B.C. court orders insurance firm to pay for man’s emergency surgery in U.S.

VICTORIA – An insurance company that refused to pay for a British Columbia man's emergency heart surgery has been ordered by a B.C. Supreme Court judge in Victoria to cover the US$180,000 bill.

Paul Fletcher took the Royal & Sun Alliance Insurance Company to court when it refused to pay, claiming an exclusion clause applied because there was medical evidence that the man might be hospitalized while travelling.

Fletcher testified that his doctor told him his angina was stable and he was safe to take a trip to Mexico.

He booked a return flight to Canada when he began having chest pains, but when his symptoms worsened his plane made an emergency landing in Seattle where he underwent coronary artery bypass surgery.

The insurance firm's expert physician criticized both Fletcher and his doctors at trial, saying there was a reasonable expectation that treatment or hospitalization could be required while travelling.

But Justice Jacqueline Dorgan said in a ruling posted online this week that the exclusion clause does not apply and she ordered the firm pay for the emergency surgery.

"The plaintiff’s evidence is that following consultations with his treating physicians, he was satisfied the trip would pose no risk to his health and that it was safe for him to travel. There is no evidence he had medical evidence or opinion to the contrary," the judge concluded.

She also ordered the insurance company cover his legal fees.