Sask. man's staggering Arizona medical bills will now be covered

A Saskatchewan man facing a massive pile-up of medical bills following a stroke in Arizona will now have his costs covered after his insurer reversed its previous decision to deny his claim.

In an email to CTV News, Rebecca Fee said Saskatchewan Blue Cross has now agreed to cover her grandfather Louis Lamothe's hospital bills and the expense of his medical flight home to Regina — costs which ran into the hundreds of thousands.

Lamothe suffered his stroke in early February in Yuma, Az. where he spends winters with his wife.

Fee said that Saskatchewan Blue Cross did not explain why it was reversing its decision but said the family was extremely relieved to receive the news.

“They are covering the medical flight and hospital bills, not any hotels, meals or travel expenses, but we are extremely relieved,” Fee said.

According to Fee, Blue Cross initially denied her grandfather's claim due to a 10-milligram increase in his cholesterol medication that was not reported to the company — a change she speculated Lamothe may not have even been aware of.

Fee said Blue Cross wanted Lamothe to sign the paperwork himself but he is still unable to do so, so now the family is compiling paperwork.

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“We will need to find power-of-attorney paperwork and will be doing another full day of correspondence, but every second is worth it,” Fee said.

According to Fee, there are 54 pages from the insurance company for the family to review and return, but Fee said she has it in writing that once the paperwork is complete they are confident the claim will be approved.

Fee said her grandfather is in stable condition but that he still has a feeding tube inserted and remains completely paralyzed on his left side.

He is being cared for at Regina General Hospital, where he was transferred after his family managed to cobble together $56,000 to cover the cost of a medical transport flight

She added that her grandfather has said a few words and is now eating ice chips but is still unable to put a full sentence together.

Fee had started a GoFundMe page to help the family cover the staggering medical debt it was facing.

The family has informed donors it now intends to use the money to cover flights and travel expenses for Lamothe’s wife as well as potential modifications to the couple’s home or mobility devices Lamothe may require.

"Anything to make them both more comfortable, [we also] offered money back if anyone wanted it,” Fee said.

Fee said she, and her entire family, have learned a lot from this situation. She said she hopes others have learned from their story, too.

“Fight the fight. Read the fine print. Ask for professional legal help,” she said. “Just push and push and push until you get the answers that you want.”

Despite remaining hurdles, Fee said the family is feeling lucky that they can now put their attention on what matters most.

“We can take our time and our energy and just focus that on my grandpa now,” she said.

BLUE CROSS

In a statement provided to CTV News Blue Cross said the following:

“We’ve been working with the Lamothe family with respect to their claim and can confirm that the situation has reached a conclusion through our standard claim management process. As with all claims and claims decisions, privacy requirements prohibit us from sharing specific details.

We remain confident in the handling of the Lamothe claim overall and thank the family for their cooperation and patience while we worked together toward a conclusion. Our hearts continue to go out to the Lamothe family during this time.”

The statement also said that less than one per cent of personal travel claims are denied by Blue Cross due to false claims or application omissions.

“When claims are denied, assistance to facilitate repatriation arrangements is always offered to plan members to alleviate that administrative burden during a time of need, and plan costs are refunded,” Blue Cross said.

Travel insurance is essential and it’s critical that individuals understand what they are covered for and that they provide accurate medical information when purchasing coverage, Blue Cross also said.

“It’s equally essential to ensure that you update your travel insurer when health circumstances change. If you’re ever unsure about your travel insurance coverage or contract, we urge individuals to reach out to their insurers for support before travelling. We’re here to help,” Blue Cross said.

- With files from CTV News' Stefanie Davis.