Request for Refund

Authority Fraser Health
Details

Joe, like many seniors, had a modest fixed income. His residential care facility charged him a subsidized rate. 

To qualify for his lower rate, Joe provided income verification – a Notice of Assessment (NOA) from the Canada Revenue Agency. This verification worked until Joe’s health began to decline and he became unable to manage his finances. Fraser Health sent Joe a letter warning that his monthly fee would more than double to the maximum monthly rate of $3168 if he did not submit his NOA before the deadline.

Joe’s sister Cheryl took over Joe’s financial affairs. Joe had not filed his taxes, so she quickly did so and submitted the NOA to Fraser Health shortly after, before the deadline had passed. 

Trouble emerged five months later when Cheryl saw her brother’s bank statement. Without further warning, Fraser Health had withdrawn the maximum monthly rate and Joe’s account was overdrawn. Cheryl asked Fraser Health to adjust the rate retroactively but Fraser Health declined, only agreeing to adjust the rate going forward. Unsatisfied, Cheryl came to us.

We investigated and learned that Fraser Health had no record of receiving the NOA. Because Cheryl said she faxed it over, we asked whether there may have been an administrative error. Also, we questioned whether Fraser Health might have considered a Temporary Rate Reduction on account of financial hardship from such a significant rate increase. Health authorities may authorize a temporary rate reduction for up to one year, where a client will experience serious financial hardship by paying the assessed client rate. 

Because Cheryl had proof the NOA was dated before the deadline, Fraser Health agreed to backdate the rate adjustment, issuing Joe a refund of $6133. Fraser Health also enhanced their administrative procedure by recording the date that all NOAs are received by the health authority to ensure clients are charged the appropriate subsidized residential care rate based on their income. Cheryl was grateful for receiving the refund and pleased that her complaint led to an improved process for others.

Names in our case summaries have been changed to protect the privacy of individuals. This case study can also be found in the 2016-2017 Annual Report.

Category Seniors
Type Case Summary
Fiscal Year 2016
Location The Lower Mainland