"We were just in absolute shock."
Those were the words from Rebecca Fee after learning of Saskatchewan Blue Cross's decision to reverse the denial of the medical claim for her grandfather Louis Lamothe, who suffered a heart attack in Arizona last month.
The insurance provided had initially said they would not cover the medical costs incurred at a Phoenix ICU or the medical flight for Lamothe to return home to Saskatchewan, which combined to total well over $200,000. Fee and her family were planning to appeal the decision and take legal action against Blue Cross.
"They called us, they let us know that they reviewed the claim and will accept expenses," Fee said. "Of course right away I said I wanted this in writing. Within about 15 minutes we had an email explaining all the steps and stating all the information they required for this and just confirming that they've reversed their decision and will be covering the claim."
"We were just shocked actually...honestly we expected a much longer fight, we expected to have to get more lawyers involved," Fee said, after learning of the reversal Thursday afternoon. "Of course, we were very relieved."
Fee said Blue Cross did not give a reason for the reversal.
"They did not. I asked if the national news coverage had impacted their decision and of course he said no. I'm not sure if I believe that," she said. "There was no new information submitted, so I honestly have no idea why they reversed it."
Fee said the initial reason given for denying the claim was due to a dosage increase in Lamothe's cholesterol medication, from 10 to 20 milligrams.
"I'm just happy that they're doing the right thing...it was such a petty, small thing to deny the claim over," she said.
Saskatchewan Blue Cross also issued a statement on the resolution of the claim.
"We’ve been working with the Lamothe family with respect to their claim, and can confirm that the situation has reached a conclusion through our standard claim management process. As with all claims and claims decisions, privacy requirements prohibit us from sharing specific details," reads part of the statement.
"We remain confident in the handling of the Lamothe claim overall and thank the family for their cooperation and patience while we worked together toward a conclusion. Our hearts continue to go out to the Lamothe family during this time."
Fee said Lamothe, who lives in Halbrite, remains at Regina General Hospital.
"He's stable, he still has his feeding tube, he still has his oxygen, he still has no use of his left side, but he's with us and that's all that matters," she said. "He has a very long road to recovery ahead of him which is going to include a lot of trips to Regina, it's going to include rehab."
"Moving forward we can now just take this time and energy and focus it on my grandpa and his recovery and his long road ahead of him, so that's a major sense of relief to our family...I hope he continues to fight, and I just hope one day he can come home."
Fee also thanked everyone for their support, and said their GoFundMe page had reached about $29,000.
Fri, Apr 26, 7:30 PM
