Injury leads to year-long fight for Qualicum Beach woman
Fractured hip wasn’t diagnosed until after she had returned home
A Vancouver Island woman’s five-week trip last spring to her favourite village in the south of France has turned into a year-long fight with her travel insurance provider.
Linda Reid, 64, of Qualicum Beach, said that before leaving she and her husband took out a travel insurance policy with Pacific Blue Cross for $888.
Shortly after arriving in France, Reid slipped and hurt herself, leading to a trip to the emergency room at a local hospital.
Reid said that after an examination, the French doctor determined she had sprained her groin and recommended she walk as much as possible.
She filed a claim with Pacific Blue Cross for the trip to the hospital and tests, and was paid for that.
However, a few weeks later her knee swelled up and she suspected something else was wrong.
She said she contacted Pacific Blue Cross and they said they would not cover the costs of further medical tests because, after 10 to 14 days, it is company policy to consider an injury stabilized and no longer an emergency.
This was confirmed by Pacific Blue Cross spokeswoman Anne Williams in an email.
After suffering in pain for the rest of her trip, Reid returned to Canada and learned she had fractured her hip, which she said required surgery and months of physiotherapy and other treatments.
Reid then contacted Pacific Blue Cross to ask for compensation.
Jan. K. Grude, CEO of Pacific Blue Cross, told Reid in writing last month that it had honoured her policy and it “consider [s] this matter closed.”
However, according to Reid, Grude did not provide her in writing information about further avenues of appeal or redress.
“Where a dispute remains unresolved, they [insurers] must provide the complainant with a final decision letter and information on how to contact the appropriate ombudservice,” said Chris Carter, deputy superintendent of supervision at B.C.’s Financial Institutions Commission, which regulates the insurance industry.
He said consumers not given that option can file a complaint with FICOM.
Williams said that Pacific Blue Cross is a member of the Ombudservice for Life and Health Insurance, which offers claims dispute resolution, and that information is provided on the company website.
Reid said she has now asked Pacific Blue Cross to change its policy regarding reassessments.