The Naked Truth: Too Many Canadians Travel Uncovered

Six per cent of Canadians travel without underwear, according to a revealing national survey. Far more dare to go without travel health insurance, though. A third of us leave the country completely uncovered.

The naked truth, according to John Thain, president of the Travel Health Insurance Association of Canada, is that “travel health insurance should be as essential to a vacation as underwear.”

The cost of treating an ordinary fracture in the United States––an average of $10,000­­––would be a “financial crisis” to many. About a third of poll respondents rated a $1,000 or $5,000 bill as a financial crisis.

Other revealing findings were these:

  • Six per cent realize that provincial health plans cover only about 9 per cent of out-of-country medical expenses.
  • Twenty-one per cent of travellers have required medical attention during one trip or another.
  • Only 60 per cent of those had insurance to pay for the associated expenses.
  • Thirty per cent admitted to binge drinking while on vacation. (If they were injured due to excessive drinking, they would not have full travel health coverage.)
  • The top three reasons for needing care were:
    • Gastrointestinal issues (21.8 per cent)
    • Infection (16.2 per cent)
    • Fractures (10.7 per cent)

“Many people will already have some coverage through employers or credit cards,” Thain noted in a news release. “It’s important,” he cautioned, “to understand [your] existing coverage and ensure you have the necessary supplemental coverage.”

THIA recommends that you:

  • Know your health status, and consult a health care provider if you have any questions about your eligibility for coverage.
  • Understand your travel insurance policy; insurance companies have staff available to answer any questions related to their policies.

It’s important to cover your assets. So don’t join the 40 per cent of Canadians who risk leaving without out-of-country medical coverage. When you buy coverage, be sure you qualify by answering the questions on your application truthfully and accurately. Beware that any changes to your health status before travelling, and your behaviour and activities during your travels, could strip away your eligibility for coverage.

Claim Denied! Summary of 7 Cases

 

 

At age 60 in late January, 2004, Frank Falvo purchased a 30-day travel insurance policy at the local Allstate office in Thunder Bay, Ontario. A few days later, he felt chest pain. So his doctor prescribed a third medication for high blood pressure. Nevertheless, Falvo’s agent assured him he would still be covered. He later underwent a stress test, which showed no problems. Despite receiving a green light to travel, and having a week without symptoms before he left, he felt pain again in Florida. He went to a hospital, and received and angioplasty operation at a cost of more than $53,765.04. Allstate denied his claim, but a judge of the Ontario Superior Court of Justice ruled that none of the policy exclusions it cited applied to Falvo, including a limit of coverage for 15 days. Falvo had come home early on the 14th day. The Court of Appeal for Ontario later upheld that ruling unanimously.

Lillian Rosenblat of Manitoba did not qualify for low-premium versions of the Reliable Life Insurance Co. policies she purchased at age 84 for two trips to the United States. So when she fell and incurred $27,723 in medical expenses on one of those trips, Reliable refused to pay. A judge faulted Rosenblat for failing to reveal she had been examined again for her ongoing heart problems, and had been prescribed an additional medication, within 12 months of her planned trip. However, in 2003, the Appeal Court of Manitoba found an insurance broker acting as her agent was the one at fault for selling Rosenblat a “super-preferred” policy when he should have realized she would not qualify. He had not read the policy or application before going to see her. The court ordered the broker to pay her medical expenses, plus legal expenses, for the two court cases.

The late Marcella M. Bird of Lindsay, Ontario, fell ill due to her cirrhosis of the liver two months after she and her husband arrived at a home they had rented for the winter in Lady Lake, Florida. She died in hospital a few days later. Canada Life denied a claim for $99,276.65 (US) for medical treatment and $696.58 (CDN) for a plane ticket for her son to visit her. Canada Life attempted to rely on a policy exclusion referring to abuse of alcohol, but a judge of the Ontario Supreme Court, ruled that would not apply. She had been advised to stop drinking in 1994, her medical condition had been stable in the previous year, and her husband testified she had not abused alcohol in Florida.

Sandra Turpin of British Columbia had pain in her abdomen during a trip to Disneyland with her family. She saw a doctor at a walk-in clinic, and later went to hospital, where she spent five days getting tests and treatment. Her claim for $27,170.81 in expenses was denied on the grounds she had also seen a doctor about abdominal pain shortly before the trip. After the trip, she needed to have her appendix removed. A judge agreed in a 2011 ruling that Turpic was right to expect and receive compensation, although she had never read her insurance policy. But the BC Court of Appeal ruled later that the policy’s 90-day exclusion for pre-existing conditions was reasonable and valid.

Kenneth Roy Kulak of British Columbia was in his 70s when he collided with a car while cycling in Arizona in 2008. Hospital and air ambulance bills came to $185,140. Lawyers for Reliable Life Insurance Co. argued successfully that Kulak had reported his health status inaccurately when using a scoring system on the application for coverage. He left out any mention of his heart condition, and paid a premium of $903 instead of the $2,260 he should have paid. A judge ruled his contract was void, and he was ineligible for any coverage under that policy.

Bonnie Margaret Ouitmet died in 2002 of an infection in Denver, Colorado. She was 52. Before leaving from Vancouver, BC, she had paid $14 for $2 million of travel insurance coverage, declaring “I am in good health and know of no reason to seek medical attention.”  A judge initially ruled that Co-operators Life Insurance Co. should pay for her $115,000 (US) in medical expenses. But, in 2007, the Court of Appeal for British Columbia ruled unanimously that she had lied on the application. “She had a problem with alcohol,” the judges noted. She admitted in Denver she regularly drank two pints of alcohol a day, and the night before she bought insurance was found unconscious at home, in respiratory distress after taking a prescription narcotic. She was revived in hospital, but she refused to be admitted for further investigation.

Stephen Ramsay of British Columbia injured his head in the parking lot of a bar in Fremont, California, in 1992, but his claim for $25,190.18 in medical expenses was denied. So Ramsey sued and, in 1996, a judge ordered Voyageur to pay on the grounds that Ramsay was injured in a separate, identifiable event after he had stopped drinking excessively in the bar. That ruling was overturned two years later. The Court of Appeal for BC noted there was no evidence of obstacles or hazards in the parking lot, and “the only reasonable inference to draw from the evidence” was his acute intoxication, as noted by police and the hospital.

Dear Doctor: I Need Your Help Before I Travel

Tell Me Like It Is. Be frank if you think my best-before date for travel has passed, or if my health is unstable. Travel insurance policies may NOT pay for my care outside of Canada if you imply, condone, or encourage me to travel when I am not in stable health. So cheerful advice like this may not (on its own) be helpful:

  • You have my blessing*
  • Do whatever you want
  • You are in pretty good shape for 85
  • You can either be miserable here, or in Vegas by a pool

*I may have to ask you if I have your permission to travel. Please don’t give me permission unless you know the conditions and exclusions in my insurance policy.

  • Consider my mental capacity – Would you trust me to shop for YOUR travel insurance? No? Then suggest I get help from an agent or broker, along with a member of my family.
  • Be sure I have the facts – Please check my answers to the medical questions and the sections of travel insurance policies that refer to excluded health conditions and excluded travellers. Try to use terminology, like “stable” and “pre-existing medical condition,” as defined in my insurance policy.
  • Dates and time periods are important – Provide a summary of my medical status, prescriptions, treatments, and changes of conditions. Please supply your reasoning to go along with those dates, because I am not going to remember precisely. Suggest that I pay to get a copy of my medical history to show my insurance adviser. Or, if you think I’m capable, recommend that I keep my own journal.
  • Be sure I have enough medicine – Please provide repeat prescriptions to last beyond the length of my trip, and suggest extra pills that would be safe and effective to relieve discomfort, such as motion sickness** on a cruise.**Ami Maishlish, owner of CompuOffice Software Inc. in Toronto, recalls the time that a doctor on a cruise ship billed $1,500 to examine and observe his wife before providing her with Gravol. The doctor moved on and her travel insurer refused to pay.
  • Think before you change my prescription – Insurers regard a recent change of prescription (even a reduced dosage or a switch to a generic brand) as a sign of instability. That could void my coverage. So avoid making a change that could safely wait until I get home. Please don’t ruin my coverage for nothing.
Sources: Suggestions provided by Matt Davies of Ingle International, Toronto; Dave Harris, Benefit Resource Group, Alliston; Markham; Nigel R. Ottley of Global Insurance Solutions Inc., Toronto; Ron Singer, Megacorp Insurance Agencies Inc., Mississauga.