Gerald Augustin complained of stomach pains on Thursday but the receptionist at the St-Andre medical centre told him he had to return home to get his health card. He didn't make it back to the clinic in Montreal's east end.
About four hours later, a friend alerted police and called an ambulance for the man, who had a fatal attack of appendicitis in his apartment. He was pronounced dead in hospital.
Rouslene Augustin, administrator at the St-Andre clinic, said the man didn't appear to have any urgent symptoms when he came to the clinic.
"If this guy was an emergency case, we would accept him if he had his card or not," she said.
"I don't see what we did wrong. I'm not defending the clinic, we just followed the rules."
Health Department spokesman Dr. Marc Giroux said clinics are obligated to provide service for emergencies even if no medicare card is produced.
"In the case of an emergency, the medicare card is not necessary," he said.
In non-emergency situations, patients must provide payment upfront and are later reimbursed by the provincial health insurance board.
Esther Noel said she wonders if her brother was aware he could have paid for medical attention.
"Maybe they did not say to him you have to pay," she said.
Quebec Health Minister Philippe Couillard said it's too soon to say if anyone is to blame for the man's death.
"Was the person or was the person not presenting obvious symptoms of emergency, when he presented himself at the clinic?" he asked.
"This has to be known and it will be known after the inquiry."
The provincial coroner's office has called an inquiry. The coroner has asked police to determine if Augustin had been injured in a criminal act in the past few days.