Jamaicans Denville Clarke and Kenroy Williams had been in Canada for mere days in August 2012 when the van carrying them and seven other foreign workers rolled over on the way to a southern Ontario farm.
Another of the seasonal labourers was killed, Mr. Clarke and Mr. Williams suffered serious injuries and the driver was charged. The pair say they required treatment well after they were supposed to return home at the end of harvest season.
An Ontario court has just ruled, however, that their medicare coverage ended when their work visas expired that December, leaving them potentially on the hook for months of health-care costs.
The case raises new questions about one of the federal government's controversial temporary-worker programs, with the Divisional Court suggesting that rule changes are needed if Canadians want to fund extended medical care for such workers.
In the meantime, provincial regulations make it clear that coverage by the Ontario Health Insurance Plan (OHIP) lasts only until a worker's visa is up, said a three-member panel of the court in a judgement this month.
It overturned a decision by a health appeal board that granted the Jamaicans a right to medicare, calling that ruling unreasonable.
"Under [the injured men's] interpretation, any seasonal worker who simply keeps possession of the original work permit could have OHIP coverage essentially in perpetuity," wrote Justice Ian Nordheimer.
The federal government's Seasonal Agricultural Worker Program (SAWP) cannot alter provincial regulations, "especially ones that create fiscal responsibilities and liabilities," he said.
If there is a gap in the case of seriously injured workers, it needs to be fixed by requiring employers to obtain extra health insurance or a change in government policy, not by "contrived" rulings from legal bodies, said Justice Nordheimer.
Maryth Yachnin, lawyer for Mr. Clarke and Mr. Williams, said her clients requested that she not comment on the case, which could still be appealed.
The Ontario Health Ministry also declined to comment, a spokesman saying the case is still before the courts.
The ruling essentially means any foreigner here on a work or student visa ceases to receive medical coverage once their permit expires - even if they have a visitor's visa or extenuating circumstances. And that probably make sense, said Sergio Karas, a Toronto immigration lawyer.
"We can't make these allowances for people who do not have a legal right to work or study in Canada," he said. "In which countries can visitors avail themselves of public health care? It's unheard of."
Mr. Clarke and Mr. Williams arrived on Aug. 2, 2012 with 100 other Jamaicans, heading to work with Chary Produce Ltd., south of Brantford, Ont., which produces various vegetables.
The accident occurred a week later, the van rolling over several times and the passenger who died thrown out of the vehicle, according to media reports.
It was reminiscent of a horrific van crash just months earlier in another part of southern Ontario, when 11 seasonal poultry workers from Peru were killed.
Mr. Williams received neck, chest and lower back injuries and a mild concussion, while Mr. Clarke suffered from whiplash and a spine injury, their treatment initially covered by both workers compensation and medicare. When their temporary work visa expired that December and they still needed treatment, both obtained visitor visas from the federal government.
OHIP refused to extend their coverage, however. Ontario's Health Services Appeal and Review Board overturned that decision, but the province appealed.