So you’ve had a travel insurance claim, now what? To begin a claim, you should call the phone number on your wallet card to advise you require medical attention before going to a hospital. If it is not possible to make the call beforehand, do so as soon as possible. If you do not have your wallet cards, they can be found on your Confirmation of Insurance documents available on our client portal.
You should be aware that an assistance centre will answer your call rather than the insurance company itself. The assistance centre is staffed 24 hours a day, seven days a week, by individuals who will assist you through any medical situation you face. They will ask you plenty of questions which you will answer verbally at the time of the call to help process your claim and help you find the best hospital in the area to meet your needs.
Claims forms
After your medical situation has been resolved, you will need to complete claims forms. A claim form will ask for basic information such as your name, address, date of birth, policy number. It will also ask for information about your medical problem, along with any receipts or invoices for medical expenses you have incurred. Also, the claims paperwork will include a consent and authorization form. This form will provide the assistance centre with authorization to obtain any personal information required to resolve the claim.
These claims forms are necessary because they give the claims centre the information they need to finalize your claim and make payments to the medical centres. Ensure that you mark your claim or file number on every sheet and every receipt, then make copies to keep for your files and finally submit them to the assistance centre.
Once the assistance centre receives the claims forms, they may require additional information from the attending physician at the time of the medical situation, in addition to medical information from your regular family doctor in Canada. Obtaining this information can be a lengthy process and can sometimes cause a delay in the final resolution to your claim.
How long will it take?
On average, a claim can take up to six months to be closed. While waiting for the insurance company to finalize your insurance, it is not uncommon for individuals to receive additional requests for copies of their invoices, past-due notices or even calls from collection agencies. If you receive invoices, you can mark your claim or file number on the top and forward it to the insurance centre. If you receive calls from a collection agency, call the assistance centre to advise them. You should not make a payment for any of these. The assistance centre will be negotiating with each medical facility to reduce the billed amount.
The insurance company will submit any invoices for medical care to your provincial healthcare body. Your government healthcare coverage will cover out-of-province medical expenses to the same value had your medical situation occurred at home. By negotiating and recouping some of the costs from your government healthcare body, insurance companies can keep their costs down as much as possible, allowing them to keep their expenses as low as possible so that they can keep their rates down.
Once the insurance company finalizes your claim, you will receive a cheque from your government healthcare body. At this point, you will then deposit those cheques and issue the payment of the same value to the insurance company.
What if things go wrong?
Occasionally, things don’t go that smoothly, and you may experience hiccups along the way. The claims centre may ask you for information that you have already submitted. They may ask for invoices that you have already included in your original submission. Again, we recommend that you keep copies of everything so that you can resubmit any documents as needed.
In a perfect world, everything will go smoothly, but if it doesn’t, remember that you can always give us a call to assist you. We will help you with the claim form, making copies of your documents, and even following up with the assistance centre if necessary. With any new product you receive, you should have a warranty. Just consider us your warranty!