ABOVE: The parents of Reece Huculak, the “Million Dollar Baby”, talk to Global News about their ordeal
TORONTO – A Saskatchewan mother who says she is facing more than $900,000 in medical bills after giving birth prematurely in the United States is devastated after being told the costs won’t be covered by insurance, and feels like she “did everything right” when it came to her travel health insurance.
Jennifer Huculak said she purchased Blue Cross insurance before her trip and got the green light to travel from her doctor. She acknowledged she had a bladder infection and hemorrhaged at four months, but said her doctor told her she was stable enough to go on vacation in Hawaii. She said she received no questionnaire from Blue Cross.
The insurance company denied her claim, citing a pre-existing condition. Several requests from Global News to Blue Cross were not answered Wednesday.
So what can you do to prevent a similar situation?
Citing the statistic that 95 per cent of claims get paid with no problem, Travel Health Insurance Association of Canada (THIA) Vice President Will McAleer says situations like Huculak’s can be a good reminder for Canadians to take it upon themselves to ask informed questions about their coverage.
“You’d want to ask the question – okay how will my pregnancy be affected by the coverage? Will I be covered if a complication happened? What happens if I give birth early?” McAleer told Global News.
He said when it comes to pre-existing conditions like pregnancy, insurance companies typically look at whether there have been any new conditions, symptoms or changes in medication in a period of 30 days, six months or even a year before travel, depending on the type of trip.
“For instance, many of the companies will allow coverage for complications to a pregnancy as long as you’re not within nine weeks of delivery,” he said.
“But it’s still subject to okay – what’s been happening with that particular condition prior to travel? Have you been in to see your doctor with complications?”
WATCH: Christina Stevens reports on how you can avoid a “million-dollar baby.”
Huculak told Global News she did get the green-light to travel from her doctor, and double-checked with the Blue Cross employee about the policy.
“Before we left the table where we were buying the travel insurance, I said: ‘Okay, are you sure we are covered? We’re good?’ She said ‘yes – you’re covered.’”
Huculak’s travel insurance policy was to cover herself and partner Darren Kimmel for the duration of their two-week trip in fall 2013, with an extra day of coverage at the end.
A Dec. 16, 2013 letter from Saskatchewan Blue Cross said the claim was denied because her medical emergency “is excluded from coverage under the terms of her pre-existing condition provision” and noted “Ms. Huculak’s travel policy expired on November 9, 2013.”
Scroll down to read the full letter below
“Our insurance policy was valid for our travel dates—for when we were to leave and return,” she said. “We were supposed to return on the eighth of November,” she added, after acknowledging the Nov. 9th expiration date.
“According to our knowledge, when you take an insurance policy out, if something happens while you are there, they continue insuring you for that claim until you get home. But we were supposed to be home already.”
Kimmel added there was no indication from Blue Cross in the first week that they wouldn’t receive the funds.
“We had travel insurance, and we had a medical emergency, and that’s the type of insurance we purchased,” he said.
The couple says lawyers have approached them since their story made headlines, and legal action is one option they’re considering.
Filing a claim against the broker for “failing to explain the ins and outs of the coverage and the limitations” is one option, according to Western University law professor Craig Brown.
The law professor added insurers are often concerned about exposing themselves to multi-million dollar claims, and so they do “circumscribe the risk with all kinds of limits and exclusions.”
“If an insurer is deliberately deceiving people in terms of pay the premium, knowing secretly they’ve got all kinds of small print they can hide behind, then that’s clearly what’s known as bad faith,” he added. “Insurance companies if guilty of that can be really severely punished –they can have their licence removed, have to pay punitive damages, so I expect insurers would know about that and would be fairly leery about high-handedly denying claims without some justification.”
The couple says paying the bills out of pocket isn’t an option for them. Besides legal action, they’ve received calls from people wanting to start crowdfunding campaigns for them, but haven’t confirmed any details.
The Financial Services Commission of Ontario suggests you make sure to shop around for a policy that reflects your health, age, any medication you’re taking, where you’re going and the length of your trip. It’s possible that your employer, union, credit card, bank “gold” card or home insurance policy already offer enough coverage, so check there first.
And don’t hesitate to call companies (usually at a 1-800 provided to you) if you’re ever unsure of key definitions or which policy is right for you. It’s incumbent upon you to fill out medical questionnaires accurately, since claims can be denied due to mistakes that may or may not be related to the incident.
When you’re away, THIA suggests the assistance telephone number given by your insurance provider should be kept with you and given to your travel companions in case you can’t make an emergency call yourself.
McAleer says many younger Canadians don’t even consider travel health insurance, and referred to a September survey that found as many as forty per cent of travelers under 50 years of age don’t even know what coverage–if any–they have before departing.
His final advice?
“It’s knowing your health condition, knowing the type of coverage you’ve got, and knowing the type of activities you’re going to do while traveling,” he said. “That’s the other component –accidents happen. You need to make sure your coverage covers high-risk activities you’ll be doing on your beach vacation this cold winter.”