CLHIA-ACCAP - Consumer Information

A guide to travel health insurance

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Page 9 of 14

MAKING A CLAIM What to do if you're not successful Most claims are resolved successfully, but if your claim is turned down and you do not agree with the decision reached, you can appeal the decision, especially if you have new information to add to the file. If your appeal is turned down and you still believe the decision is unjust, you may wish to discuss your case with your insurer's ombudsman/complaints department. If you are still unsuccessful, you can contact the OmbudService for Life and Health Insurance (see Consumer Assistance). TIP: Your holiday or business trip is interrupted by a sudden illness or accident and you are rushed to the local hospital. Who pays the bills? Procedures can vary from policy to policy; it is important to check what procedures are required under your policy before starting your trip. TIP: If you have a claim, notify your insurance company immediately (even if you are still waiting for appropriate documentation, or if your provincial health insurance plan has not yet paid). Submit your claim as soon as possible. There is often a limited time period for submitting claims. 7

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