How to make a travel insurance medical claim?

18 October 2016

The bad press when paying insurance claims

Every insured person has already heard it said that the insurance companies do not always properly repay when an accident occurs. Even if the reimbursement rules are specifically listed but due to the fastidious way of insurance contracts, there may remain an afterthought on the risk of not receiving the coverage to which one would be entitled by paying the premium insurance.

This bias may come from several sources. One of the situations is that the insured person has misinterpreted the cover which he thought he had. The role of a broker or insurance representative is crucial because they are the privileged interlocutor to understand the needs of a traveler and to adequately inform the guarantees but also the restrictions and exclusions. Another situation is that the traveler is exposed to a risk of which he had forgotten that was not under his travel insurance policy. A final situation is sometimes the insured traveler did not correctly assess his condition beforehand from the conditions agreed in the travel insurance policy for emergency medical care abroad.

Complaints are perhaps not always easy to complete, but if the rules were well set out in the sale of insurance and where they were being followed by the insured, there is no reason that an insurer does not pay during a disaster.

The restrictions and common exclusions in travel insurance

Whether with travel insurance or without medical questionnaire, any contract includes provisions regarding the prior state of traveler health before his departure date or the date of entry into force. In addition, any traveler must keep in mind some general exclusions on most products. Many travelers are unaware of them and therefore this opens the door to a dispute at the presentation of a medical claim.

The travel insurance does not usually cover

  1. sports risks;
  2. the activities of paid professional sports;
  3. speed or endurance races;
  4. piloting an aircraft or a flight as a paying passenger in another public transport method;
  5. countries, regions or cities in which Canada’s Foreign Affairs issue a warning not to stay;
  6. and in some cases paid work (some insurance travel products for the Snowbirds do not cover people working against remuneration).

Exclusions that can be felt more by all travelers:

  1. an optional treatment (medical care that can wait for the return trip);
  2. a trip undertaken for the purpose of receiving medical treatment;
  3. concealment or deliberate misrepresentation regarding insurance or the presentation of a claim;
  4. drug use, abuse of drugs or alcohol that directly or indirectly leads to a claim;
  5. attempted suicide or self-harm;
  6. mental or emotional disorders, anxiety, stress or depression unless you need to be hospitalized. Here it should be noted that some travel insurance products never cover mental or psychological problems because they are not considered a medical emergency.

Of these exclusions, the one that causes problems most often is the abuse of alcohol.

If you go to the emergency room following a banal accident from a fall causing a blow to the head, a cut above one eye or a sprained ankle, and if they think you exceed the permitted alcohol limit and after a blood test result are above the legal limit, the insurance company has the right not to pay your medical expenses related.

The importance of calling the emergency phone number before any medical consultation

Failure to call the assistance center before consulting (unless a serious medical condition or admission to hospital in extreme emergency) can create unpleasant surprises for you, such as non-payment of the claim. By contacting the support center, the speakers will tell you immediately how to proceed, so you do not make a mistake. The emergency numbers to call are listed on your insurance certificate and your insurance policy detailing the exact scope of coverage purchased.

The importance of having a valid health insurance card

Whatever your province or territory of residence, you will normally have a registration for a public insurance plan. This gives you a health insurance card. It must always be in place, because during a claim when traveling abroad, the insurer verifies if you are in good standing. If unfortunately, your card is no longer valid, your medical claim is likely to be refused or the level of reimbursement of benefits may be drastically reduced.

The best way to avoid problems in medical travel claims is to read your insurance policy before departure and ask all relevant questions to your broker or your insurance representative.

7 keys to understanding international driving permits

2 October 2016

1. What is an international driving permit?

The international driving permit or IDP has information from the usual driving license translated into ten languages. The languages are English, French, Spanish, Russian, Chinese, German, Arabic, Italian, Swedish and Portuguese. The holder thus has a new photo ID in addition to his other identity documents. In addition, most car rental companies will ask for an IDP, although it is not required to drive in the country visited. The international driving permit is not valid in the state or province where the holder has established his main residence. This should cover the formalities for obtaining regulatory permits for the state or province of residence. The international driving permit or IDP is a title of conduct where one is qualified as non-resident.

2. Does a Canadian motorist need a IDP in North America?

The international driving permit was created as part of a UN convention on road traffic in 1949. This document is recognized in all the signatories to this agreement. Even though some have not signed it, IDP is often accepted in their territory.
For Canadians, the IDP is usually required outside of North America. Normally, the Canadian driver’s licenses are sufficient to circulate in the United States or Mexico. Unfortunately, without explicitly requiring this famous international driving permit, some US states have adopted legislation that did not accept licenses not in English. This has a direct impact for residents of Quebec.

The US state of Georgia is almost a must for those traveling by car to Florida. Many Canadian retirees, commonly called snowbirds, were likely to be confronted with local laws regarding driving licenses. Indeed, any motorist driving in this state should have a driving license in English. This led de facto impossible for Quebecers to ride locally with their driving license denominated in French. The Georgian authorities seemed rarely fined motorists holding only allowed Quebec. Getting suspended since this law will be repealed end 2016, which will allow Quebec drivers to present their passport and driving license of Quebec when needed. From January 1, 2017, Georgia will no longer require that its agents present international driving permit if the lead held permit is written in a language other than English. The presentation of the Canadian passport with the Quebec driver’s license written in French is only admissible for local authorities. There will be no need for Quebeckers to have an international driving permit in Georgia.

3. How to get information about permits for the countries visited?

In addition to the travel advisory, the Department of Canadian Foreign Affairs informs about whether or not to obtain a prior international driving permit. The information is specified in the “Laws and Customs” tab of each country profile. To view the information by country, please follow the following link: https://travel.gc.ca/travelling/advisories.

4. Where to get an international driving permit?

For Canadian residents, the CAA is the only Canadian jurisdiction authorized to issue and to deliver international driving permit.

An international driving permit is valid for a period of one year from the date of issue. Motorists must reapply each time another IDP is required.

5. What are the conditions for an IDP?

A Canadian traveler wishing to use a road vehicle in a country requiring an international driving license must be at least 18 years. He must also hold a valid and unrestricted Canadian driving license. The Canadian drivers who can not get an IDP are those who hold only a temporary permit (or learning) and those who were stripped of their license because of violations of the code of the road.

The international driving permit does not apply to the category of vehicles which the Canadian license held by the motorist does not authorize driving.

6. What is the cost of this license?

The Canadian motorist can report to their local CAA Club with the required documents (two-sided photocopy of the driving license in good standing issued by the province of residence, two passport photographs and the IDP application form for the CAA).

The cost is currently $ 25 (subject to change without notice from CAA).

You can also apply by mail. A request sent by mail must include the payment of fees by credit card or by bank draft, money order or check in Canadian currency from a Canadian financial institution payable to your local CAA Club.

Note that IDP will not be issued earlier than a month before the departure date. The IDP is valid for one year from its date of issue. No need to be a member of the CAA to apply!

7. What will happen if you stay abroad for over a year?

If the stay abroad exceeds one year and your IDP expires, you can request a new one, provided that your Canadian driving license is still valid. Your new international driving permit will be posted abroad, at your expense.

The RAMQ and travel outside Québec

15 September 2016

Travelling outside Québec involves many rules with its provincial health plan. The Régie de l’assurance maladie (board of Québec Medicare) provides support for the majority of medical costs in case of accident or illness occurring in the territory of the province. However, Quebecers enrolled in the RAMQ are often unaware that when they leave the territory of Québec to travel to another Canadian province or a country other than Canada, the standards for reimbursement following a medical problem will vary.

Reimbursement of medical expenses elsewhere in Canada

Travelers who are holders of a valid RAMQ health insurance card can claim reimbursement for health services received in another Canadian province. However, refunds may be partial. Some services are not covered by the health insurance plan.

The board of health insurance reimburses medical services provided by a doctor, dentist or optometrist up to the rates in effect in Québec. So if travelers do not have travel insurance taken out with an insurer, the fee not reimbursed by RAMQ will be dependent on them.

The Pan-Canadian Public Health Network

Canada has a national health system. Thus, hospital services are fully covered. These services include services associated with a hospital stay or services from hospital to outpatient (nursing, diagnostic, ward accommodation and drugs administered during hospitalization).

By cons, you should know that medical procedures such as surgery, doctor visits, etc., are paid to the pricing of Québec. If a traveler is to undergo any operation, you will probably pay surpluses since the Québec service fees are often lower than in some other provinces in Canada.

We must also think about repatriation to the province of Québec. If the traveler is hospitalized for a long time, they will probably wish to be back close to home. Back in Québec, costs can be quite expensive. In light of this information, travel insurance, even in Canada, is very useful.

Reimbursement of medical expenses for a trip outside of Canada

Following the points made above, it is obvious that for a beneficiary of the RAMQ bound for anywhere in the world, a travel insurance plan becomes even more important because medical costs are generally even higher abroad to non-residents. The amounts paid by Québec are minimal when the amounts can be astronomical in some countries. The Régie de l’assurance maladie (board of Québec Medicare) reimburses hospital services following a sudden illness or accident according to established amounts:
● Up to CA $ 100 per day of hospitalization
● Up of CA $ 50 per day for care received at the outpatient hospital.
La Régie also pays up to CA $ 220 for hemodialysis treatment and drugs attached to it, whether the person is hospitalized or not.

The reciprocal agreements on social security with other countries

Social security reciprocity agreements have been signed between the Government of Québec and Belgium, Denmark, Finland, France, Greece, Luxembourg, Norway, Portugal, Romania and Sweden. They benefit Quebecers who are travelers for longer stays in those countries to be covered by the health insurance plan offered in these countries, while avoiding a waiting period before being entitled to the protection offered. Steps are undertaken to advance this with the RAMQ.

The impact of travel time with the RAMQ

Anyone traveling outside of Québec and wishing to benefit from a private travel insurance to cover all emergency medical expenses must ensure to maintain their valid RAMQ card for the duration of the trip. Indeed, every traveler must follow certain rules:
● Québec authorizes to travel outside the province for 182 days per calendar year, from January 1 to December 31;
● Travel for 21 days or less are not accounted for example:
1st example:
a) in January, you go 120 days to Florida
b) in July, you will spend 15 days in Old Orchard.
c) Total of the year: 120 days

2nd example: You want to go back to Florida in late October. If you were in Florida at the beginning of the year, make sure you calculate your days used since 1st January so as not to exceed your 182 days of the calendar year.

Other details relating to the count of days:
● As soon you leave Québec, the days add up even if you live in Canada.
● You should also know that Québec allows registrants to the RAMQ to leave the province more than 182 days once every 7 years (seven-year) without losing their rights to the health insurance card. A request must be made with the RAMQ.