Mississauga man owes $800K in medical bills after travel insurance claim denied

Pat Foran, Consumer Reporter, CTV News Toronto

A Mississauga man who took a trip to Las Vegas now owes a U.S. hospital more than $800,000 in Canadian funds after his travel medical insurance claim was denied.

Clifford MacAuley says that when he took his trip in July, he thought he had the proper travel insurance.

When he went to Las Vegas with his brother, MacAuley was recovering from a heart operation that took place two months earlier. Four days into the trip he had a heart attack.

“They took me to the Las Vegas hospital where they pronounced me dead and then they brought me back to life.”

To save his life, doctors had to give MacAuley a pacemaker. They checked to see if he had travel medical insurance before proceeding with the operation—and he did. But while MacAuley was recovering, the hospital told him his medical coverage had been denied.

They gave him a bill for $662,476 U.S., which is equal to $877,207 Canadian.

MacAuley is 68 years old and on a pension. He says he can’t afford to pay the bill.

“I’m not going to freak out because I don’t have it. I have three fender guitars and about 1000 videos. They can take them if they want I don’t care.”

MacAuley paid $116 for the travel insurance policy with RBC. A spokesperson told CTV News Toronto it was a sad situation but that “Mr. MacAuley had pre-existing medical conditions and was on home oxygen prior to travel. This classified him as “not medically stable” in the six months before travel. For these reasons, Mr. MacAuley’s claim was denied.”

A spokesperson for The Valley Health System in Las Vegas said for privacy reasons it could not discuss MacAuley’s case, but did say patients need to contact the billing department to discuss payment options.

RBC said it had to pay $50,000 to fly MacAuley home in an air ambulance. The RBC spokesperson said people need to understand the type of coverage they’re purchasing and that 98 per cent of its travel claims are paid out to clients.

MacAuley says there is no way he can pay the hospital the money.

“Even if I was to live to 150 years old, I just can’t pay it back.”

Most Canadians don’t know key details about their properties & that makes getting home insurance quotes inaccurate & annoying

A recent home insurance survey conducted by LowestRates.ca found that the majority of Canadians don’t know key details about their homes, meaning when it comes time to get home insurance, their initial quote might not match the final price.  This also means comparing prices to get the best rate is often time consuming and a pain.

The survey found that 59.24% of respondents do not know the replacement cost of their home — essentially, what it would cost to replace the structure they inhabit. Many homeowners mistake this as the price they paid for their home when they bought it or what they could sell their home for now.

The survey also found that 30% of Canadians don’t know what year their property was built, 43% don’t know what the square footage of their property is when including the basement and one in four don’t know how close the nearest fire station is to their home.

Knowing this information is crucial to getting an accurate home insurance quote.

“These results are pretty surprising,” says LowestRates.ca’s Co-Founder and CEO Justin Thouin. “Having the right information is crucial to getting an accurate home insurance quote, but more importantly, incorrect information can invalidate your home insurance.”

Respondents fared better in other areas of the survey: 81.11% of homeowners are aware of the kind of primary and secondary heating their homes use. But in all areas, there was a significant percentage of Canadians who weren’t aware of basic details of their homes.

LowestRates.ca has simplified the home insurance quoting process by introducing a brand new comparison tool that automatically pulls all this information for homeowners. The new quoter is now live in British Columbia, Alberta, Ontario, Quebec, Nova Scotia, the Yukon and the Northwest Territories, and will go live in the rest of Canada in the coming months. Canadians can use the quoter to quickly and easily compare prices from leading brokers and insurance companies to find the best price.

“This will eliminate errors when it’s time to get home insurance,” says Thouin. “We’re thrilled to launch this brand new, innovative quoter, which will allow Canadians to quickly and easily compare home insurance quotes online so everyone can save money and get the right policy for their unique needs.”

The LowestRates.ca survey results show that the majority of homeowners, 75.44%, currently have home insurance, while just over half (50.36%) of homeowners have gotten a quote for home insurance during the past year. The survey asked how much time Canadians think it takes to get a home insurance quote — 40.76% of respondents reported they thought it takes ten minutes, while 20.43% believed it takes twenty minutes. The remaining responses are split down the middle: 19.40% of respondents reported that they thought it takes less than five minutes to get a home insurance quote, while 19.40% indicated that they thought it would take more than thirty minutes.

With the new LowestRates.ca home insurance quoter, however, it’s possible to get more than 15 quotes in just three minutes.

“We want to make sure that homeowners have the coverage they need to protect their homes, and to be aware of the costs associated with unexpected events,” said Thouin.

The LowestRates.ca home insurance survey was conducted from July to August 2019 and sampled 969 respondents across Canada.

About LowestRates.ca
LowestRates.ca is an online rate comparison site for insurance, mortgages, loans and credit card rates in Canada. The free, independent service connects directly with financial institutions and providers from all over North America to offer Canadians a comprehensive list of rates. LowestRates.ca’s mission is to help Canadians become more financially literate, with the goal of saving them $1-billion in interest and fees.

SOURCE LowestRates.ca

Manulife’s insurance app rewards healthy lifestyles, but also raises ‘health surveillance’ concerns

Making 10 per cent of Canadians less sedentary by 2020 would increase the national GDP by $1.6 billion, according to a study

BY Nicholas Sokic | Financial Post 

Elevators at Manulife Canada’s Toronto headquarters are now adorned with signage that reads, “the stairs go the same way.” It’s part of Manulife’s efforts to change sedentary lifestyles, as it rolls out its life insurance app to its employees and the rest of the country in partnership with Discovery Health, the South Africa-based subsidiary of the financial services group Discovery Ltd.

The Vitality app tracks your health based on several personalized physical and mental personalized assessments. Users can reach bronze, silver, gold or platinum ranking based on their own fitness goals, and win discounts and gift certificates for hotels.com, Amazon, Cineplex and Tim Horton’s, among others.

Manulife launched Vitality in the U.S. four years ago under its John Hancock Financial division, and on an individual basis in Canada in 2017. The group benefits version was launched for Manulife employees in July, which reported 50 per cent participation in its first month.

The Toronto-based insurer has now opened the group benefits program to other companies during a staggered rollout, and already counts Walmart Canada and Scotiabank as customers.

The Vitality app is used in more than 20 countries with 10 million participants. Manulife signed a global pledge with other life insurance companies to make 100 million people more active by 2025.

“About a year ago we decided to launch it in the benefits business so that’s been about developing the platform for the employer market and testing it,” said Donna Carbell, the head of group benefits at Manulife Canada.

Participation in the program is entirely optional and there are no consequences for choosing not to participate, the company notes.

“Customers can select the method, type and amount of information they share,” according to Manulife. “The information is used to encourage customer engagement with the program and reward customers for participating in healthy activities.”

Despite privacy and other concerns, getting people to move around is an uncontroversial goal. During a presentation, Manulife’s chief executive officer Mike Doughty stated that four chronic conditions — respiratory, cardiovascular, cancer and diabetes — are responsible for 60 per cent of all deaths worldwide and 85 per cent of Manulife’s group benefits claims.

The highly personalized nature of the assessments in the app result in a radically different fitness experience for each user, even accounting for pregnancy, Carbell said.

“I may be a very sedentary person who has a chronic condition and it will create a different program for me so I will achieve a gold status with a very different exercise and fitness regime than a marathon runner will,” said Carbell.

Manulife cited a study from the Conference Board of Canada saying that making 10 per cent of Canadians less sedentary by 2020 would increase the national GDP by $1.6 billion and reduce national healthcare costs by $2.6 billion.

RAND Europe, an independent research institute, conducted a study last November surveying 400,000 people in South Africa, the U.S. and the U.K. and found that people using the Vitality app in conjunction with Apple Watch saw an equivalent of 4.8 extra days — an increase of 34 per cent — of physical activity on average each month.

Still, there are some obvious apprehensions in handing over the minutiae of your health information to a third-party.

“There’s always concerns about privacy,” said Carbell. “Any info an employee keys into the system, which might be my waist circumference or body mass index, all of that is housed with Vitality. We don’t even have access to that.”

Instead, the monthly report that employers receive would only contain demographic data such as how many employees are actively using the app.

“They could, theoretically, sell the information to third-parties without any consent on the part of the subject. But (totally voluntary) means nothing,” says Ann Cavoukian, the executive director of the Privacy by Design Centre of Excellence at Ryerson University. “Most people probably haven’t even looked at who the information is shared with, what that consent means.”

Toronto-based John Wunderlich of the self-named privacy and security firm also thinks the situation is not so cut and dry.

“I think it’s hard for me to see what the value offering is for both employer and insurance provider if it isn’t employee health surveillance.”

While employee consent is required, “the pendulum is swinging” on how rigorous that consent may be, Wunderlich says. For those that don’t want to participate, the impact could be anything from increased stress or pressure to perform in an unnatural fashion.

This hypothetical situation is not beyond the pale either. Last year, a statewide West Virginia teacher’s strike was partially brought on due to the Go365, a heartrate- and step-tracking app. A US$500 hike in a teacher’s annual insurance deductible was the punishment for failing to reach a certain amount of points. The program was later abandoned.

However, Manulife counters that it’s “committed to respecting and protecting” customers’ personal information.

“We have organizational, physical and technical safeguards in place to ensure the confidentiality, integrity and availability of the data entrusted to us,” the company said.

Southern Manitoba communities drenched, with some seeing more than 100 mm of precipitation

Read more

How to avoid insurance fraud

 Sonnet Insurance, Canada’s digital insurance company, combats home and auto insurance fraud daily using sophisticated predictive data models, AI tools and analytics, and ongoing monitoring of behavioural patterns. Now, Sonnet wants to empower Canadians to recognize and prevent potentially harmful scams. Home and auto insurance seller fraud is common in all regions of Canada, especially the GTA1, where victims who don’t understand the process for purchasing home and auto insurance are targeted.

“Sonnet is committed to making insurance easier for Canadians to understand,” said Roger Dunbar, SVP, Sonnet. “Fraud impacts all Canadians and especially those who don’t understand local insurance regulations, so we want to educate the public on seller fraud.”

Seller fraud takes place when insurance policies are being sold to customers by fraudulent actors. Unlike claims fraud(using fake accidents or reports to cash in on real insurance policies), seller fraud leaves its victims open to a high degree of personal risk. A fraudster will offer discounted insurance and take the victims’ money in return for home and auto insurance pink slips that are invalid or forged.

Legitimate insurance policies are sold in Canada through registered brokers, licensed insurance agents, and regulated direct-to-consumer insurance companies:

  • A legitimate broker or agent is an individual or firm that sells insurance policies to clients and has a license number from their provincial regulator
  • Direct-to-consumer insurance companies (like Sonnet) are federally regulated and licensed to sell insurance policies directly to the end customer

Sonnet is doing everything possible to protect consumers against fraud – from plain language policy documents to simplifying the online insurance experience – and wants to educate the public on how to identify scams. A few key indicators can help tip off potential victims of insurance fraud, saving them from losing thousands of dollars and failing to have proper insurance coverage in place when it counts. Two of the most common seller scams in Canada are ‘ghost brokers’ and ‘fake brokers’.

Ghost Brokers take money for insurance upfront, provide a pink slip showing proof of insurance then disappear, or ‘ghost’ the customer. Sometimes the slip is simply a forgery. Other times the fraudster will set up an actual policy, download the slip and give it to the victim, then cancel the policy without the knowledge of the victim. What this scam looks like:

A new Canadian sees an ad for cheap insurance rates online and agrees to meet the ghost broker in a coffee shop with cash to pay a full year’s premiums. The ghost broker exchanges the cash for an insurance slip and pockets the money. The victim thinks the coverage is real until an inspection or accident prompts a check – and the insurance policy, along with the ghost broker, can’t be found.

Fake Brokers have an actual physical address and may do some legitimate business, such as selling or financing cars. Fake brokers purchase an insurance policy with the name of the client to secure an insurance slip. However, the policy will include incorrect information such as unlisted high-risk drivers or the wrong address, to obtain more favourable rates. Policies can be cancelled and claims can be denied if information is misrepresented, which makes it hard for the consumer to get insurance coverage in the future. Some fake brokers make money by charging a ‘broker fee’, while others are trying to clear the path to sell a car. In contrast, a certified broker makes a commission from insurance companies and never charges consumers directly for services. What this scam looks like:

An individual with a bad driving record has been quoted a high premium and sees an ad offering cheap insurance to high-risk drivers. The driver visits the fake broker and pays a lower premium to the fake broker in return for an auto insurance slip. The driver gets into another accident and discovers that the insurance policy contains misrepresented information and their policy is cancelled or claims won’t be paid out. After paying for damages out of pocket, the driver is unable to get standard insurance and opts to give up driving.

“In Canada, auto insurance is mandatory and highly regulated by the government,” added Dunbar. “Generally, if a deal looks too good to be true, it probably is. That is because insurance rates are based on pooled risk – companies need to collect enough money to pay out claims in a given year.”

Victims are encouraged to report fraudulent activity. Reporting fraud helps stop repeat offenders and reduces insurance premiums for everyone. To report fraud, visit the Insurance Bureau of Canada website here: report fraud.

Regulatory bodies issue regular warning notices about suspected fraudsters and offer additional resources. Trusted websites are the best place to check on licenses and suspicious activity. Find your provincial regulator here: insurance regulators.

Canadians looking to better understand home and auto insurance can view answers to frequently asked questions at sonnet.ca/FAQs.

About Sonnet Insurance

Launched in 2016, Sonnet Insurance Company (Sonnet) is a federally regulated insurance company. Our mission is to provide Canadians with an easy, transparent, and customized way to buy home and auto insurance online. Experience the future of insurance at Sonnet.ca, and say hello on Twitter, Instagram, Facebook, and LinkedIn.

1 FSCO Survey, March 1, 2017 http://www.fsco.gov.on.ca/en/pubs/News-Releases/Pages/2017-mar1-fpm.aspx

SOURCE Sonnet Insurance Company

OPP reminds public to be vigilent of scams

Members of the Temiskaming Detachment of the Ontario Provincial Police would like to inform the public of several different types of frauds/scams in the Temiskaming  area.

Police would like to remind the public to be aware before providing any personal information or money. Police are suggesting to inquire about the company that is asking for your personal information such as your bank account, computer information. Listed below are some of the recent scams investigated by the OPP.

The Romance Scam – Fraudsters take advantage of people who are lonesome. They may steal other profile photos to make themselves appear like someone else, use social media and lure victims. They may rush into the relationship, and promise a wedding or expensive items, once they meet in the victim’s country, or they may continue the online relationship over an extent of time to develop a trust level which usually results in the victim losing a significant amount of money, and the victim never actually meeting their so called partner.

Canada Revenue Agency (CRA) Scam – If you receive a fraudulent communication by email, phone, text, mail, from someone that claims to be the CRA and they request personal information, these are scams and never respond.

The CRA will never send you a link and ask you to divulge personal or financial information.

Compromised Credit Cards – Fraudsters have been calling the public lately claiming to be employees from the fraud department at a bank. They proceed to advise people that their credit card has been compromised and in order to verify they have the right account, to please read them your credit card number. In these cases, the fraudsters already have your name and first four digits on the Visa or MasterCard. This tactic is used to make them sound legitimate.

Do not divulge any personal information related to credit cards or banking particulars over the phone, by email, letter, fax, or any other means of communication. Call your credit card company or financial institution on your terms to verify/report any suspicious activity.

If you believe that someone is posing as a fraudster on the phone, hang up. Also, you can file a complaint through the Canadian Anti-Fraud Centre at 1-888-495-8501. If you are a victim of a fraud or scam, contact your local police agency.

Important Safety Tips to Remember:

  • Before giving money, ask questions. If the organization is legitimate, they welcome questions and will provide reasonable answers;
  • Never provide personal information through the internet or email;
  • Keep your passwords and PIN’s a secret;
  • Do not write down passwords or carry them with you;
  • Shred unwanted documents and make sure that your name and social insurance numbers are secure;
  • Ask a trusted friend/relative/neighbour to pick up your mail when you are away or ask that a hold be placed on delivery.

FRAUD…Recognize it …Report it …Stop it

LEARN MORE

If you suspect you may be the victim of fraud or have been tricked into giving personal or financial information, contact your local OPP detachment at 1-888-310-1122 or the (Link) Canadian Anti-Fraud Centre at 1-888-495-8501.

The Government of Canada Competition Bureau: aims to increase your awareness of the many types of fraud that target Canadians and offer some easy steps you can take to protect yourself and avoid falling victim to fraud.

Source;

Northern News

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