It’s every snowbird’s nightmare.
Elderly Mr. X from Ontario bought travel insurance through Manulife before departing for Florida for a winter stay.
He answers questions via telephone with Manulife.
He answered “no” to questions about prior conditions and treatment, seemingly without giving it enough careful consideration.
Manulife emailed him a copy of the completed application for verification.
Mr. X verified it.
In Florida, he became ill. He incurred about $130,000 UDS in medical expenses.
Manulife denied the coverage, on the basis that he misrepresented his prior history in his application.
Mr. X died.
His estate tried to sue Manulife for the coverage.
His estate lost.
The Court reviewed the Ontario Insurance Act and other applicable law.
The Court concluded that Manulife’s application process was lawful and upheld it – no insurance coverage.
The lesson here for anyone applying for new insurance, particularly travel insurance to go to the U.S. if when that opportunity arises again, including if you already have insurance and before you travel?
- Listen to the questions carefully
- Disclose every prior existing condition or treatment (to the extent you can recall it)
- Double check the written application for verification after you receive it
- Review your current insurance application to ensure it is accurate and complete
- Double check you have COVID-19 testing and treatment coverage, if needed
While the Court is unlikely to require every application for insurance disclosure every medical issue in that person’s life historically, it will require that anything of material signifciant be disclosed, which could reasonably impact an insurance company’s decision to offer insurance to the applicant.
Therefore, treat the application process seriously, even if it seems overly informal online, or that the insurance company doesn’t seem overly concerned. They will deny coverage, if that opportunity is available to them.
Estate of Donald Farb v. Manulife, 2020 ONSC 3037