Howie, Sacks & Henry LLP – Personal Injury Law – Michael J. Henry
Michael J. Henry

Canadians travel throughout the year, but when the weather turns cold people’s thoughts turn to warmer climes and beach holidays. Whenever you are going to travel, you should consider if you need travel insurance. Travel insurance products can range from cancellation insurance, to auto rental insurance (to be discussed in a later article, so stay tuned), to coverage for lost or stolen items, and life insurance, but usually it is purchased in relation to medical coverage for disability or injury and associated medical bills. While being covered for any of these possibilities is important, clearly a significant one is coverage for the cost of potentially very large medical bills for health problems that occur while outside of Canada.

Travel insurance policy document with paperwork and technology. There is an image of a tourist resort with cocktails and a swimming pool which adds to the peace of mind concept. There is also a mobile phone, map, digital tablet and calculator. Image featured on the brochure can be found in my portfolio 20943516Travel Insurance vs. Provincial Health Insurance: While all Canadian citizens benefit from some level of provincial health insurance coverage and are covered by their provincial health plan while out of the country, you are only covered to the very amount that would otherwise be paid in your province. This amount is inconsequential in relation to the very large bills that could be rendered, especially in the US. If you are in receipt of medical treatment outside of Canada, you are able to have your provincial plan reimburse you its cost first, but as that is very small, you would be responsible for the remaining amount. You also almost always will have to pay the out of the country bill yourself first and then seek reimbursement. It is for this reason that you should consider, and many people purchase, medical travel insurance when travelling outside of Canada.

Denial of Medical Insurance Claims: While the travel insurance industry would say that their denial of medical insurance claims is as low as 1%; in my reading it can be as high as 9%. In my personal injury practice, I certainly see a lot more denials than that. The standard denials are for when an application is completed that does not disclose pre-existing medical conditions, or the extent to which the individual is having treatment, or taking medication, before the application. While some of these errors are simple mistakes in answering the health questions, they will invalidate one’s coverage. It is imperative that you be meticulous in filling out the application forms and disclose your full and accurate medical history.

Consult Your Doctor, If Necessary: If you are not sure about a question and/or your answer, you should speak with your doctor. It is better to disclosure something and be denied, than not disclose it and be denied the coverage after the fact. If you are denied the policy initially, the insurer has the option of revaluating and setting a higher premium, or even to exclude some of your pre-existing issues, and still give you coverage for other things that might happen while you are away, such as an accident or other new health problems.

Read the Fine Print Carefully: Be sure to fully read all documentation in respect of the application and the actual policy. There are many limitations and exceptions noted in the documentation which may apply to your particular situation. How long you intend to stay is important as there may be a time limit to coverage. By reading carefully, you may find that you cannot apply at all and therefore you should not bother to waste your time in doing so. For example, high risk activity or adventure travel is likely excluded. Even should the insurer approve your application in this situation, they still have the ability to deny you coverage after the fact. If you have any doubt, ask the broker or insurer.

Full Disclosure is the Best Policy: One must realize that when applying for medical travel insurance you cannot have any medical secrets. After you make a claim the insurer can and almost always will ask for and is entitled to permission to review all of your medical history to see what conditions you may have been treated for and what medications you were on before the application. They can make a denial based on this information even if you believe you honestly answered the questions. They can make the denial even if the health issue suffered and expense incurred is not related to the pre-existing condition you answered incorrectly.

Understand How to Activate Your Policy, If Necessary: Some policies require that you call the insurer before treatment is even commenced. If you are injured or need treatment while away, call your insurer as soon as you can to see what you are, or are not covered for. If you do have a claim, there are specific time frames to make your application for reimbursement, which if you do not apply in time, will be denied, so be sure to make your application as soon as you can. Read your policy, even bring a copy with you in the event you require coverage while you are away on your holiday.

Your best means of ensuring you are covered is being upfront in disclosure, fully reading and understanding the policy and submitting any claims in a timely manner. A tall order, but the onus is on you. Having proper and adequate coverage will help you to relax and enjoy your vacation.

If you have any problems or questions about your policy, or are denied coverage, feel free to contact Michael Henry at 416-361-0889 or mjhenry@hshlawyers.com.

Bon Voyage!

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