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Seniors with travel insurance billed $107,000
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The Star
If you take a trip outside Canada, it’s smart to buy travel health insurance to cover the costs of getting sick in a foreign country.
But it’s not enough just to buy travel health insurance. You have to fill out the application correctly and disclose any relevant information about your medical history.
Failure to disclose can lead to a nasty surprise when you make a claim.
Joe and Suzanne Lefebvre are struggling to pay $107,000 in medical bills. They want to tell their story to warn others about what can happen when an insurance claim is denied.
The retired couple bought a travel health policy from RBC Insurance Co. in October 2010, long before their planned Alaskan cruise in May of this year.
They filled out the forms at the travel agent’s office and didn’t consult with their doctors first.
On the fourth day of the cruise, 80-year-old Joe was taken off the ship and sent to a hospital in Fairbanks, Alaska. He was diagnosed with pneumonia, which led to complications. After he spent 15 days in the hospital, RBC arranged to fly him and his wife to a hospital in London, Ont. (near their home in Port Colbourne).
“I got a call while Joe was still in emergency to say, ‘You know you’re going to be denied coverage.’ Two or three times a day, the company would call to confirm, as if I didn’t understand English properly,” Suzanne says.
“RBC called again to say we were denied on the same day we came home. They could have waited until the next day.”
They were turned down because Joe had a heart condition, atrial fibrillation, which wasn’t disclosed on the insurance application.
The couple asked for a review. This led to another denial in October.
“The questionnaire warns of the importance of accuracy in the answers,” said a customer care adviser at RBC Insurance.
On a cover page that defines and lists heart conditions, the questionnaire says: “If you are unsure if you have ever had a heart condition, please consult your doctor.”
Joe had experienced a blood clot in his leg in January 2008, leading to irregular heartbeats, Suzanne told RBC Insurance. His doctor prescribed warfarin, an anticoagulant, and referred him to a cardiologist for tests
“My husband has not been referred back to the heart specialist or any other heart specialist. The only medication he has used since that time is warfarin, used as a blood thinner to prevent any future blood clots.”
Martha Turnbull, RBC head of travel claims, denied coverage after I asked for a review. She blamed the Lefebvres’ incorrect answer to the question: “Have you ever been diagnosed with any heart condition or been prescribed medication for any heart condition?”
Turnbull added: “This was not a last minute purchase. The travel agent gave them adequate time to do research. We make resources available to help, such as a toll-free number staffed by nurses who can answer questions.”
The Lefebvres have hired a lawyer, arguing it wasn’t clear they had to report Joe’s irregular heartbeat, which had been stable for three years.
The questionnaire says insurance is denied for pre-existing conditions that aren’t stable before a trip. That confused them and led to a wrong answer, Suzanne says.
“In hindsight, we would have done things differently,” she admits.
Milan Korcok, a travel insurance expert, says medical questionnaires can be quite daunting. He recommends consulting your doctors if you have chronic conditions requiring occasional treatment or you’re on medications.
Insurers should require higher-risk applicants to have their doctors sign off on the medical questionnaires, he adds. That would add a layer of protection, though it might slow down the application process.
My advice: Know your medical history and consult professionals, as needed. Don’t rush to fill out the forms. Take time to answer questions.
Thousands of dollars in health care expenses could rest on the results.
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