Toronto Sun – Deny and delay on Hamilton man’s insurance claim

By Michele Mandel ,Toronto Sun
First posted: Thursday, November 17, 2011

HAMILTON – William Huang flatlined on the operating table at St. Michael’s Hospital.

It was just ten days before Christmas last year and the 52-year-old millwright was delivering gifts in Etobicoke when a dump truck suddenly ploughed directly into the driver’s side of his van. It took emergency responders an hour to cut him out of his crushed vehicle and when they got him to the trauma centre, his condition was so grave that the father of two was given last rites.

Almost a year later, the memory still reduces his 18-year-old son to tears. “I thought I was going to lose him,” Richard says.

After he was resuscitated, Huang’s family was told he had only a 50-50 chance of making it through the night. The force of impact had shifted all the organs of his body to the right, fractured his spine, his hip, his leg and left him with serious internal bleeding. He would need 20 blood transfusions and numerous operations, but after six weeks in St. Mike’s ICU and another four and a half months in Hamilton General Hospital, Huang was finally discharged in May.

But his tough battle to survive has been nothing compared to the one he’s been cruelly forced to wage with his insurance company.

Huang will never be able to breathe through his mouth or nose. He has a permanent tracheostomy tube and can speak only with a microphone to his voicebox or through a computer that reads out what he’s typed. He needs 24-hour care because if the tube clogs with mucous, he will die.

He is scarecrow thin and terribly weak. He’s in constant pain and sleeps in the den downstairs because it’s too difficult to manage the stairs up to his bedroom. He’ll never be able to return to the job he loved and he’s had to close down his business. He’s on 13 medications, including one that costs $735 a prescription.

He is a proud man. “I was the main breadwinner and I feel like I let my family down,” Huang says slowly.

Life, he says, is as different now as “night and day.” How unfair that with everything he must endure, he also has to withstand the slow torture of dealing with adjusters from Intact Insurance, who seem determined to place roadblocks at every turn: holding up cheques, refusing to recognize his catastrophic injuries, claiming forms have been lost in the mail — all while the family runs through their savings.

“It just makes me angry and frustrated,” he says. “They want their money but when roles are reversed, they’ll do anything not to pay.”

Just getting his income replacement benefit was a struggle. The maximum is $400 a week, but as he lay in intensive care hooked up to machines, they would give only $150 on the chance he could soon work. Intact then failed to pay anything at all for two months over the summer. With no apology, their adjuster blamed it on “system failure.”

“It was our mistake and for that we are deeply sorry,” Intact spokesman Sandra Nunes tells the Toronto Sun. “We took corrective measures to resolve the issue with catch-up payments and accompanying interest.”

He almost couldn’t be discharged, he says, because Intact hadn’t paid for the breathing equipment he needed at home. And now they’re stalling again.

If his insurer determines the accident left Huang with a “catastrophic impairment”, his benefits go from $100,000 to $1 million to cover his very expensive rehabilitation, prescription and medical costs. His trauma surgeon at St. Mike’s filled out the form last May. In September, Intact said their own doctor says Huang’s condition hasn’t “stabilized” so they won’t assess him yet.

Deny and delay seem to be their operative words.

Meanwhile, much of the worry falls on his wife Davanh and their son, who are in constant battle with Intact. “It scares me to death,” Davanh says, breaking down. “How am I going to pay bills and what about my son? How are we going to keep going without help, without money?

“When you buy insurance, you depend on that, thinking insurance is going to help you out. Then you have to fight for everything, every step of the way.”