Posted on 02/28/2023 5:04:31 PM PST by nickcarraway
The family of a Saskatchewan man who suffered a stroke in Arizona says he racked up hundreds of thousands of dollars in medical bills after his insurance company denied coverage.
According to his granddaughter Rebecca Fee, Louis Lamothe had a "massive stroke" on Feb. 3 in Yuma, Arizona where he spends winters with his wife. The stroke left him paralyzed on one side, and unable to speak and swallow.
While Lamothe had taken out travel insurance, Fee said her family was devastated to learn he wouldn't be covered.
"We had no words we just sat in the hallway and cried," Fee said, recounting the moment her family recieved the news at the Arizona hospital where Lamothe was being treated.
"One of his primary doctors walked past us just as we got the news and he said 'Do you need something?' … and I said insurance just denied our claim and his jaw just hit the floor."
Get the CTV News app for local breaking news alerts and top stories According to Fee, Lamothe's insurer, Blue Cross, denied coverage due to a 10-milligram increase in a cholesterol medication he takes that was not reported to the company.
"They wanted me to confirm his dosage for this cholesterol pill and of course I confirmed it right away. I found the bottle (and told Blue Cross) its 20 milligrams," Fee said.
"It wasn't until five days later that they called us and said 'Well his dosage changed so your claim has been rejected.'"
Fee said her grandfather wouldn't hide information intentionally and may not have been aware that his dosage had been increased.
"My grandpa was very honest on his application. He disclosed a lung disease — he has COPD. He disclosed a heart attack. He would not hide a 10-milligram cholesterol pill change," Fee said.
"It was just disgusting that they just said 'your contract's over; we're done. We'll refund your policy amount. Good luck,’" Fee said.
She estimates that the family racked up "hundreds of thousands" of dollars in medical bills during his three-week stay in a U.S. hospital, plus more than $56,000 to cover the cost of a medical flight to safely transport him to Regina General Hospital.
Fee and her husband paid $36,000 for the flight out of their own pocket and the rest of the money was raised by selling her grandparents' RV.
Fee said the crushing debt from her grandfather's medical care and other costs incurred by the family is compounded by the fact her grandmother has an early Alzheimer's diagnosis.
"When you think you've followed all the right steps and you've paid all this money for coverage," Fee said.
"Like my grandma was just absolutely in shock. She couldn't even function for the first two days after we got that phone call."
Fee has started a GoFundMe to help cover the costs the family is facing and said she's "grateful" for the support they've received so far.
"It was such a learning curve and we thought we had it all covered and there is just still so much to deal with."
BLUE CROSS RESPONSE
In a statement provided to CTV News, Saskatchewan Blue Cross said while it can't provide specific details concerning claims, the insurer is "confident in its handling of the Lamothe claim overall."
"Our hearts are with the family during this difficult time. We are in active contact with the Lamothe family regarding the appeals processes available to them," the statement said.
In its statement, Blue Cross said all decisions "undergo a formal review with multiple stages involving both internal and external experts including medical care providers."
"As a not-for-profit insurance provider, our top priority is to pay valid claims and support individuals we serve who are experiencing unexpected travel events," the insurer said.
"Less than 1 per cent of personal travel claims are denied due to false statement or application omission."
Yes, you would think Blue Cross would know.
Sask. man left with huge medical bills after insurer denies coverage following stroke in Arizona
Appeal?
Rent a Uhaul and bring him back to Canada on a cot, I guess.
As someone who was self employed for several decades and had to buy individual health policies, I can say I’ve been screwed and tattooed by insurance companies more than a few times.
It took serious threats of a class action suit to get Principal Mutual to pay a legitimate knee surgery claim on my wife back in the 80s. With a few exceptions I am not a grudge holder - this is an exception.
His Canadian socialized medical coverage doesn’t cover travel medical expenses?!? How rude/cheap of them!
All Canucks gotta buy travel medical policies I guess:
https://www.bluecross.ca/travel-coverage/
https://travel.gc.ca/travelling/documents/travel-insurance
Yes there is an appeal process.
Just not our Claims Department.
Same is true for Americans in other countries. Our policies do not cover us travelling to other countries, we always buy additional insurance.
I think it sounds like a “pre-existing” condition. If his medication had changed within the policy’s “look back” period, that might have been a problem. Preexisting condition guidelines are very particular in the policy coverage.
But all of the illegals welcomed here by puddinghead skip out on their bills. Yuma Regional Medical Center is reeling from that debt, into the millions.
There’s an underlying reason. Insurance companies are not insuring jabbed people and have been dropping them. They’d all go bankrupt otherwise.
But when you think about it the guy might have known something was wrong and didn’t want to wait on Canadá to suggest euthanasia so he came down here knowing he could get better care
“But when you think about it the guy might have known something was wrong and didn’t want to wait on Canadá to suggest euthanasia so he came down here knowing he could get better care”
I tend to think your theory, while possible is unlikely.
Ins companies in my experience are mostly shady sewer dwellers.
The lesson is, never leave Canada, ever; or they will screw you over if you have a medical emergency not in Canadistan.
It is Saskatchewan Blue Cross but you know where Blue Cross parent company resides.
My Blue Shield regular policy has “out of USA” coverage...and my wife’s new (she just turned 65) Blue Shield “Plan G” supplemental policy for Medicare also has “out of USA” travel coverage. (No extra charge or policy needed). There are co-pays involved, but one can always get extra “travel insurance” to help cover those I guess.
https://www.bcbsglobalcore.com/Account/Login
Canadian snowbirds come down here for months at a time. If they travel for medical purposes, they go to Los Algodones Mexico three miles away.
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