MONTHS, have you been diagnosed
with or have you taken or been prescribed medication or received
treatment for Arthritis and or osteoporosis (if you do not take
prescription medication for these conditions you can answer No.)

So if you have not taken or been prescribed the Actonel in the last 12 months then you can answer no to this question. However, if you are taking or have been prescribe Naproxen within the last 12 months to treat Arthritis then you still need to answer yes to this question.

If you require any further clarification with this information please call 1-800-565-3129 and speak to one our of licensed insurance representatives.


My mistake obviously since it does state 'in the past 12 months'. I still would be in the same price group though because I take the Naproxen whenever I have a bad bout of arthritis in my knees/feet.

Take care,
Pat
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friendshipgal
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Guess everyone wants their own Trudashians
Thanks for the clarification.



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