We appreciate your patience as we respond to a higher than usual volume of inquiries. If you have already left a voicemail or submitted an online complaint, rest assured that your inquiry has been received and we will contact you once it has been reviewed. Please note that duplicate inquiries can further delay our response times.
The consumer was planning to travel out of country and purchased travel insurance for his trip. He did his due diligence by visiting his physician & specialists for regular follow ups to confirm he was medically stable prior to his out of country travel. His physician assessed him as stable and acknowledged further testing would only be required if his condition worsened. The consumer proceeded with his trip and the purchase of travel insurance.
During the trip he became ill and required out of country medical care. Coverage was denied, because, unbeknownst to him, his physician had submitted further medical testing upon his return as there was a lengthy wait period to obtain the testing. As such, the insurer deemed him to be unstable and denied coverage.
GIO’s Investigation Officer reviewed the communication between the doctor and the consumer and provided clarification of this communication to the insurer. The testing was pertaining to an existing stable condition, and as such, the Investigation Officer discussed a potential resolution with the insurer.
After discussions with the insurer, they agreed that the consumer’s condition was stable, the claim denial was reversed, and the claim was paid.
GIO is an independent body set up to help Canadians find a fair resolution to disputes with insurance providers. GIO can provide advice on dealing with your insurance company as a first step. If you are not satisfied with the decision from your provider on your claim, GIO can help resolve your claim.
If you’d like to submit a claim visit here.
