Someone who contracts COVID-19 while traveling, and who has emergency travel medical insurance, will be generally covered according to the terms of his or her policy as with any other illness or accident. Of course, whether there is coverage will depend on the terms of the policy in question. We can examine in general terms those policy provisions that are most likely to be in issue.
As with pre-pandemic coverage disputes, questions would be resolved by the application of common law principles of policy interpretation. Generally, the court would give effect to any definitions or exclusions contained in the policy. The court would apply the plain language of the policy unless to do so would nullify the coverage provided.
"Sickness" is usually defined to mean an acute illness requiring immediate emergency treatment as "a result of sudden onset of symptoms which first manifested after coverage commenced". Someone who became infected with COVID-19 while traveling would likely fit within this definition. Yet a typical policy might exclude coverage for:
Emergency sickness or injury incurred if you choose to travel to a destination after a formal written travel advisory and/or travel warning has been issued by GlobalAffairs Canada or Public Health Agency of Canada (PHAC) recommending that you avoid all or non-essential travel to that destination during your trip. This exclusion applies if the advisory/warning is issued before the date you leave for your trip and the sickness or injury is directly or indirectly caused by the reason for the travel advisory/warning.
There may be advice from the government, for example, not to travel to a specified place. This would take the form of an advisory or warning to avoid "unnecessary travel" or "all travel" to that place. The mode of travel may even be specified, as in an advisory to avoid "all cruise ship travel." These different phrasings suggest levels of caution in the government advice.
Based on the relevant government warning, therefore, coverage for COVID-19 costs will be largely triggered according to when and where the traveler became infected. The question would be: which degrees of caution will count as a "travel advisory" or "travel warning" under policies containing terms like that quoted above? Arguably any these notices amounts to advice to avoid such travel.
Lastly, the parties' reasonable expectations and the contra proferentum principle would be invoked in the event there is ambiguity within the policy. The latter principles favour a finding of coverage.
Questions?
The above is general legal advice but can not account for every specific situation. Should you have any questions with respect to this bulletin, or if you would like more detailed information, please contact the Brownlee LLP Insurance practice team.