Couple Gets Baby and Million Dollar Hospital Bill

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The “babymoon” is becoming a buzz word worldwide, a little vacation for expectant parents as they get prepared for such a life-changing event. Unlike the honeymoon, which celebrates a marriage after the fact, a babymoon celebrates an impending birth.

For one Canadian couple from Saskatchewan, their babymoon turned out to be an experience that has gained worldwide coverage. Their baby was born prematurely while they were vacationing in Hawaii. Thankfully, the couple’s daughter survived the ordeal, but their health insurance company refused to pay for the mother’s treatment and the daughter’s treatment while they were in Hawaii. The bill totaled nearly $1 million – money the family says it doesn’t have. Bankruptcy is a possible outcome.

The ensuing media attention has brought scrutiny upon Blue Cross and has also invited large displays of good will from a worldwide network of strangers via pro bono work, crowd funding and free advice. Though the woman and her daughter are healthy, the battle with the insurance company to pay for the treatment is anything but settled.

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The Story

Jennifer Hucalak-Kimmel and her husband, Darren, went to Hawaii while she was six months pregnant on their babymoon, securing the blessing of her doctor, who said the trip would be safe, according to media reports. The couple purchased travel insurance as well, but were turned down.

medical_billing_advocate-34While on the vacation, Hucalak-Kimmel’s water broke unexpectedly and she had to be airlifted to a hospital in the state capital of Honolulu. She spent an entire week in the hospital, racking up big medical charges, before Blue Cross contacted her and informed the family that their coverage was being denied because of a preexisting condition. What condition? Hucalak-Kimmel had recently suffered from a bladder infection, and this was the insurance company’s reason for not covering the patient.

The family, which comes from a country with universal healthcare, attempted to get itself back to Canada as quickly as possible but ran into a glut of problems. Her condition prevented any method of travel other than a medevac flight, but finding a medevac company to transport Hucalak-Kimmel proved to be a difficult task. The only way a medevac team would agree to transport her was with a surgical team on board the plane. Even then, it was recommended that she did not travel due to her condition.

According to globalnews.ca, a small amount of the total charges were reduced. The $950,000 was lessened by $20,000 by Saskatchewan Health, and the United States picked up $12,000 for the cost of delivery. That leaves the outstanding total at $918,000.

 

So Why Did Blue Cross Deny the Charges?

The Salon story states that Blue Cross denied the charges because Hucalak-Kimmel’s bladder infection was a preexisting condition. Hucalak-Kimmel stated in the article that she had a bladder infection in her fourth month of pregnancy and hemorrhaged, and that was the reason the insurance company gave her for denying the coverage.

The couple told the Canadian Broadcasting Corporation that they were never asked about any preexisting conditions by the insurance agent they dealt with. Furthermore, they provided a letter from her doctor that stated the pregnancy was not a high-risk one, and that her pregnancy was stable when they left for their vacation.

The CBC reported that the family received a letter in November of 2013 from Blue Cross, citing nine events that led to the denial of the claim. However, this document was never shown to the CBC.

 

Fighting the Charges

Because of the vast coverage of this seemingly preposterous issue, the family has received some benefits. According to Globalnews.ca, a Toronto lawyer has offered his services pro bono to help them fight Blue Cross Saskatchewan.

medical bills coupleSivan Tumarkin was a guest on a radio talk show segment which featured the parents. He then decided to lend his time and expertise to help them fight the insurance company. Tumarkin said he feels that the insurance company does not have a leg to stand on if it comes down to court action. Only time will tell who will win in a court’s decision.

It appears that Tumarkin’s role in the legal aspect of things is still being determined. He was quoted in the globalnews.ca story as saying that he still doesn’t have all the information that he needs and that he is offering free legal advice. That does not mean, however, that he has volunteered to go to court or other proceedings for them.

If they are not able to get pro bono services in court, the couple will be faced with a tough decision. Standing up for themselves and their principles would mean extensive litigation and likely travel charges as well, which would almost certainly add to an already stressful financial situation. As Hucalak-Kimmel was quoted as saying in the Salon story, “We can go deeper into debt and try to fight Blue Cross.”

 

Solutions for the Family

If their claims are denied in the end, the generosity of others is something that could help pay the $950,000 in medical bills. The CBC reported that a woman in Manitoba started a gofundme page to help the family pay its medical bills and that the fund had $7,900 at the time the article was published.

That woman, Lynda Dobbin-Turner, said that her experiences with her son’s struggle with cerebral palsy persuaded her to act. Her son died at age 17.

While the online funding helps the family pay for the expensive medical bills, there is still the possibility of the insurance company changing its mind or being required to pay for the claim. In that case, the family has said, they would donate the raised money to the neo-natal intensive care unit in Saskatoon.

Obviously, that number does not come anywhere close to the total charges of care in Hawaii, which means bankruptcy is an option. The couple have been receiving calls from collection agencies since July and are simply ignoring those calls and have not paid anything toward the massive hospital bill.

 

There is Precedent

The CBC uncovered a similar case in 1997 when a couple from Calgary was traveling in the United States and the woman unexpectedly went into labor. They also had travel insurance, but their trip to a hospital in Nebraska was not funded by their insurance. A two month ordeal ended up costing about $1 million.

Where this story differs from that of Hucalak-Kimmel is that the government in Alberta was driven to act in part because of media attention and uproar from citizens. The government and members of the public pulled together and helped the Calgary couple pay their bills so they could be free from the burden of the debt.

The story from the CBC did not detail the reasons why the couple’s claims were denied.

Laurie Wolfe, the woman who gave birth in Nebraska, told the CBC she plans on contacting Hucalak-Kimmel and sharing her experience and some advice.

 

Obvious Need for Change

The Kimmel family has also taken an outspoken role in attempting to shine light on the insurance industry and ways to make it more accountable. According to a CBC story, they are calling for more looks into travel insurance and how it is overseen by the government. They said they answered all the questions they were asked and that the main issue is that the salesperson did not ask about preexisting conditions, which provided a false sense that the travel insurance would cover them.

Another call for change came from Vancouver lawyer Scott Stanley, who was quoted in a CBC story, stating that the Canadian insurance industry needs reform.

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