The household of a Saskatchewan man who suffered a stroke in Arizona says he racked up lots of of hundreds of {dollars} in medical payments after his insurance coverage firm denied protection.
Based on his granddaughter Rebecca Payment, Louis Lamothe had a “huge stroke” on Feb. 3 in Yuma, Arizona the place he spends winters along with his spouse. The stroke left him paralyzed on one aspect, and unable to talk and swallow.
Whereas Lamothe had taken out journey insurance coverage, Payment stated her household was devastated to be taught he would not be lined.
“We had no phrases we simply sat within the hallway and cried,” Payment stated, recounting the second her household recieved the information on the Arizona hospital the place Lamothe was being handled.
“Certainly one of his major medical doctors walked previous us simply as we obtained the information and he stated ‘Do you want one thing?’ … and I stated insurance coverage simply denied our declare and his jaw simply hit the ground.”
Based on Payment, Lamothe’s insurer, Blue Cross, denied protection resulting from a 10-milligram enhance in a ldl cholesterol medicine he takes that was not reported to the corporate.
“They needed me to substantiate his dosage for this ldl cholesterol tablet and naturally I confirmed it straight away. I discovered the bottle (and informed Blue Cross) its 20 milligrams,” Payment stated.
“It wasn’t till 5 days later that they referred to as us and stated ‘Properly his dosage modified so your declare has been rejected.'”
Payment stated her grandfather would not cover info deliberately and will not have been conscious that his dosage had been elevated.
“My grandpa was very trustworthy on his software. He disclosed a lung illness — he has COPD. He disclosed a coronary heart assault. He wouldn’t cover a 10-milligram ldl cholesterol tablet change,” Payment stated.
“It was simply disgusting that they only stated ‘your contract’s over; we’re accomplished. We’ll refund your coverage quantity. Good luck,’” Payment stated.
She estimates that the household racked up “lots of of hundreds” of {dollars} in medical payments throughout his three-week keep in a U.S. hospital, plus greater than $56,000 to cowl the price of a medical flight to securely transport him to Regina Normal Hospital.
Payment and her husband paid $36,000 for the flight out of their very own pocket and the remainder of the cash was raised by promoting her grandparents’ RV.
Payment stated the crushing debt from her grandfather’s medical care and different prices incurred by the household is compounded by the very fact her grandmother has an early Alzheimer’s prognosis.
“Whenever you assume you have adopted all the precise steps and you’ve got paid all this cash for protection,” Payment stated.
“Like my grandma was simply completely in shock. She could not even operate for the primary two days after we obtained that cellphone name.”
Payment has started a GoFundMe to assist cowl the prices the household is dealing with and stated she’s “grateful” for the assist they’ve obtained to this point.
“It was such a studying curve and we thought we had all of it lined and there may be simply nonetheless a lot to cope with.”
BLUE CROSS RESPONSE
In an announcement supplied to CTV Information, Saskatchewan Blue Cross stated whereas it could possibly’t present particular particulars regarding claims, the insurer is “assured in its dealing with of the Lamothe declare total.”
“Our hearts are with the household throughout this tough time. We’re in lively contact with the Lamothe household concerning the appeals processes out there to them,” the assertion stated.
In its assertion, Blue Cross stated all choices “bear a proper assessment with a number of phases involving each inner and exterior consultants together with medical care suppliers.”
“As a not-for-profit insurance coverage supplier, our high precedence is to pay legitimate claims and assist people we serve who’re experiencing sudden journey occasions,” the insurer stated.
“Lower than 1 per cent of non-public journey claims are denied resulting from false assertion or software omission.”
–With recordsdata from Luke Simard
