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This Sask. man had a stroke in Arizona. His family awaits massive bill after insurance claim denied

This Sask. man had a stroke in Arizona. His family awaits massive bill after insurance claim denied

CBC
Tuesday, February 28, 2023 02:10:02 PM UTC

After a man from Halbrite, Sask., had a stroke while vacationing in Arizona, his family learned they were on the hook for a $56,000 flight home — and other medicals bills yet to come in — as their health insurance claim was denied.

"He has forgotten how to talk, how to swallow," Rebecca Fee said, talking about her grandfather who she said has been like her father.

Fee said her grandparents, Louis and Arlene Lamothe, are avid snowbirds and spend half the year in Yuma, Ariz.

On Feb. 3, around 6 a.m., Arlene found Louis on the floor. He had suffered a stroke and was paralyzed on the left side. Louis was airlifted to Banner - University Medical Center in Phoenix. The next day, Fee drove for 30 hours from Estevan, Sask., to be with her 80-year-old grandmother.

"He was immediately intubated. He had a lot of heart problems after this," Fee said. "He was in ICU for two weeks and now his breathing tube has come out."

About 16 days into their stay there, the family learned their Blue Cross insurance was not covering their medical fees and her grandfather was denied coverage.

Fee said the insurance company argued it was because Louis Lamothe did not disclose a change in cholesterol medication, which he had been taking. Louis was on a 10-milligram pill in Saskatchewan, which was increased to a 20-milligram dosage. The family cannot confirm when exactly that change was made.

Lamothe also suffered from chronic obstructive pulmonary disease.

Fee said that because the 10-milligram dosage increase was not communicated, Blue Cross declined to insure Louis for his hospital stay or flight home. The family said they do not know why Louis did not disclose the change in medication but say it was not deliberate.

"It was a major shock when insurance folks said we are on our own," Fee said, noting Louis filled out his application correctly disclosing he had a previous heart attack and lives with chronic obstructive pulmonary disease.

"He would not have hid a 10-milligram cholesterol dosage change. So, whether he forgot as a 72-year-old that this dosage change even happened, or that he even knew, we can't confirm it."

The family has not received the bill for his 24-day hospital stay in Arizona, but believe it will easily be a couple of hundreds of thousands dollars.

Fee said the family doesn't know how to prove to the insurance company that Louis did not deliberately hide this, but rather it was a minor error.

"I'm just disgusted with them. It is absolutely unbelievable and unfair." Arlene said. "He is a very honest man and he would never try and scam anybody."

Read full story on CBC
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