A Canadian couple decided to go on a nice, warm visit to Hawaii. Jennifer Huculak and her husband Darren Kimmel were three months away from the birth of their daughter when they came to the U.S. on vacation. Unfortunately, a few days after their arrival, Huculak went into labor and gave birth to a baby girl. Because their daughter was born premature, they racked up some expensive hospital bills. Well, actually, expensive is kind of an understatement. To be more precise, they are being charged $950,000 for the medical care they received.
Now, despite being our friendly neighbors to the North, there are many differences between the U.S. and Canada. They have poutine, their milk sometimes comes in bags, and they have free health insurance. As a result of the extreme differences in healthcare provisions, Canadian tourists are required to buy health insurance for their travels here.
That’s exactly what Huculak and Kimmel did. Before going on the trip they not only got permission from her doctor to travel, but also purchased insurance through Blue Cross.
Unfortunately, just a few days into the trip her labor was induced by a bladder infection, which was not only unforeseeable, but even her doctor in Hawaii explained that this kind of thing “just happens.” Huculak’s daughter, Reece, is now healthy, but had a lot of complications due to her premature birth. She spent two months in an intensive care unit, and Huculak spent time in the hospital as well.
Blue Cross is flat out refusing to pay the $950,000 bill, arguing that Huculak had a “pre-existing condition,” which their policy does not cover. She did not have a pre-existing condition or a high-risk pregnancy, both of which her doctor has confirmed and tried to convey to Blue Cross. Kimmel and Huculak even claim that they specifically talked to a Blue Cross Representative who told them that they were covered. Of course, Blue Cross’ response to the media has been pretty unhelpful; a representative said in response to CTV News:
We review each claim carefully and are confident that our decision to decline this claim was done in a considered manner based on the contract terms, the situation which resulted in this emergency medical claim, and a review of recent medical history.
It seems like Kimmel and Huculak are now seriously considering bankruptcy, because they really have no other choice. They simply can’t pay the $950,000 medical bill. Their other option is to continue fighting Blue Cross, but that also is tough given that they’ve been on that path for what would seem to be about a year now and clearly not much progress has been made.
A case like this comes down to the fact that insurance is a fundamentally difficult process to negotiate, particularly health insurance. Even when you think you take all the necessary steps–purchase what you’re supposed to, speak to a representative, and travel after getting advice from a doctor–it’s still possible to basically get screwed by the insurance company. Kimmel and Huculak learned that lesson a very, very hard way.