CLHIA-ACCAP - Consumer Information

A guide to travel health insurance

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4 MAKING A CLAIM What's involved? 1. Make sure you file your claim promptly and take the necessary steps to obtain the information that you need to submit. Obtain all bills or medical evidence in English or French, if possible. Call the emergency assistance line if your policy provides one. In some cases, you may be required to call this number within 24 or 48 hours after the emergency occurs and to follow the advice of the assistance agency (e.g., about repatriation or transfer to another hospital) to retain coverage. 2. You may have to pay up front, and then seek reimbursement from your provincial health plan and insurance company when you return home. In other situations, out-of-country hospitals may bill your provincial health insurance plan and/or your insurance company directly. This is especially valuable if you have incurred a substantial bill. 3. Normally you are required to submit your claim and all original receipts to your provincial health insurance plan first. Be sure to retain copies of everything. Then submit the outstanding bill, along with proof of payment from the provincial plan and copies of all receipts to your insurance company. 4. In some provinces, your insurance company may be able to submit your claim to the provincial health insurance plan on your behalf; check with your company. 5. If you have coverage through more than one policy, the first insurance company you call will ask you about additional coverage and may be able to coordinate the claim with the other insurance company(ies). 6

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