Robert ‘Builder Bob’ Woodcock set out on a mission this fall. The 72-year-old Toronto retiree wanted all Canadian travellers to have the option to buy travel health insurance without the risk of a claim being denied. He was dismayed that so many claims are denied––nearly 15,000 a year according to an insurance industry representative quoted in 2012.
“If someone stumbled over a question that was just too ambiguous and they answered what in their mind was truthful, and it turned out it actually wasn’t because of the misunderstanding, they could still be dead in the water,” Bob warned during a recent interview.
He no longer expects provinces to sell denial-free coverage any time soon. But he no longer fears for himself. He is now a fully qualified *Policy Hitch Detector (PHD).
“Assuming we are able to travel south [this year], it will be the first time since turning 65 that I will have been able to do so without worrying about insurance coverage, thanks to my PHD and direct connection with… Ingle [International].”
With his newfound knowledge, he immediately recognized a potential snag when his wife Lynn was, for the first time, prescribed a medication for high blood pressure. While their departure could be delayed unless her medical condition is stable long enough to be covered by a travel insurance policy, the good news is that Bob now understands how the newly prescribed pill could limit her insurance options. He also knows what to look for when the time comes to shop for her coverage.
How Bob Prepared To Buy Insurance
This fall, Bob reached out to writers, associations, and his MPP about his wish for denial-free coverage. But he realizes now that his proposal would face an uphill battle. Most provinces have held firm to their decision to cut out-of-country medical coverage for about two decades. In the past, they had difficulty controlling abuse and rapidly rising costs.
So we set out to explore Bob’s fears and provide him with some personalized advice. Both the medical director and an insurance expert at Ingle International confirmed that Bob was eligible for the coverage set out in a President’s Choice Financial policy he bought for a trip this past summer. They examined his medical record, insurance application, and health questionnaire. They also looked for potential errors, and found none. (Ingle does not sell PCF products, and charged Bob nothing for the counselling.)
Despite his hernia and gallbladder operations, and his pills for blood pressure and acid reflux, Bob’s records showed his prescriptions had not changed in at least 12 months. And he had recovered from the hernia operation earlier in 2013 without difficulty. So, if nothing changes, he will have a choice of economical coverage for another few weeks of fun in the sun in 2014.
Bob is well aware, however, that it would be vital to inform his insurer (and broker, if he chooses to use one) if his health changes after purchasing coverage. Speaking up may or may not raise the cost of coverage, but it’s vital to ensure that an unexpected and unplanned claim for medical care will be paid.
“I am not taking any chances with this stuff,” says Bob. “I have learned far too much since I got involved in it to fool around and say: ‘Oh, well, it’s okay. You can’t do that.’”
Now to Find His Wife Lynn the Best Coverage
It’s uncertain whether Lynn’s health could become an issue. “Until her recent episode with severe arthritis pain in her shoulder, Lynn could answer ‘no’ to all of the application questions [about health problems],” says Bob.
But after a recent check-up, she was prescribed a medication for elevated blood pressure––a condition that could prove dangerous. Nearly half of Canadians ages 65 to 74 have been diagnosed with high blood pressure, according to a 2011 Canadian Community Health Survey. While hypertension can be reduced with medication and diet, if left uncontrolled, it can lead to a stroke, heart attack or heart failure, dementia, kidney disease, or eye problems.
To qualify for the coverage that Bob would prefer for Lynn, her medical condition would have to remain stable for 90 days prior to departure.
Lynne Champagne, Client Services Supervisor at Ingle International, explained that Bob and Lynn could revisit coverage options closer to their departure date. Then, as late as the day they hope to leave Canada, they could purchase plans that would suit each partner’s individual health status at that time.
One option would be a policy that would provide $150,000 of coverage for expenses related to an unstable medical condition, and $5 million for another type of medical emergency. But a medical bill larger than $150,000 could put the couple at risk of losing their second-generation family cottage on Georgian Bay.
“So it’s a very interesting situation,” says Bob. “I want to be sure when I cross the border that I have…paid for something and it’s good,” says Bob. “I don’t want the cheapest thing available. I just want something [so] that I have…a good comfort level.
“I thought I had an idea [about how to buy travel insurance] before, but I had no idea how uninformed I was,” Bob sums up. “I think about it every day, and I chat with people every day. It has become like a specialty for me. I can now help friends to make sure they check stuff out [before they rely on coverage].
“That is going to be my mission now.”