Claims settled for man needing surgery, senior
Written on July 20, 2009
Even if you do try to read the insurance contract, you may find it impenetrable.
But unless you understand the terms and conditions, you can be left without the protection you thought you had.
On Your Side recently won settlements for two customers with insurance disputes.
Life insurance paid by client too old for coverage.
Eduardo Suarez applied for a five-year mortgage and a mortgage life insurance plan with First National Financial in 2002 when he was 60.
He renewed both at 65, after being told the maximum insurable age for existing applicants was 70.
But Suarez — who turns 67 in August — was notified last May that a routine audit found he did not qualify for life insurance after all. The maximum age was 65.
He had been diagnosed with lung cancer last April. So, finding that his mortgage would not be paid off at his death was an unwanted surprise.
"If he was not eligible for insurance, this should have been brought to his attention during the renewal process," said his son Ryan Suarez.
The letter included a refund of the premiums paid for the previous two years.
I asked Manulife Financial, which underwrites the mortgage life plan, to review the complaint.
Within five days, the family had good news.
Because Manulife recently had raised the expiration age to 70, it agreed to apply that change to his policy as well – even though his coverage was supposed to end at 65.
"I hope you understand the huge burden that you helped take off my dad’s shoulders," said Ryan. "He can now focus on his health and not stress out about this."
Travel insurance claim cut when client did not notify the tour company.
Larry Morrow booked a trip to Mexico and paid with his ScotiaGold Passport Visa card, which includes travel insurance payday loans guaranteed no fax.
Just before leaving last November, he had to undergo emergency surgery for a torn retina.
His doctor said not to fly for six to eight weeks because of a gas bubble placed in his eye.
He called Scotia Assist, the travel insurer, to ask for a refund on the cost of the trip ($2,074). But he got a cheque for only half of the claim.
The other half was not paid because he did not call to notify the tour company by the deadline – which was three days after his eye surgery.
"I was not healthy enough to undertake the notification in that time period," he says.
Morrow has been a loyal Scotiabank customer for 23 years. But when he asked for flexibility, he was turned down.
Joe Konecny, a Scotiabank spokesman, pointed to language in the four-page travel certificate that said in bold type:
"It is therefore important that you cancel your travel arrangements with your travel supplier as soon as the cause for cancellation arises.
"Also, you must immediately advise Scotia Assist as soon as a cause for cancellation arises."
Morrow had received the doctor’s letter on Nov. 6 (the day of his surgery), Konecny said.
But he did not notify Scotia Assist or the travel supplier until Nov. 13. The travel supplier’s deadline for claims was Nov. 9.
After the Star got involved, Morrow received a call from his bank branch manager proposing to pay half of the outstanding claim ($518.50).
"After discussing it with my wife, we accepted the offer. It has been such a protracted process and some reimbursement was better than none," he said.
The lesson: A travel insurance claim may not be paid in full if you do not notify the travel supplier in a timely fashion.
eroseman@thestar.ca