'We don't deserve it': B.C. man with Stage 4 cancer says he was denied insurance coverage

A B.C. man says his insurance provider has decided to cancel his and his wife’s coverage for failing to disclose a visit to the emergency room to the insurance provider nearly three years before he was diagnosed with Stage 4 colon cancer.

“We kind of got dropped off the side of a cliff,” said Toby Cleary, who spent the last few years receiving chemotherapy treatment at Abbotsford Regional Hospital and Cancer Centre.

On Sept. 17, 2019, Cleary and his wife, Danielle Raymond, applied for insurance through Manulife. Raymond said the plan included critical illness, disability and life insurance. On Jan. 5, 2022, Cleary was diagnosed with colon cancer. The couple decided it was an apt time to access the critical illness portion of the package, which provides a lump sum payment if either one of them is diagnosed with an illness covered by the policy, such as cancer.

“When we submitted that claim, we were told you need to give us access to 10 years of your medical records,” Raymond said.

Six months later, they received a response from Manulife indicating their entire insurance policy would be terminated due to Clearly’s failure to disclose to Manulife an emergency room visit at Meadow Ridge Hospital on Oct. 11, 2019, a few weeks after they first applied for the insurance plan.

REFERRAL OVERLOOKED

According to the letter, Manulife noted the visit included rectal bleeding, no diagnosis, and a referral for a colonoscopy. The letter stated that under the insurance agreement, Cleary signed a declaration on March 2, 2020, confirming that, since the application date of Sept. 17, 2019, he had not had “any illness, disorder, injury, operation or treatment”; had not “consulted, been examined or treated by any healthcare professional or been advised to or have a medical appointment or consultation with a healthcare professional that has not yet taken place”; and had not had “any medical tests completed or been advised to have any medical tests that have not yet been completed.”

The letter concluded,“It is therefore clear that we did not receive the medical information necessary to properly underwrite your policy.”

A subsequent letter from Manulife further indicated that, “We would not have issued this policy without understanding the site and cause of the bleed.”

Cleary went to the ER in October of 2019 due to rectal bleeding and was told it was likely due to a hemorrhoid.

“Because it was such a minor thing, I never thought about it and it was so long before I got diagnosed with cancer,” he said.

The couple added they were never told about the colonoscopy referral made by the ER doctor who examined Cleary. A doctor’s note viewed by CTV News from the office of Dr. Linda Bohacek, the surgeon who received the referral request from the ER, indicates the referral was overlooked and her office never booked an appointment or consultation for a colonoscopy. “On our end, it was not entered as a referral and it got overlooked on our part,” the letter reads.

In a separate letter from Dr. Pardeep Dhillon, Cleary’s family doctor, the physician states the first time the 53-year-old presented with symptoms related to colorectal cancer was Oct. 1, 2021. “Prior to that, the patient never presented to my office with any rectal bleeding, abdominal pain, weight loss or change in bowel habit etc.,” the letter reads.

Dr. Dhillon adds while she was aware of the 2019 ER visit, “that rectal bleeding most likely was not related to his colon cancer diagnosis as it’s quite unusual for a person to have one episode of bleeding in a period of nearly two years.”

In a statement to CTV News, Manulife spokesperson Emily Vear said, “We take the responsibility of protecting our customers' privacy very seriously and cannot discuss the specific details of any individual.” Adding, “As outlined in our application documents, we require that medical treatment received by an applicant prior to and during the application process be disclosed, and that failing to do so is in violation of the terms of the policy.”

“It was pretty devastating,” Cleary said. “Not to be too morbid, but if all these cancer treatments don't work, Danielle is going to be left with really nothing. That’s the whole idea of having an insurance policy.”

Raymond said since having their insurance terminated, they’ve been left scrambling, trying to cover their bills. The family has launched a GoFundMe to help cover the costs of experimental treatments only offered in the U.S. 

Raymond added she hopes their story serves as a reminder to other families who may find themselves in a similar situation.

“We don’t deserve it and Toby most especially doesn’t deserve it,” she said.