Ask a Lawyer: Insurance and Personal Injury

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Insurance Claim Denied

Cecile Paris (Edmonton)

Hi, I bought a travel insurance for my mother who holds a supervisa. She was hospitalized twice, once in 2023 and once last year. The first admission/surgery was paid. But they are denying the second claim for ‘pre-existing illness’ reason. She complained of back pain in February 2024 before the year of insurance ended. I took her to the doctor x-ray was done confirming the reason for pain was sacroiliac osteopenia.
Her insurance was renewed in March then she was rushed to ER in May for severe back pain in a different location. CT scan and MRI was done confirming it as Lumbar 1&2 Osteomyelitis or spine infection due to E.Coli bacteria infection.
The insurance company is saying that both illnesses are the same despite the submission of xray results and medical records. The spine infection was acute and totally different from osteopenia which is bone weakness due to age.
I sent a letter to ECLC to ask for help. I do not know how to begin with the appeal and complaint. Now the AHS collections legal department is asking me for payment for the amount that was supposed to be paid by the insurance company.
Please, please help!

0 73 days ago

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