By: Luke Jones, Published on September 29, 2017 09:03 AM, Last Update on September 29, 2017 06:05 AM
The Canadian Automobile Association (CAA) says customers that drink alcohol before an accident can nullify their travel medical insurance. CAA sent out a release in direct response to a policyholder who made a claim.
Kitchener resident Ernie Ceres was visiting New York to attend a family funeral. On September 18, he was drinking with his brother before he left to stay with his son. However, in the process, he fell down the stairs and fell unconscious.
Ceres was taken to Kings County Hospital and was diagnosed bleeding in his brain. CAA was informed of the incident when Ceres’ girlfriend Lucy Reis phoned the association to file a claim.
CAA decided to deny the claim, explaining that the policyholder had consumed alcohol and blood levels were high at the time of his accident. While it is unclear if alcohol directly caused the fall, CAA warns that its travel insurance coverage has an alcohol exclusion clause.
This means the company does not have to fulfil a claim pay out if there is “alcohol related sickness, death or injury or the abuse of medication, drugs, alcohol or any other toxic substance.” The same policy also points out that “alcohol abuse includes having a blood alcohol level in excess of 80 milligrams of alcohol per 100 millilitres of blood.”
According to a CBC report, it is unclear how high Ceres’ blood level was and Reis believes the insurance company should be clear about the policy exclusions.
“He’s purchased a product and not been informed,” she said. “I understand that some of it was his responsibility to read the fine print, but let’s be serious, people buy insurance all the time and you just expect the person you’re buying it from is selling you a product that they’re going to stand by.”
However, the Travel Health Insurance Association of Canada (THIA) says it is the responsibility of the policyholder to know and understand for what instances they are covered.
“You need to understand your policy and you need to take time to read that policy document,” THIA president Will McAleer told CBC. “In this case, I certainly would have thought there would have been the opportunity and responsibility to take a look and see whether or not there is an exclusion related to excess alcohol consumption.”