Calgary couple disheartened by repeated cardiac arrest insurance claim denials
Published Thursday, January 14, 2016 3:20PM MST Last Updated Friday, January 15, 2016 6:39PM MST
A Calgary family survived a frightening ordeal that left a perfectly healthy 37-year-old Calgarian fighting for his life but they now find themselves in the midst of a new battle with their insurance companies.
On a fateful night last August, Jason Glennie returned home to his wife Tammi at roughly midnight after spending a night out with friends. Tammi awoke at 3:32 a.m. to sounds that she believed were her husband dreaming but her attempts to wake her husband were unsuccessful.
“It looked like he was having a seizure,” recalls Tammi Dann-Glennie. ‘I got up and called 9-1-1.”
Jason’s breathing stopped. The 9-1-1 operator instructed Tammi to remove her husband from their bed and perform cardiopulmonary resuscitation (CPR). Tammi attempted CPR on Jason four times. During her fourth attempt, she was unable to revive her husband. Moments later a paramedic crew arrived at the family’s home.
Jason was transported by ambulance to the hospital where Tammi says she was told by hospital staff to “Call the family. This is serious. He is the sickest person here tonight.”
Doctors determined Jason had suffered cardiac arrest and he was placed on life support for four days. He came to without any recollection of the night of the incident, where he was, or even the year.
The cause of the cardiac arrest has not been confirmed and doctors located no blockages or viruses that may have contributed to the episode. Doctors told Jason he was an anomaly.
Jason remained in hospital for 26 days while he awaited the arrival of an implantable defibrillator that was being sent from Europe.
After returning home, Jason was prescribed blood pressure medication and he underwent rehabilitation for his speech and memory. He did not feel different than he did prior to the cardiac arrest but the surgical procedure to implant the defibrillator left him unable to fully lift his left arm.
Jason, a mechanic, missed a total of 16 weeks of work and the couple began to feel the economic impact.
“For the number of weeks that I was off, we were getting short term disability which is up to 60 per cent, I think, of your normal wage, but it has a cap on it,” said Jason. ” I hit the cap and I was getting pretty much half my paycheque for that entire time I was off.”
The couple incorrectly assumed insurance would help during the time of need.
“Through my work, through Desjardins critical illness coverage, is a payout of X amount and it only covers stroke, heart attack, and cancer,” said Tammi. “I thought we would be covered through them with the payout.”
“Jason’s line of credit at the bank has critical illness coverage where it would pay off the debt so we thought we would be okay, there would be some help there.”
Jason and Tammi soon discovered that, in the eyes of their insurers, cardiac arrest patients do not receive the same payouts as heart attack patients.
“A heart attack is a blockage that causes the cardiac arrest,” explains Jason. “Since I don’t have any blockages and my arteries are good, my heart stopped for no reason, no coverage.”
Tammi says Desjardins asked for additional medical information on Jason’s episode including the results of an enzyme test that would indicate a cardiac arrest occurred and a stress test that proves a portion of Jason’s heart had died. Doctors chose not to conduct the stress test during Jason’s hospital stay to reduce the patient’s exposure to unnecessary radiation treatment.
Jason’s cardiologist vouched to the validity of the cardiac arrest through emails and other correspondence, but Desjardins denied the claim.
The couple found their dealings with TD Insurance to be equally frustrating.
“We ended up sending in the claim to TD Insurance. It was denied,” recalls Jason. “We sent them more information from my medical file. It was denied again. Then, we sent it to escalations and it was denied again.”
“This whole time we keep sending them emails from my cardiologist, documents, everything, and they just kept denying it. Now it’s with the office of the ombudsman from TD Insurance and we’re still waiting to hear back from them. It’s been with them for six weeks.”
Jason recently received a phone call from the TD Insurance ombudsman who informed him that cases can take up to three months to review.
TD issued a statement to CTV News on Thursday saying...
"As the customer has noted, this file has been escalated for additional review by the business. This is a complex medical scenario, and we apologize for the length of time the review has taken. We will contact the customer with further details once a final decision has been reached."
No matter the outcome of their claims, Tammi and Jason hope their situation will prevent others from encountering insurance claim surprises.
“Check your fine print on your insurance policies,” said Tammi. “You may not be covered for what you think.”
Tammi and Jason say they continue to hold out hope that their insurance companies change their original stance and offer payouts.