How to make a claim?
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.
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