All Ontarians have heard the jokes that go with needing medical care in the United States or elsewhere outside Canada. The image involves an ambulance attendant or ER nurse quickly rummaging through a wallet for a credit card first and checking for injuries (or even a pulse) second.
We laugh at this joke because, as Ontarians, we are accustomed to a health care system which is mostly free at the point of use. The Ontario Health Insurance Plan (OHIP) pays for most of the medical and emergency services we receive anywhere in Canada as long as the services are needed for medical reasons. Getting OHIP to pay for all the costs associated with a medical emergency experienced outside Canada can be much more difficult.
If you are hurt or become ill outside Canada the issue is not that OHIP will refuse to pay your treatment. OHIP will cover the cost of an acute, unexpected condition, illness, disease or injury that arises outside Canada and requires immediate treatment. Unfortunately, the amount that OHIP will pay may not cover the full cost of the treatment received. For this reason, OHIP encourages Ontario residents to purchase vacation insurance anytime there is a trip planned outside Canada.
Vacation insurance is available to protect against medical emergencies that arise during a short weekend trip or an extended stay in another country. You can determine which type of travel insurance is best by considering your own specific needs.
Perhaps the most important consideration is the level of coverage you need and the price you are willing to pay for it. If you suffer an injury out of the country and you find yourself not being covered because you tried to save a few pennies when buying the insurance you will regret it. Make sure you know exactly what is covered and what is not. The last surprise you need in a medical emergency is getting a whopping bill for services outside the plan you purchased.
It is equally important to disclose everything about your trip to the insurer. Travelling to an excluded country, travelling outside of the coverage period, and/or participating in risky activities may all give the insurer reason to deny coverage. For example, your insurer may refuse to pay for treatment of injuries suffered when skiing, scuba diving, or bungee jumping even if that was the primary purpose of your trip.
Another part of disclosing everything to your insurer relates to your medical history. Most times we buy insurance “just in case”. We are insuring ourselves to protect against the unforeseen. Your insurer will want to make sure that the medical condition or emergency was not something that you should already have known about. Insurers will often request paperwork from your doctor’s office prior to processing payment for a medical emergency. If this paperwork reveals an undisclosed pre-existing condition your insurer will likely deny coverage.
A vacation should be a time to relax and find experiences that are not available to us at home. Purchasing the appropriate travel insurance will help protect you against the vacation gone wrong. Disclosing everything to the insurer will make it easier for you, or your lawyer, to fight on your behalf in the event that coverage is denied.