Toronto Injury Lawyer Blog
When an international student or a visitor to Canada has a serious accident in Ontario, it can get very complicated.
Who will pay for the medical treatment? The hospital visits? The ambulance? The out of pocket expenses? What about the loss of opportunity to pursue their studies, or the wage loss from a part time job?
These are really hard questions, and all depend on the facts of the case, along with the coverage of the injured party.
For starters, people in Canada on Student Visas, or a Visitors Permit won’t have access to the publicly funded OHIP system, the same way that Canadian Resident will. This is why it’s so important for the student or visitor to Canada to make sure that they have proper health care coverage before they come to Canada.
Having bad insurance will end up in a less desirable result. Just because an insurance plan is the cheapest, doesn’t mean that it’s the best. Often, you get what you pay for. Nobody ever expects to be involved in a serious accident, but if one happens, it sure helps to have a responsive and supportive insurer; rather than an insurance company which is the habit of denying claims, or being non-responsive to their insured.
Most schools will offer private health insurance to international students. The cost of the insurance might be built in to the cost of tuition, or part of the general school bill. But, just because you’re involved in the school’s private health care plan, does not mean that it’s the best option. Check to see how their claims process works. Ask other students if they’ve had a positive experience dealing with that insurer. Is this the sort of plan where you have to pay for the medical visit out of your own pocket first, and then submit the bill to the insurer? If that’s the case, then keep that in mind because you will need to pay out of pocket each and every time you see the doctor. Then, the insurer has all of the power in terms of whether or not they approve, partially approve, or deny the medical expense. You then have to wait an undetermined period of time to get reimbursed for the out of pocket medical expense.
If the out of pocket medical expense is denied, then what recourse do you have? Let’s say that the medical bill is $300; and the entire medical expense is denied by the insurance company. What do you do? Is there an appeals process? Will you need to hire a lawyer to fight for you to get paid for this $300 medical expense? Does it even make sense to hire a lawyer, with an hourly rate of $500/hr, over a $300 out of pocket medical expense? You will end up paying disproportionately more to the lawyer than you would expect to recover from the law suit.
When these sort of payment issues loom; such as requiring up front payment for medical visits, our personal injury lawyers see that injured people are less likely to get the medical treatment they need. Keep in mind that if they were back home, or if they had OHIP coverage, the injured party would be more inclined to see doctors on a more regular basis to get the care and treatment which they need. It can be devastating to a personal injury case; not to mention one’s health; if they aren’t seeing a doctor for their injuries when it’s so important for them to do so.
The best insurers for medical visits are those where you have some sort of benefits card. When you attend at the doctor’s office or the hospital, they reach out directly to the insurer with your card in hand and get payment. There is no need for the service provider to ask for money up front. If there are any coverage issues, they will reach out to you after the medical visit has taken place.
Sometimes, car insurers will pay for the treatment following a serious car accident. But, you shouldn’t count on them being eager to do so, timely, or generous with their benefits. Car insurers will do anything in their power to pass their obligation to pay for treatment along to another insurer altogether; even through the injuries were a direct result of a car accident. When insurance companies fight with each other with respect to who should pay for benefits, it’s called a priority dispute. These are very common. So common in fact, that there are standard forms when there are such priority disputes between insurers as to who should be paying out on the claim. The benefits coming from the car insurer are called accident benefits. These benefits are not as generous as you might find in a standard health insurance policy for foreign students or visitors to Canada. There are limits on how much money can, and will be paid out in accident benefits.
Many international students have part time jobs, in order to help pay the bills. After an accident, they might not be able to work. Most health policies will NOT offer any form or wage subsidy or income replacement benefit when you can’t go back to work. Income replacement benefits are available through accident benefits following a car accident. But, the injured student will need to elect the income replacement benefit, and show that they were earning a meaningful income. This means that they will need to have declared the income on their tax returns. Cash jobs, with very few exceptions, don’t cut it. This means that if you were working for cash under the table and not reporting the income to Revenue Canada, then you would get paid an income replacement benefit. You can’t have it both ways; meaning hiding your taxable income while still declaring that you were earning a pre-accident income. Hearing this is very frustrating for many people; particularly when the accident was not their fault. They were simply in the wrong place at the wrong time. But this is how the system works in Ontario. If the injured student or visitor is looking for some form of wage subsidy if they can’t work, they need to consider purchasing short term, or long term disability insurance. These policies will provide an income replacement in the event of an accident which prevents them from returning to work.
