Ontario is about to scrap out-of-country emergency health care coverage

Travelling to the U.S.? Here’s what you need to know

The Star Vancouver

When Toronto resident Jill Wykes had a health scare over a racing heartbeat in Florida a few years back, the $3,000 hospital bill for a two-hour visit and three tests added insult to illness.

Fortunately, the seasoned snowbird had a comprehensive travel health insurance policy that paid the full tab.

But the incident, which turned out to be nothing serious, served as a reminder that medical emergencies can happen any time, anywhere.

Buying enough travel insurance to cover all eventualities becomes even more important for Ontario residents when the province scraps its out-of-country coverage of emergency health care expenses on Jan.1.

Until Dec. 31, OHIP will continue to pay up to $400 per day for emergency in-patient services and up to $50 per day for emergency outpatient and doctor services. Starting next year though, that coverage stops.

A new program will provide kidney dialysis patients with $210 toward each treatment — actual prices in the U.S. range from $300 to $750 — but travellers will be on the hook for everything else.

The province says it’s cancelling the existing “inefficient” program because of the $2.8-million cost of administering $9 million in emergency medical coverage abroad each year. OHIP’s reimbursements also tended to offset only a fraction of the actual expenses.

Without private insurance, travellers can face “catastrophically large bills” for medical care, warns Ministry of Health spokesperson David Jensen, who “strongly encourages” people to purchase adequate coverage.

Health care south of the border, in particular, costs an arm and a leg. On average, fees in the U.S. are double those of other developed countries, according to the International Travel Insurance Group.

The insurance provider cites an array of costs, including: ambulance, $500 and up; ER visit, $150 to $3,000; hospital stay, $5,000 per day; MRI, $1,000 to $5,000; X-ray, $150 to $3,000; hip fracture, $13,000 to $40,000.

The monetary ouch factor can be especially painful for snowbirds, who are flocking to warm spots like Florida, Arizona and Texas in growing numbers as baby boomers reach retirement age.

But a significant number of vacationers of all ages are putting their financial health at risk.

According to a recent survey by InsuranceHotline.com, 34 per cent of Canadian respondents said they were unlikely to buy travel insurance, often in the mistaken belief their province would cover them. And 40 per cent had unrealistic expectations of health care costs, thinking, for example, that emergency medical evacuation would be under $2,000. In reality, the service can cost tens of thousands of dollars.

Jill Wykes and her husband Pierre Lepage leave nothing to chance during winters in Sarasota, Fla., an annual trek since 2011 when she retired as a travel industry executive.

The couple, now in their 70s, purchase a multiple-trip plan with a 60-day top-up for their four-month sojourn, which includes driving there and back and flying home for two short visits. Her policy costs about $900 while his is $1,600, because he falls into an older age bracket. They’re each covered for up to $5 million.

Wykes, a blogger and editor of, snowbirdadvisor.ca, calls it “foolish” to travel anywhere without health insurance and advises against thinking “you would just drive or fly home if you were sick.” The financial fallout from an accident or sudden illness “can quickly rise into six figures” in the U.S., she adds.

Anne Marie Thomas of InsuranceHotline.com, which provides free quotes for all types of insurance, echoes Wykes’s advice.

“Now, more than ever, you need travel insurance because there will be zero coverage (as of Jan. 1),” she says.

There’s no one-size-fits-all policy and insurance can cover everything from trip cancellation or interruption to lost baggage and medical costs, Thomas explains, so it’s important to match your needs and situation. A sunseeker driving south, for instance, wouldn’t need trip cancellation.

Insurance offered in Elliot Lake for water-sewer problems

The excerpted article was written by Brent Sleightholm | Elliot Lake Today

For the second year running, the City of Elliot Lake has offered residents a way to be insured against water and sewer issues.

“The City of Elliot Lake has partnered with Service Line Warranties of Canada (SLWC) to offer protection to city homeowners with Service Line Warranties of Canada to offer protection to city homeowners for the water and sewer service lines that connect their homes to the city’s systems,” Elliot Lake CAO Daniel Gagnon, explained in an email.

“The coverage is voluntary and available at affordable monthly prices. Since 2015, SLWC has partnered with over 50 leading cities in Ontario to provide repair service plans that offer homeowners peace of mind and convenience,” said Gagnon.

“Many homeowners do not know that damage to the service lines on their property is their responsibility to repair. In the event of a service line repair emergency, the homeowner is responsible for scheduling the repair and covering the associated cost. The SLWC Service Line Warranty Program protects against repairs needed to pipes on homeowners’ property,” Gagnon added. “Repairs to these pipes are not often covered by basic homeowners insurance. If a customer’s service line is in need of repair, a simple call to the SLWC 24-hour hotline will dispatch a local, licensed contractor familiar with local code. There are no service fees or deductibles.”

“A recent mail-out was done by SLWC to homeowners in Elliot Lake and is completely voluntary. The city is not delivering the service but is simply facilitating the offer,” Gagnon concluded.

Motorist Ordered To Pay $34,980 in Damages Following “Road Rage Incident”

Reasons for judgement were published today by the BC Supreme Court, Vancouver Registry, ordering a motorist to pay almost $35,000 in damages after striking another motorist in the face.

In today’s case (Henderson v. McGregor) the parties were both operating motor vehicle moving in the same direction of travel.   The Plaintiff was concerned that the Defendant was not paying adequate attention.  The vehicles stopped close to each other and the Plaintiff exited his vehicle and approached the Defendant.  The Defendant “struck him without warning, grabbing and scratching his face causing lacerations and bruising and drew blood.”.

The Court found the Defendant liable for the torts of assault and battery and ordered damages just shy of $35,ooo to be paid including $2,000 in aggravated damages.  Mr. Justice Walker provided the following findings regarding liability:

[27]         I accept that Mr. Henderson believes he was calm and non-threatening when he approached Ms. McGregor’s vehicle. I also find that Ms. McGregor was surprised to see Mr. Henderson walking toward her vehicle.

[28]         That said, Ms. McGregor committed an unprovoked assault and battery on Mr. Henderson (I will refer to both collectively as an assault). She struck him without warning, grabbing and scratching his face causing lacerations and bruising and drew blood.

[29]         Mr. Henderson conceded in submissions that with the benefit of hindsight he should not have approached Ms. McGregor’s vehicle. However, that does not provide Ms. McGregor with a defence.

[30]         Her submission that she acted in self-defence is without merit. She has not met the onus to establish self-defence: Mann v. Balaban, [1970] S.C.R. 74 at 87. She has not established that she perceived an imminent attack. Without provocation, Ms. McGregor hit and grabbed Mr. Henderson’s face, scratching his skin with such force to cause lacerations, bleeding, bruising, and swelling.

[31]         Even if Ms. McGregor felt threatened and perceived an imminent attack, which I do not accept she did, in exercising her right of self-defence, she must use only such force as on reasonable grounds she believes is necessary for her defence. The nature of the injuries suffered is not necessarily indicative of whether the force was reasonable. The issue is informed by the facts and circumstances of each case, including the nature and seriousness of the threatened attack. Here, the force Ms. McGregor used was not reasonable in the circumstances: Buchy v. Villars, 2008 BCSC 385 at para. 112, aff’d 2009 BCCA 519; Provencher v. St. Paul’s Hospital, 2015 BCSC 916 at paras. 45-46.

Assault, Battery, bc injury law, Eye Injury, facial cuts, facial lacerations, Henderson v. McGregor, Mr. Justice Walker, Road Rage

Cannabis Exclusion In Home Insurance Policies May Not Be Effective When Tenants’ Grow-Op Causes Loss

Article by Robert Gilroy

Despite the efforts of insurers to exclude coverage in habitational insurance policies for losses caused by cannabis cultivation or production, a recent Alberta case serves as a reminder that coverage may, nevertheless, apply where an insured’s tenant’s grow-op causes a loss.1 This is due to the existence of so-called “innocent insured” provisions in the Insurance Acts of Alberta, British Columbia and Manitoba.

Background

Home insurance policies have traditionally excluded coverage for losses caused by illegal activities. Many have also specifically excluded coverage for losses arising from illegal drug activity. With the Cannabis Act having come into force on October 17, 2018, Canadians may now legally cultivate up to four cannabis plants at a time in their dwelling-house.2 As such, some insurers have amended their policies to exclude losses caused by growing cannabis, regardless of its legality.

However, insurers in Alberta, British Columbia and Manitoba may still be at risk of cannabis-caused losses even with broad exclusions on the growing or production of cannabis in a dwelling.

The innocent insured provisions

The innocent insured provisions protect insureds who are not responsible for or complicit in intentional acts that cause damage. Specifically, exclusions barring coverage for losses caused by a criminal or intentional act or omission are of no effect vis- à-vis an insured person who does not:

  1. Cause the loss;
  2. Abet or collude in causing the loss; and
  3. Consent to the act or omission while knowing—or having ought to have known—that the act or omission would cause the loss.

The innocent insured provisions of the three provinces are all identical.3 British Columbia, Alberta and Manitoba brought their provisions into force in 2011, 2012 and 2014, respectively. Their enactment was a response to the Supreme Court of Canada’s (SCC) decision in Scott v. Wawanesa Mutual Insurance Co. [Scott].4 In Scott, the majority of the SCC held that, upon the insured plaintiff’s son intentionally setting fire to the plaintiff’s house, coverage was not available to the plaintiff, as the policy excluded coverage for loss caused by a criminal or wilful act of the insured.5

Recent cases

While the innocent insured provisions have received relatively little judicial consideration, the recent 2019 Alberta case of Lafferty v. Co-Operators General Insurance Co. [Lafferty] should serve as a reminder that an insurer in Alberta, British Columbia or Manitoba could be on the hook for damage caused by a tenant’s grow-up, notwithstanding a cannabis exclusion.6

In Lafferty, the insured plaintiffs owned a house in which their tenants were growing cannabis. The insureds had no knowledge of this. The grow-op caused damage to the house. After the insurer denied coverage based on an illegal drug operations exclusion, the insured sued for coverage. Ultimately, the Court held the innocent insured provision to be unavailable to these insureds, as the loss occurred in 2010, while the provision came into force in Alberta on July 1, 2012.7

Nevertheless, the Court in Lafferty commented that the innocent insured provision could have prevented the insurer from relying on the drug operations exclusion had the loss occurred after the provision came into force.8

One may contrast the Court’s comments in Lafferty with a recent decision out of Saskatchewan, a province that does not have an innocent insured provision in its provincial Insurance Act. In the 2018 case of Carteri v. Saskatchewan Mutual Insurance Co., the Court dismissed the insured plaintiffs’ claim for coverage after an explosion and fire severely damage their rental property.9 The explosion and fire evidently resulted from the tenants’ attempt to produce cannabis resin.10 The insurance policy contained an exclusion denying coverage for loss caused by the manufacturing of illicit drugs.11 The exclusion functioned to bar coverage, even though the insured property owners were arguably “innocent of any wrongdoing.”12

Rental properties are at a much higher risk

The innocent insured provisions afford protection to property owners when a tenant’s act or omission causes a loss, provided the insured is a natural person (as opposed to a corporation), and does not consent to or collude in such activity. This may prove problematic for insurers writing habitational policies in Alberta, British Columbia and Manitoba.

As rental properties already represent a higher risk exposure, insurers will want to underwrite such policies carefully, especially considering the increased likelihood of tenants seeking to grow marijuana plants in their dwellings legally, regardless of whether the property owner forbids it. Given that cannabis exclusions may not protect insurers in this situation, it is even more prudent that insurers require their insureds to conduct regular, periodic inspections of rental dwellings, in an effort to sniff out any cannabis production before it causes a loss.

Source: Mondaq

SSQ Insurance continues with its digital healthcare strategy

SSQ Insurance partners with HALEO and MindBeacon Group in an effort to give its group insurance plan members access to digital cognitive behavioural therapy (CBT). These partnerships stem from the insurer’s desire to find innovative ways to satisfy the needs of its customers, namely through the deployment of a digital healthcare strategy. Through this modern, online approach, SSQ Insurance is hoping to help its customers with mental health management, specifically through the prevention and early detection of sleep- and stress-related problems as well as mood and anxiety disorders.

“Through our agreements with HALEO and MindBeacon, SSQ Insurance plan members will have access to the latest CBT advances and obtain therapy that is adapted to their specific situation, whether for sleep disorders, anxiety, or depression. By taking preventive action in a timely manner, we can ultimately help control group insurance plan costs,” said Éric Trudel, Senior Vice-President of Strategy and Product Management, SSQ Insurance.

HALEO and BEACON each offer innovative cognitive behavioural therapies delivered online by qualified healthcare professionals. HALEO’s CBT focuses on sleep disorders whereas BEACON’s focuses on mild to moderate symptoms of anxiety and depression. In both cases, the insured determines the pace and platform on which the therapy is applied, making CBT a simple and accessible option.

Through these partnerships, SSQ Insurance proposes a variety of content on stress- and sleep-habit management in order to raise awareness about these problems and learn to recognize them. For those who feel concerned, they can also take a test to evaluate whether or not the HALEO or BEACON approach is right for them.

About SSQ Insurance
Founded in 1944, SSQ Insurance is a mutualist company that puts community at the heart of insurance. With assets under management of $12 billion, SSQ Insurance is one of the largest companies in the industry. Working for a community of over three million customers, SSQ Insurance employs over 2,000 people. Leader in group insurance, the company also sets itself apart through its expertise in individual life and health insurance, general insurance and the investment sector. For more information, please visit ssq.ca.

About HALEO


HALEO is an online sleep clinic with a mission to make evidence-based solutions accessible for people experiencing insomnia or poor sleep.  We provide professional, clinically-proven treatment that takes half the time and at half the cost of traditional Cognitive Behavioural Therapy, all without having to set foot in a clinic or join a long waiting list.  Our team of specialized therapists uses live videoconferencing, chat and an array of therapeutic tools integrated into our mobile sleep clinic app to help clients from across Canada overcome their sleep problems. For more information, please visit haleoclinic.com.

About MindBeacon Group
The MindBeacon Group is committed to providing evidence-based mental health therapy that is accessible whenever and wherever it is needed. With the goal of empowering individuals to live their best lives, MindBeacon Group brings ground-breaking innovation and current clinical best practice to the development and delivery of mental healthcare. Their clinical practice began with CBT Associates, a network of Greater Toronto Area-based clinics that provides in-person and virtual care to individuals across Ontario. In 2017, the BEACON™ digital platform was introduced as the first commercially-available clinician-guided iCBT service available across Canada. mindbeacon.com

SOURCE SSQ Insurance

 

CAGOC seeks media coverage of an Ontario millennial’s egregious auto insurance experience

NEWS PROVIDED BY

The Consumer Advocacy Group Of Canada

The Consumer Advocacy Group of Canada (CAGOC) is currently inviting media to contact CAGOC at the information below pertaining to a consumer-facing story about a millennial customer of Sonnet Insurance, a division of and underwritten by Economical Insurance Company. This customer is calling on Roger Dunbar, President of Sonnet and Rowan Saunders, President of Economical Insurance, to revise their management skills on customer strategy and policies of how Sonnet deals with millennial consumers. The story focuses on the Ontario-based auto insurance consumer, who in CAGOC’s opinion, has and continues to be egregiously mistreated by their insurer. Are companies that target millennial consumers actually better for millennials or is it just a marketing tactic? CAGOC is seeking Canadian consumers with similar stories and encourage them to contact us at the information below.

The story may be provided upon review, on an exclusive basis, packaged facts, documents, photos, and materials by CAGOC about the consumer’s experience. A letter from the consumer allowing media to discuss their case with the corporation, and various ministers who have been notified, will also be provided. Ministers notified include the Hon. Christine Elliott, Minister of Health and Long-Term Care (Ontario); Hon. Doug Downey, Minister of the Attorney General (Ontario); and Hon. Lisa M. Thompson, Minister of Government and Consumer Services (Ontario). Interested reporters are encouraged to contact CAGOC at the information provided below.

About CAGOC
The Consumer Advocacy Group Of Canada was founded in 2009 as a non-partisan, consumer-centric, organization consisting of Canadian researchers, advocates, and thinkers, who are tuned into assisting with Canadian consumer advocacy and mandated to create a fair and equal environment for all Canadian Citizens. Funded by members of the public, CAGOC pursues matters of public interest and/or concern for Canadian consumers and the general public.

SOURCE The Consumer Advocacy Group Of Canada

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