Saskatchewan Blue Cross has had a sudden change of heart.
The family of Louis Lamothe, 72, the Halbrite, Sask. man who suffered a stroke while vacationing in Arizona, needed to pay $56,000 for his medical flight home and was facing hundreds in expected bills from U.S. hospitals when their travel insurance claim was denied.
On Thursday evening, the family says, the insurance company informed them that they’ll cover all expenses.
“We feel like we will breathe again,” Lamothe’s granddaughter, Rebecca Fee, told CBC News. “There are finally some smiles.
“It’s just an enormous sense of relief that Blue Cross reversed its decision. They didn’t give us a reason why they modified their minds, but I do not need that reason so long as they cover it.”
Fee suspects the national media coverage was a reason for the sudden reversal, but said the insurance company “declined that as a reason.” She said Blue Cross, who’s in consultation with the U.S. hospitals, informed them on Friday afternoon that their hospital fees are “greater than half million Canadian dollars.”
In a Friday morning email exchange, Saskatchewan Blue Cross declined an interview but confirmed that the situation had reached a conclusion through their standard claim management process.
“As with all claims and claims decisions, privacy requirements prohibit us from sharing specific details,” the statement said.
The letter Blue Cross sent to the family on Thursday evening says the insurer, after reviewing the family’s claim, accepted “the expenses related to the emergency medical services” received in Arizona for the period from Feb. 3 to Feb. 26, 2023.
“They’re covering his hospital bills from Yuma and Phoenix, his medical flight home and offered $500 for extra expenses, which in fact were near $10,000,” Fee said.
“They’re even transporting his truck from Yuma, Arizona to home. We’ll see what else they will do for us after this very very long month. I’m glad they took responsibility for this.”
Fee says the claim shouldn’t have been denied in the primary place. She said the insurance company had argued it was because Lamothe didn’t disclose a change within the dosage of cholesterol medication he had been taking.
Lamothe had been on a 10-milligram pill, which was increased to a 20-milligrams in July, three months before he left for the U.S. Because Blue Cross had not been informed of the dosage increase, the family said, Blue Cross declined to insure Lamothe for his hospital stay or flight home.
Fee said her grandmother, Arlene Lamothe, who told CBC on Monday that the predicament would have meant her selling her house in Halbrite, was “screaming, hugging and crying” upon learning the news.
The family said a professional bono lawyer from Toronto, in an unofficial capability, can be helping them out. Fee says she has 54 pages and multiple documents to review, and has to submit all their expense receipts to Blue Cross for reimbursement.
“They specifically stated that my grandpa is the one who has to sign the paperwork. How does he try this when he’s paralyzed on the left side and he’s left-handed?” she said.
“I’ve to search out his power-of-attorney paperwork and have a full two days of paperwork ahead, but the tip is in sight.”
Now, Fee says, he family desires to focus all their energy on Lamothe’s recovery.
“Long road to recovery”
Lamothe is in stable condition, but still relies on a feeding tube. Fee says her grandfather has been been in a position to get right into a medical chair a couple of times with the assistance of health-care staff at Regina General Hospital..
“He definitely has a protracted road to recovery and rehab. He can say some words now but even to see him attempt to speak is a miracle,” she said.
Fee advises others to triple check medication and health records before travelling: Reading the nice print is important before purchasing a travel insurance.
She is thankful to Blue Cross who can be directly contacting the 2 Arizona hospitals on Friday for the bills, and can send a cheque to the family reimbursing for the medical travel.
“I’m thankful to family and friends and strangers who helped us and donated to our GoFundMe page,” Fee said, noting all donors told them to maintain the cash when family tried to return the donations.
“Even our local fundraiser here in Estevan [Sask.] will keep it going to assist my grandma. It’s overwhelming to see such support pouring in.”
Fee says it could take as much as a 12 months for her grandfather to get well.
The ordeal took an emotional toll on her personal family, too, as she left her three kids home together with her husband for nearly a month while she was helping her parents in Arizona.
“My grandpa was an avid gardener. Immediately after he’s recovered — whether it’s at our house or his or outside a nursing home, if he finally ends up there — I would like to construct him a raised garden bed,” she said.
“I don’t need him to ever not garden again. Whether it’s from his medical chair or if he regains his strength, I would like him to maintain continuing it. But for now, we hope he comes home soon.”