Emily Laprise was hit in the eye by a ball, which left her with double vision. (Photo: Supplied/Nancy Desrosiers)
After a 12-year-old girl was left with a horrific eye injury she received during a soccer game in North Vancouver, B.C. last year, her accident insurance refused to pay her, claiming her injury wasn’t severe enough.
Emily Laprise was hit in the eye by a ball, which left her with double vision and not being able to see out of most of the lower half of her left eye. She had to have surgery to reattach her retina and has been left with a hole in the retinal lining.
When her mother Nancy Desrosier contacted her insurance company Industrial Alliance, they told her that her daughter didn’t qualify for a payout, only paying her $8.40 for the drive to the hospital.
"I was blown away. . . After 12 years of paying for insurance? I was going, 'I can't believe this,'" Desrosier told CBC News.
The policy coverage covered the loss of sight in one eye for $50,000. The insurance claimed that if Desrosier’s daughter wore strong prescription glasses the double vision could be corrected, which meant she could still see out of the eye, even though she only sees black in the bottom half of her eye.
An insurer refusing to pay an accident claim is nothing new. Scott Stanley, a Vancouver personal injury lawyer, told CBC News that it’s not worth paying for accident insurance, because "It's like playing with a slot machine that ... never pays out."
In contrast, it’s easier to get a life insurance payout since there is one major qualification for the payout of such a policy: the person has to be deceased.
The problem is that it is difficult to get a payout from an accident insurer, because insurance policies are deliberately hard to understand, and not many people are going to go public with their issue(s).
However, if people are reluctant to go to the media, another way to deal with an insurer who won’t pay is to go to an insurance lawyer. While a policy holder may not know whether an insurance refusal to pay out is legitimate, a lawyer will be able to advise on whether the person has a valid claim and negotiate with the insurer.
After CBC Go Public broke the story on Monday, there was huge public outcry:
Some of Industrial Alliance’s customers even threatened to quit the company, which prompted the insurer to quickly settle with Desrosier, the day after the story broke.
It’s too bad the insurer decided to settle only after the public backlash.