What's next for Saskatchewan family with million-dollar medical bill?
Published Tuesday, November 25, 2014 9:27AM EST
An insurance lawyer who has offered to help the Saskatchewan family facing a six-figure medical bill after they had a baby in Hawaii says there may be ways to resolve the dispute before the family declares bankruptcy.
Lawyer Sivan Tumarkin says that although Saskatchewan Blue Cross is standing by its decision to deny the claim made by Jennifer Huculak and her partner Darren Kimmel, the couple has several options before them. They include taking the case up with the national independent insurance ombudsman, entering mediation, or going to court.
Tumarkin says he has spoken with the couple by phone about their case and from his perspective, it doesn't appear they did anything wrong. He believes they would have a strong case in court.
"Based on the facts that I have right now, this is winnable," he told CTV's Canada AM Tuesday.
Huculak and Kimmel are currently on the hook for more than $950,000 after Huculak gave birth prematurely to a baby girl in Hawaii in October 2013, leading to a three-month stay in hospital. The couple says they can't afford the bill and may have to file for bankruptcy.
But Saskatchewan Blue Cross is denying their claim because they say that a bladder infection Huculak had during the fourth month of her pregnancy constituted a pre-existing condition, which nullified the insurance contract. It also noted her travel insurance expired during the time she was in hospital.
They also say they have sent a letter to the couple outlining nine other "specific events" that prevent them from paying the claim. The couple has not revealed what those other events include.
Tumarkin says it seems to him the couple did everything right when they purchased their insurance. They went in person to a broker who specialized in travel insurance, and they answered all the questions that were asked of them as truthfully as they could.
Not only that, he said, they also went to their doctor and specialist a few days before they left and were given the all-clear to take the trip.
"So what else could they have done?" Tumarkin wondered.
The Toronto-based lawyer has been offering the couple legal advice although they have not formally retained his legal services. He has offered to help them without charge.
Tumarkin says he still does not have every fact of the case, but he said if it turns out the insurance policy was valid, and the couple answered all the questions they were asked truthfully, one key aspect to look at is whether the broker who sold them the insurance did anything wrong.
"We would have to turn to the broker and say, ‘What happened? When they came to you and they gave you the information that you asked from them, did they do anything wrong?’" he said.
If it's found that the broker was at fault, it's possible the broker’s insurance would then need to step up to help pay the couple's bill.
But Tumarkin says he would hope that the case would not have to go to trial, since that becomes costly for everyone. He would rather see the matter resolved in mediation, in which all the parties – Blue Cross, the broker, the broker's insurance, the couple and the hospital – are brought together to broker a resolution.
In explaining that it would not be reversing its decision to deny the couple's claim, Saskatchewan Blue Cross said Monday the couple could also seek help from the national independent insurance ombudsman, OmbudService for Life and Health Insurance.
The couple has not yet decided whether to seek an OLHI review.