FOR one North Vancouver resident, the price of catching pneumonia was $112,000.
John Toljanich, 74, was five days from the end of a month-long vacation in Palm Desert, Calif., when an infection infiltrated his lungs.
"Just sprung up out of the blue," Toljanich said. "It was quite serious, so I had to be taken by ambulance to the hospital."
He stayed in a southern California hospital for four-and-a-half days last March before being flown to Lions Gate Hospital, where he made a full recovery.
"I know the hospital bill alone for four and a half days was $80,000," Toljanich said. "I had five doctors, for what reason I don't know . . . but their bills were up around $10,000 and the flight home was another $22,900."
It was Toljanich's third trip to Palm Desert and his first year choosing Manulife as his travel insurance provider.
The company denied his claim on the grounds he misrepresented his medical history relating to a chronic bowel disorder on a questionnaire, according to Toljanich.
In 2006, Toljanich went to a specialist due to bleeding around the lower colon. It was a minor problem that was cured in a week with suppositories, according to Toljanich.
His doctor prescribed Asacol, a drug designed to reduce the risk of cancer, which might otherwise be elevated due to scar tissue around the bowel.
The doctor described his condition as "no big deal," according to Toljanich. However, the doctor noted "chronic bowel disorder" on Toljanich's chart.
Manulife used that diagnosis as grounds to deny Toljanich's claim.
He had suffered with ulcerative colitis until 1965, but his medical history has been uneventful since then, according to Toljanich.
"After 47 years, I said, 'No.' So the 'no' should've been 'yes,'" Toljanich said. "It was an honest mistake on my part, but they don't take it that way."
For Toljanich, the dispute is about the relevance of the question.
"At the end of the day, I answered one question that wasn't to their liking," he said. "The pneumonia had nothing to do with the question I answered, but they don't care."
According to a 12-year study published in the Gastroenterology Journal, the risk of pneumonia is higher for patients with inflammatory bowel disorder, possibly due to suppression of the immune system.
Ulcerative colitis sufferers contracted pneumonia at a rate of 1.62 per 1,000, slightly higher than the control group. A different method pegged the rate at 1.45 per 1,000. Each patient had been treated for a bowel disorder within 90 days of catching pneumonia.
The study included more than 100,000 inflammatory bowel disorder patients.
Toljanich said he has no complaints about the care he received in a U.S. hospital, only with the bill.
"The care was good, there's no question about that," he said. "It's just the bottom line. The money was just ridiculous. I'm a senior citizen now and . . . it's kind of hard to take because I just don't have that kind of money."
The amount being requested may be up for negotiation, according to Toljanich.
"They did send an invoice last week and they reduced it by $15,000," he said. "Hopefully they bring that down some more."
The $112,000 bill is far out of Toljanich's price range. "I'd have to take a loan out. It'd be a loan against my house," he said.
Since getting the bill, Toljanich has considered paying the interest or refusing to pay the bill entirely.
"I get a lot of people saying 'Don't pay it, don't pay it.' I guess they can send collection agencies after you but they can't really touch you in Canada," he said.
Still, refusal could complicate future travel plans, Toljanich acknowledged.
Insurance companies selling to Canadian citizens should face tighter regulations, according to Toljanich. "The federal government's got to step in and put some criteria to these big insurance companies," he said. "It always seems to be the seniors who get caught."
