SUPPLEMENTARY HEALTH INSURANCE
Claims
Claims are simple to file, but the procedure varies from one plan to another.
Some plans require you to pay the health care providers and submit your receipts
with a paper or electronic claim form to the insurer for reimbursement. Other plans
provide you with a drug card or dental identification card, which allows the pharmacist
or dentist to submit the bill to the insurer electronically and receive payment directly.
In either case, the confidentiality of your information is protected .
Typically, you must file claims within one year after you incur the eligible expenses,
although the filing period may vary. Life and health insurance companies are
committed to considerate and prompt payment of claims and they continually make
changes to speed up the process. A straightforward health or dental claim may be
processed within a week or two; more complicated claims, such as claims for
disability benefits, may take longer.
Generally, the insurance company deposits payment in your bank account or sends
you a cheque, along with an explanation of the amount paid, once your claim is
approved. It will note, for example, whether the deductible has been paid or you have
reached the maximum amount allowed for a particular kind of expense under your
plan or policy.
If you need help making a claim to a group insurance plan, call your benefits
administrator or human resources officer. For help with a claim to an individual
plan or policy, call your agent, the insurance company's nearest branch office or
toll-free line.
TIP: Be sure to complete claims forms completely and clearly. Your claims will be
processed faster if the insurer doesn't have to contact you for clarifications and more
information
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