A BC woman is suing an insurance company after she was handed a massive medical bill following her vacation last year.
According to the lawsuit, Chuan Chao was in Texas when he tripped and fell on a sidewalk. The retiree from Surrey was left with severe injuries when he fractured his femur and required surgery in a Houston hospital.
Unlike some other travel horror stories, Chao was prepared for the worst-case outcome and had purchased medical insurance ahead of her trip. She bought it for coverage for her trip through the Pacific Blue Cross and was covered from June 4 to July 2, when she was set to return home.
However, after her surgery, she could not walk and was advised by an orthopedic surgeon that, as a result, “she could not travel.”
Not only that, while she was released from the hospital two days after being injured, she also needed to stay in the area for follow-up appointments.
Chao contacted Pacific Blue Cross to report her injury and said she was expected to remain in Texas until August.
“At no point did the Defendant [Pacific Blue Cross] ever advise the Plaintiff that she would be required to extend her insurance coverage under the Policy for the duration of her mandatory extended stay,” the lawsuit reads.
So, she didn’t extend her policy.
Chao handed a $51,012 medical bill
After she returned to Canada in mid-August, she received an invoice from the Texas hospital for US$51,012.
In the fall, Chao was allegedly told by a customer service representative that her claim for coverage was denied “because her coverage had to be active during the full duration of her stay.”
According to the policy extension included in the court document, “Policy extensions are not guaranteed and may be reduced at the discretion of the Insurer.”
In the notice of civil claim filed in the BC Supreme Court last week, it explains coverage can be extended if requested before the initial coverage period ends and the additional premium is paid, amid other reasons.
“Improper and egregious”
However, Chao argues that the Pacific Blue Cross failed to or neglected to tell her she should extend her coverage under the policy.
Chao argues the Pacific Blue Cross used the provision to “take advantage” of her health restrictions to avoid paying for the surgery.
“[Chao] was not given the opportunity to extend her coverage retroactively,” the claim reads.
“[Chao] was in a vulnerable position, and she relied on the knowledge and information of the Defendant when she reported her Claim. The actions of the Defendant are significantly improper and egregious, and there is no rational justification for failing to advise the Plaintiff that he would be required to extend the Policy.”
Chao is suing for damages and says she is entitled to be fully compensated for the hospital invoice and for the judgment against the Pacific Blue Cross.
Chao’s claims have not been proven in court, and Pacific Blue Cross has not yet filed a response.