Insurer says Calgary man stranded in Mexico will be reimbursed

A Calgary man who had a heart attack and required emergency life-saving surgery while on a tropical vacation more than two weeks ago is still waiting for a hospital bed back home.

His family has been forced to pay more than $100,000 in medical bills and travel expenses, despite having travel insurance.

Michael Smyrl, 70, suffered a major heart attack on Nov. 5, just five days into a 20-day cruise to the Panama Canal with his wife.

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The ship docked the following day at Cabo San Lucas, Mexico, where Smyrl was admitted to a local hospital and immediately underwent surgery, suffering two more heart attacks during the procedure.

The surgery was successful and he was released from the ICU on Nov. 8.

He recovered in hospital and was cleared to fly home Nov. 16 on a medically assisted flight, but the delays continued because the insurance company, World Travel Protection, was unable to secure a hospital bed in Alberta.

"Our insurance company works with a bed-finder company who liaises with all of the hospitals and we're trying to get to Edmonton, even Red Deer – just get us to a hospital. There was nowhere to go, so that became problematic and frustrating," said Kim Cameron, Smyrl’s step-daughter.

"And (Monday), I reached out to the insurance company again and said we're in a very real situation where the hospital is going to say, 'Pay your bill and get out because you're not sick anymore and you don't need to be here.'"

Cameron flew down to Cabo San Lucas herself to advocate for her parents, but she was told by the Mexican hospital that her father would have to pay his full bill before being discharged.

"The hospital itself will 100 per cent of the time not deal with insurance. They will only deal with the patient. (They) will only take direct payment from the patient," she said.

"The insurance aid companies have been selling us this almost false sense of security. We think we can go on vacation – that it will be covered and everything will be fine. It's not fine. You had best make sure that you have access to, in this case, $100,000, and that doesn't count hospital bills. That doesn't count the meds that have been picked up, food or hotels."

INSURANCE COMPANY TOLD BY BED-FINDER NO HOSPITAL BEDS WERE AVAILABLE

CTV News contacted World Travel Protection to ask about details related to Smyrl's coverage but did not receive a response back.

But emailed documents were obtained from Cameron of her correspondence with World Travel Protection.

The documents sent on Nov. 19 from a case manager read:

"Good morning Kim,

"My sincere apologies for this ongoing delay. I just spoke with our bed-finding team in Alberta. They do not have an update this morning and have asked us not to call back for another update until tomorrow. I know how frustrating this all is, and I’m so sorry for this. It’s an unfortunate situation and I wish there was a faster result, however, please know we are doing all we can to expedite this process and want to get you all home as soon as possible.

"We will continue to keep you updated on the progress of this bed. Please feel free to reach out to us anytime though."

CTV News was unable to identify the bed-finding team and those details were also not released to Cameron.

Smyrl is still recovering and was not physically able to do an interview with CTV News.

For now, his medically assisted flight back home to Calgary is scheduled for Thursday, but once he arrives there, it is still unknown if he will have a hospital bed or if he will be forced to go back home.

"He has to be with a medical nurse. He has to get his blood saturation checked. They have to set up oxygen in the house," Cameron said.

"His family doctor, which we had some phone calls and appointments with, also wasn't super comfortable with him not being in hospital. That was a lot of surgery and there's still a lot to follow up on."

AHS CONFIRMS HOSPITAL BEDS ARE AVAILABLE IN CALGARY ZONE

CTV News also contacted Alberta Health Services (AHS) for comment as to whether hospital beds would be available for Smyrl.

In a statement, AHS says it does have the resources and health-care teams available to look after the needs of all its patients and that there are currently beds and capacity available in the Calgary zone.

"When a family requests an out-of-country transfer, and provided the patient is stable enough to be transferred, we will do our best to work with health-care and health insurance providers to facilitate repatriation of the patient to Alberta," read the statement.

"Patient care and safety are of the utmost importance and AHS works diligently to ensure the safest, most appropriate environment and care team is available prior to receiving Alberta patients from out-of-country."

AHS was unable to speak on the specifics of Smyrl’s case due to patient confidentiality agreements but did confirm efforts to get him home to Alberta via medical transfer will continue.

PUBLIC HEALTH INSURANCE TYPICALLY WON'T COVER MEDICAL BILLS OUTSIDE CANADA

Onanta Forbes is a local travel expert in Calgary with nearly 40 years of experience in the industry.

She says her best advice to travellers is to make sure they purchase travel insurance to protect themselves against financial investments, but she also warns out-of-country trips have different terms and conditions.

"One thing to note is that the Government of Canada will not pay your medical bills outside of Canada, and your territorial or provincial insurance will cover little to nothing with regards to travel interruption or medical bills," Forbes said.

"Some people look at their travel credit card to be covering them also, but it doesn't really cover you for the actual bill that may incur. Like in the United States, for example, your bill can just rise into high amounts that your travel credit card may not cover."

Forbes says it is best to know what kind of travel policy you're dealing with before you book your vacation.

"It's really important that you read the fine print because not all insurances are the same and not all current coverages are the same. You may have to look at getting that money back after the fact through insurance," she said.

"So, you don't want to have to incur a large bill because no matter what the amount is that you have to pay, maybe that's just not accessible."

CTV News also reached out to Desjardins Insurance as experts for more information and was provided the following statement:

"If you’re hospitalized while you're outside of your home province, the insurer will generally pay the hospital bill directly to the hospital, though some hospitals may require the patient to pay immediately," the statement read.

"Every policy is different. This is why people who have travel insurance should contact their insurer to learn all about the coverage."

FAMILY TO BE REPAID

A week after CTV News first reached out to the insurer, World Travel Protection now says the insurance underwriter granted a promissory note for Smyrl’s repatriation costs and says the family will be covered for everything it paid at the hospital in Mexico.

“While it was very disappointing that the hospital in Mexico would not accept payment directly from World Travel Protection, the amount that Mr. Smyrl’s family paid will be reimbursed in full once the claim is submitted to the insurer in Canada. The family will not be out of pocket,” the company said in a statement.

The company said the issue over bed availability in Alberta and the associated delay in repatriating him was due to an issue with AHS' call centre, who was unable to help.