2025-04-02
渥太华微生活
来源:加拿大都市网
一名来自印度的女子在安大略省布兰普顿市探亲时,因患缺氧性呼吸衰竭被送进医院,并收到了一张高昂的账单。
约瑟夫·克里斯蒂(Joseph Christy)很高兴他的 88 岁母亲爱丽丝·约翰能够持“超级签证”从印度来探望他六个月。
超级签证允许父母和祖父母在加拿大长期居住,然而,当爱丽丝 2024 年 1 月抵达后几天,就开始感觉不适。
“母亲开始出现咳嗽、呼吸急促和发烧的症状,” 克里斯蒂说。
当时,88岁的爱丽丝正在汉密尔顿探望她的女儿,她被送往汉密尔顿综合医院。她最终住院近三周,并且需要使用呼吸机。
这家人已经为母亲从Manulife购买了一份保额高达 10 万加元的基本超级签证旅行保险,但爱丽丝接受治疗后,保险公司判定她患有既往疾病,因此拒绝了她的索赔。
家人被告知:“如果曾经被诊断患有充血性心力衰竭,那么就没有资格享受本保险的保障。”
克里斯蒂说,这个消息让他感到非常意外,因为“充血性心力衰竭”这个词“在过去三年里从未出现在母亲的任何处方中”。
这家人被告知,如果没有保险,他们必须支付总计 96,311 加元的医疗费。
该家庭购买的保险类型属于基本保险类型,且不附带调查问卷。通常,保险公司只有在某人需要医疗救治后才会询问问题。
旅行保险公司Travel Secure Inc. 总裁马丁·费尔斯通 (Martin Firestone) 告诉 CTV 新闻,虽然基础计划没有问卷任何健康相关的问题,但“核保”是在理赔时才开始进行的,这意味着如果保单中写有“不涵盖任何已有病史”的条款,就可能引发严重问题。
费尔斯通说:“你必须明白,如果保险单上说没有涵盖任何既有疾病,那么他们在记录中发现的任何东西最终将导致在加拿大得不到保险保障。”
然而,家人认为这是一个疏忽,因为他们根本不知道母亲有心脏问题。
当 CTV 新闻代表该家庭联系Manulife时,一位发言人在一份声明中表示:“有时会出现特殊情况,医疗档案的解释与合同不符。我们已仔细研究,并根据具体情况,将支付索赔。我们已通知相关方,目前正在启动付款流程。”
尽管Manulife最初拒绝索赔,但现在已同意全额支付医疗费用。
克里斯蒂说道:“我们非常感谢媒体关注事件并帮助我们找到解决方案。”
Manulife表示:“当您为自己或亲人购买保险时,重要的是要了解并清楚地传达您所知道的有关您健康状况的一切,以便获得正确的保险。”
“我们理解填写医疗问卷对某些人来说可能很困难。如果您有任何疑问,我们鼓励客户咨询他们的医生以获得所需的明确信息。”
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