Their daughter almost drowned, they fight with Canada Life to pay for her care

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Jenn and Andrew McLaughlan are doing everything they can to help their daughter.

Radio-Canada

For over a year, the McLaughlan family has done everything possible to care for their daughter, Briar, who nearly drowned in the summer of 2022. Suffering from hypoxic-ischemic encephalopathy (HIE), she fought to stay alive. Now his parents have to fight with their new insurer: Canada Life.

On July 1, 1.7 million federal government workers and retirees saw their insurance provider switch from Sun Life to Canada Life. This has led to changes to what services and medications are covered, how claims are approved, and how to contact an agent to discuss a problem or question.

Since then, hundreds of people have contacted CBC/Radio-Canada to express their dissatisfaction with Canada Life. The situation is such that last week, the Standing Committee on Government Operations and Estimates (OGGO) adopted a motion to study the transition of the Public Service Health Care Plan (PSHCP) from Sun Life to the company Canada Life Insurance.

The McLaughlan family is among those who have seen the problems the hard way.

In the summer of 2022, Jenn and Andrew's vacation to New Brunswick turned tragic when their daughter was found floating in a pool. She was unconscious and no longer breathing. Despite cardiopulmonary resuscitation, she suffered from HIE, brain damage caused by a lack of oxygen.

At the hospital, the prognosis was not optimistic. Andrew McLaughlan, who works for the Canadian Armed Forces, still recounts these moments with a broken voice.

The doctors told us, ''We're going to do everything we can for her, but there's a good chance she'll never [leave] this piece''.

Against all odds, Briar returned home to Kingston, Ontario, after spending four months in children's hospitals in Halifax and Ottawa.

While covered by Sun Life, the McLaughlans were reimbursed for the cost of food, feeding equipment, wheelchair, medical bed and airfare of $28,000 between Halifax and Ottawa.

< p class="StyledBodyHtmlParagraph-sc-48221190-4 hNZoeU">For us it was wonderful. We had our own case manager. If we had any questions, we called him directly. We didn't have to wait, says Jenn McLaughlan.

But now they have to fight with their new insurer, Canada Life, to get the same coverage.

We have spent $5000 on Briar's care since July 1st, and it has not been refunded. Most of our requests were rejected, laments the father.

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Briar McLaughlan was two years old when she was found without vital signs in a family swimming pool in July 2022.

At the start, they were told that the coverage was not going to change, even that it was going to improve.

I feel like we were totally blindsided by this, the mother said.

The family receives an annual allowance of $1,680 through the Ontario Assistive Devices Program to help meet some of their daughter's needs. For the remainder of their child care expenses, parents rely on their health care benefits. To care for Briar, the family spends $2,000 a month. This includes $662 for a special formula, $355 for bags of that formula and $20 for the gourmet tubes to be changed each week.

CBC has contacted Canada Life for this report. A representative from the insurer then contacted the McLaughlans to tell them that bags of formula would now be covered.

The insurance company also told CBC it has created a mandated team to review claims that may have been denied and decide whether they should be approved on compassionate grounds. She added that the aim was to prioritize urgent applications or those filed by people facing financial difficulties.

In an email sent to CBC, the Treasury Board, which oversees the operations of the federal government, said it shares the concerns and frustrations of members of the federal public service who cannot always reach an agent or who experience long wait times.

We understand the stress this ongoing service issue places on individuals and their families, a spokesperson wrote .

The Treasury Board has said that replacement therapeutic nutrients are covered by a prescription; it was not clear whether related items, such as stomach tubes and formula bags, were also covered.

He also reminded that Members may appeal any denied refund request.

Of the items covered, the McLaughlans say they had to wait months to be reimbursed. The family had to go into debt. The mother believes that the whole clan is losing, whether it is the parents, Briar, or their two other children.

Our children have not asked to experience this. We didn't ask to go through this, and the kids lose out because we have to wait longer to get the refund.

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Briar McLaughlan spent more than a month in a pediatric hospital in Halifax, before spending three more months at CHEO in Ottawa. (File photo)

Before the accident, Briar was vibrant and happy, with a mischievous side. Today, she requires a wheelchair, is unable to speak, and requires a feeding tube and 24-hour care.

She depends on us for everything, summarizes her father.

Parents hope that their daughter will one day regain certain lost abilities. They live on hope, given the progress made over the past year. She learned to laugh and sing again.

Each week, Briar continues to improve and shows us how amazingly she is strong. We are so grateful that she continued to fight and wants to be here with us. Because we love it so much, McLaughlan concluded.

With information fromKimberley MolinaofCBCNews