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CLAIMS

TuGo

Key Benefits Maximum Limit
Maximum liability Available in $10,000 increments to a maximum of $300,
Emergency medical treatment
  • Emergency medical treatment for sickness or injury whether in-patient or out-patient
  • Services of physician, surgeon, anaesthetist, registered graduate nurse
  • Private duty nursing
  • X-rays and laboratory services
  • Rental of essential medical appliances
Non-emergency treatment Up to $3,000 if treatment is a direct result of the initial emergency
Ambulance Including mountain and sea rescue
Prescription drugs Up to $10,000 or limit of a 30-day supply
Professional medical services Up to $500 per practitioner including a licensed physiotherapist, chiropractor, chiropodist, osteopath and podiatrist
Emergency air transportation Up to sum insured for air evacuation or airfare back to Canada or country of residence for treatment and medical attendant
Return of insured travelling companion One-way economy airfare back to point of departure if insured is transported or repatriated back to Canada
Family transportation One return economy airfare or ground transportation costs and up to $100 per day for meals and accommodation
Out of pocket expenses while hospitalized on scheduled return date Up to $200 per day to a maximum of $2,000
Child care Up to $50 per day to a maximum of $500
Dental
  • Up to $4,000 for accident
  • Up to $600 for dental pain
Maternity Up to $3,000 for pregnancy, childbirth or complications during the 9 weeks prior to the expected delivery date
Repatriation
  • Up to $12,000 for repatriation (excluding cost of a burial coffin)
  • Up to $5,000 for burial/cremation at place of death (excluding cost of a burial coffin or urn)
Return of vehicle Up to $2,500
Accidental death and dismemberment
  • Up to $25,000 for air flight
  • Up to $25,000 for 24-hour accident
Age limit 15 days old to 89 years of age
Rates Single person or family rates available
Deductible $0 automatic; deductible options are available for a premium discount
Waiting period
  • No waiting period if Insurance is purchased prior to arrival in Canada
  • 48 hours waiting period on sickness if policy is purchased within 60 days of arrival in Canada
  • 7 days waiting period on sickness if policy is purchased 61 days or more after arrival in Canada
Pre-existing condition coverage
  • 120 days stability required for ages 0-69
  • 120 days stability required for ages 70-79 IF the optional pre-existing condition coverage is purchased
  • No coverage for 80-89
Travel to and from Canada Coverage will be provided up to 7 days each way
Travel worldwide Travel worldwide is valid as long as majority of time is spent in Canada. No coverage provided while in country of permanent residence
Exclusions
  • Elective treatment and surgery
  • Tests and investigative consultation
  • Refer to the policy wording for a complete list of exclusions
Claims procedure Consult the claim guideline in the policy wording

The language in this document may not be the same as the actual policy wording which will prevail in all instances and is available upon request. Certain exclusions, limitations and conditions may apply. TuGo and Visitors to Canada Platinum are registered trademarks of and are administered by North American Air Travel Insurance Agents Ltd. d.b.a. TuGo, a licensed insurance broker in British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario, represented by licensed insurance agents Kathleen S. Starko and Bradley G. Dance in New Brunswick, Nova Scotia and P.E.I. 11th Floor - 6081 No. 3 Road, Richmond, BC Canada V6Y 2B2. Insurance is underwritten by Industrial Alliance Insurance and Financial Services Inc. and certain Lloyd’s Underwriters, severally and not jointly.

The Company will not provide coverage, provide services, or pay claims for expenses incurred directly or indirectly as a result of:
1. Pre-existing Conditions as defined except as follows:
a) for persons 69 years and under, if Stable in the 120 days prior to the effective date of this Policy; or
b) for persons 70 to 79 years, if Stable in the 120 days prior to the effective date of this Policy and the applicable optional coverage was purchased.
2. Any loss incurred as a result of Sickness that originated or was symptomatic during the Waiting Period as follows:
a) the first 48 hours from the effective date of this Policy, if this Policy was purchased within 60 days of Your arrival date in Canada; or,
b) within the first seven (7) days from the effective date of this Policy, if this Policy was purchased 61 days or more after Your arrival date in Canada.
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Claims Procedures and Payment of Benefits
1. Any notices of claim or correspondence concerning a claim should 
be promptly sent to:
OneWorld Assist Inc.
11th Floor – 6081 No. 3 Road
Richmond, BC Canada V6Y 2B2
2. Any cost incurred by OneWorld Assist Inc. in obtaining further 
documentation required to confirm eligibility of Your claim is the 
responsibility of the claimant.
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REFUNDS:

Refunds are available as follows:
1. When no travel has taken place:
a) a full refund is available when the request for refund is received PRIOR to the effective date of the Policy.
b) a full refund less a cancellation administration fee is available when the request for refund is received AFTER the effective date provided the request for refund is received no later than 30 days after the effective date and prior to the expiry date of the Policy.
2. Partial refund is available if:
a) You return to Your country of permanent residence and a minimum term of 45 days remains unused on the Policy or,
b) You become eligible and covered under a provincial or territorial health plan during the Period of Coverage.
Applicable to Partial Refunds
A written request for refund, including proof of return to country of permanent residence or proof of the date You became covered under a provincial or territorial health plan, must be sent to TuGo. Refunds will be calculated from the date You become covered under a provincial or territorial health plan.
All refund requests must be received by TuGo no later than 30 days from the date You became covered under a provincial or territorial health plan. All administration fee.
Applicable to All Plans
Refunds are not available if a claim has been or will be submitted.

EXTENSIONS:

You can extend Your period of coverage before Your policy expires by calling Your broker or TuGo during general business hours. Please refer to Contact Information on page 4. You must meet the following conditions: 
  1. You have not seen a Physician since your arrival date in Canada or the effective date of Your Policy;
  2. You have not submitted a claim and have no intent to submit a claim;
  3. You are in good health;
  4. Your period of coverage has not already expired.
This Policy, after termination of any one Period of Coverage, will be automatically extended:
  1. for 72 hours in the event a Delayed Common Carrier prevents You from returning to Your country of permanent residence;
  2. if You are hospitalized during the term of this Policy, for the period of Hospital confinement plus 72 hours after release for You to travel home.

SIDE TRIPS:
Travel worldwide during the period of coverage is valid as long as the majority of the period of coverage is spent in Canada. Coverage is not applicable while in your country of permanent residence.

EMERGENCY MEDICAL TREATMENT: 

Actual, usual and customary charges for reasonable and necessary Hospital and medical expenses for: 
Emergency Hospital confinement as a resident in-patient (limited to semi-private accommodation). Any coverage related to the Hospital confinement terminates upon release from Hospital.
Emergency Medical Treatment as an outpatient.

ABOUT TuGo:
TuGo and OneWorld Assist are member companies of TU Group, an organization established in 1964 to provide insurance and health care services to North American consumers. Areas of speciality include insurance products and services, health care management and international travel and medical assistance services. TuGo delivers the highest level of support when travellers face an emergency through a multilingual customer call centre and experienced travel assistance team.

TU Group companies include TuGo, OneWorld Assist, OneWorld Medicare, and TravelGold Mexico. TU Group is based in Richmond, BC, with offices in Calgary, Toronto, Montreal, San Diego and Mexico City.

Claims at TuGo
10th Floor
6081 No.3 Road
Richmond, BC V6Y 2B2

Making a Claim Over the Phone

To make a claim over the phone, call Claims at TuGo at 1-800-663-0399. Have your policy number ready to provide to a member of our Customer Service team.

Making a Claim In-person

To submit your travel insurance claim in-person, visit Claims at TuGo Monday to Friday 9:00am to 5:00pm:
10th Floor
6081 No.3 Road
Richmond, BC V6Y 2B2

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GMS Visitors

  - Emergency Medical Expenses maximum benefits: $25,000; $50,000; $100,000 and $150,000.
  - Hospital Room - semi-private.
  - Physicians or surgeons.
  - Diagnostic Treatments: Lab tests and X-ray examinations ordered by a physician. Magnetic resonance imaging, computerized axial tomography scans, sonograms, ultrasounds, and biopsies have to be pre-authorized by GMS.
  - Ambulance Transportation: Licensed local air or land ambulance, when necessary, to the nearest hospital.
  - Prescription drugs or medicines, 30 day supply.
  - Professional Medical Services - care received from a licensed physiotherapist, chiropractor, osteopath, chiropodist, and/or podiatrist, up to $300 per category of practitioner.
  - Funeral Expenses: In the event of death from covered condition, up to $7,000 is provided to return the body home, or up to $3,000 for cremation or burial at the place of death.
  - Accidental Dental: Up to $2,000 for repair or replacement of natural teeth or permanently attached artificial teeth, damaged by an accidental blow to the face.
  - Dental Emergencies: Up to $250 for treatment or relief of acute dental pain.
  - Child Care - up to $500, with prior GMS approval, for licensed care of dependant, should you be hospitalized for forty-eight (48) hours or more due to a medical emergency.
  - Out of pocket expenses - up to $150 per day to a maximum of $1,000 for accommodations, meals, necessary telephone calls and taxi or bus fares incurred by an accompanying family member in the event that you are hospitalized. This benefit must be pre-approved by GMS.
  - Emergency Transportation: The cost up to the policy limit of air ambulance, one-way economy airfare or stretcher to transport you to your country of origin, and a medical attendant if required, when immediate medical consultation is required following a covered emergency sickness or injury.
 - Parent and Grandparent Super Visa holders will be deemed to have coverage for a full 365 days, without limitation as to the number of departures and re-entries into Canada.

EXCLUSIONS: Your coverage is subject to various exclusions, which are completely set out in the Exclusions section of the policy document. The following, although not an exhaustive list, are some of these exclusions:
ELIGIBILITY:
1. You are eligible to purchase this insurance if you are an immigrant or visitor to Canada who is not covered under a provincial or territorial government plan.
2. You are not eligible to purchase this plan if:
   a) You are age 80 years of age or older as of the date of application.
   b) You have had a medical consultation with a physician since you arrived in Canada.
   c) You have been in Canada for more than thirty (30) days at the time of application;
   d) You have reason to seek medical attention when you apply;
   e) You are not eligible for coverage if, on your effective date; you are a visitor to Canada over the age of 55  or are an immigrant of any age and in the past twelve (12) months:
        i) You have suffered from, been diagnosed with, received new treatment for, or had a recurrence of, or complications relating to any of the following: stroke/TIA, blood clots, congestive heart failure, atrial/ventricular fibrillation, AIDS, any terminal illness, renal failure, gastrointestinal bleeding;
       ii) You have undergone the following procedures: renal dialysis, valve replacement or organ transplant;
       iii) You are awaiting further tests or treatment for heart disease;
       iv) You have both heart disease AND insulin dependent diabetes and are taking prescription medication for both;
       v) You use home oxygen for a heart and/or lung disease;
       vi) You take oral steroids for a lung condition;
       vii) Any of the following apply to you; under active treatment for cancer, have an aortic aneurysm that remains surgically untreated, have experienced undiagnosed episodes of syncope/fainting or falling;
       viii) You have and ICD (Implantable Cardioverter Defibrillator).
3. If you apply for coverage prior to your arrival in Canada, there is no waiting period to obtain emergency medical treatment.
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You or someone on your behalf must contact GMS prior to treatment whenever possible. Failure to contact GMS within twenty-four (24) hours of receiving medical treatment or admission to hospital will limit benefits, otherwise payable to you, to 70% of eligible expenses to maximum of the sum insured amount purchased. Emergency phone numbers: Toll free within Canada and the USA: 1-800-459-6604 and Collect call from all other locations: 905-726-5196.

Claims Instructions:
   1. Complete a claim form and attach all original itemized medical bills and prescription receipts.
   2. Sign and date completed form and return package to:
                          Group Medical Services
             150 Commerce Valley Drive W. 9th floor
                          Thornhill, ON, L3T 7Z3

For claims inquiries, please contact:
Toll Free 1-800-459-6604(within Canada and the USA) or
Collect (905) 726-5196 (from all other locations)

Please keep a copy of all the submitted correspondence for your records.

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EXTENSIONS:
Automatic Extensions: if coverage expires while hospitalized due to an emergency, coverage will continue to you, your spouse and any dependants for whom coverage is purchased and listed on the application, up until seventy-two (72) hours after discharge from hospital.
Extensions may be approved if GMS is notified forty-eight (48) hours prior to the expiry date of the existing coverage and you have not required medical services in excess of $500 during your period of coverage.

SIDE TRIPS: This insurance plan provides coverage for travel to the U.S.A. or Mexico (excluding your country of origin), as long as your trip originates and terminates in Canada and 50% of your period of coverage is spent in Canada. Travel to the U.S.A. or Mexico does not apply to residents of the U.S.A. returning to the U.S.A. or to Mexican residents returning to Mexico.

REFUNDS:

Daily Immigrants & Visitors Option

1.  A full refund is available if the entire trip is cancelled prior to the effective date of coverage.
2.  A partial refund is available if:
    a.  you return to your country of origin and a minimum of thirty (30) days remains unused on the policy;
    b.  you become eligible and covered under a provincial or territorial Government plan during the period of coverage; or
    c. you have a minimum of thirty (30) days unused on the policy as a result of your death.
3.  No refunds are available if claims have been incurred under this insurance plan.
4.  No refunds will be issued for amounts under $5.00.

Annual Immigrants & Visitors Option
1.  A full refund is available if the entire trip is cancelled prior to the effective date of coverage.
2. A partial refund is available if:
    a.  you have a minimum of thirty (30) days unused on the policy as a result of your death; or
    b.  you become eligible and covered under a provincial or territorial Government plan during the period of coverage.
3.  Supporting documentation may be requested when applying for a refund.
4.  No refunds are available if claims have been incurred under this insurance plan.
5.  No refunds will be issued for amounts under $5.00.

About GMS
Group Medical Services (GMS) has been providing health and travel insurance coverage since 1949. GMS is expert in emergency medical coverage and offer a wide range of flexible plans at competitive rates. GMS is a non-profit corporation based in Regina, Saskatchewan.

EMERGENCY TRAVEL ASSISTANCE

toll-free 1.800.459.6604
(within Canada & USA)
collect 905.762.5196
(for all other locations)
Emergency Travel Assistance is available 24 hours a day, 7 days a week.

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Travelance

What We Cover

You are covered up to the Plan Limit which is the overall benefit limit for the entire Period of Coverage. Certain sections below have a specified benefit limit for an eligible Emergency medical expense as described.

1. Emergency Medical Expenses: a Physician orders or prescribes the following as Medically Necessary for the diagnosis or Treatment of Your Emergency Sickness or Injury:
a) the services of a Physician, surgeon or inHospital duty nurse;
b) Hospital semi-private accommodation where available;
c) transportation by a professional ambulance Company to and from a Hospital;
d) diagnostic testing including but not limited to sonograms, electrocardiograms, computerized axial tomography (CAT scan) and magnetic resonance imaging (MRI). The Company must pre-authorize all diagnostic tests;
e) medical equipment purchased or rented for therapeutic purposes. The Company must preauthorize this benefit;

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Exclusions only Applicable to the Emergency Medical section of this Policy:

There is no coverage and no benefits will be payable for claims presented under this section resulting from:

1. Pre-Existing Conditions or related Medical Conditions as follows:

a. For the Premier Plan:
i) For ages 69 and under on the Start Date, any Pre-Existing Condition or Medical Condition that was not Stable and Controlled during the 180 day period immediately prior to Your Start Date.

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Travel Claims Department
P.O. Box 557, Hamilton, Ontario L8N 3K9
Toll Free Fax: 1-866-551-1704
Toll Free Telephone Canada & USA: 1-888-526-0111
Direct Dial Telephone 905-667-3391
If You experience an emergency or require medical assistance while You are travelling at any time call:
USA & Canada 1-800-334-7787
Elsewhere Operator Assisted Collect 905-667-0587
Direct Dial 1-905-667-0587
Email: assistance@oldrepublicgroup.com
How To Submit A Claim
You can download a claim form directly from Our website:

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Are you Experiencing a Medical Emergency?

Call the Emergency Assistance Provider prior to admission, or within 24 hours of a life or organ-threatening emergency
Emergency Assistance Provider (24/7)
1-800-334-7787 (in Canada & USA)
905-667-0587 (elsewhere operator assisted collect call)
1-905-667-0587 (direct dial)

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Manulife

WHAT IS COVERED UNDER EMERGENCY MEDICAL INSURANCE?
Under Emergency Medical Insurance, you are covered for the actual eligible covered expenses related to the medical attention you need if a medical emergency begins unexpectedly after your effective date of insurance and when these expenses are not covered by any other benefit plan. The maximum amount payable is based on the plan you have purchased. Medical attention must be required as part of your emergency treatment and ordered by a physician (or a dentist in the case of dental treatment ). Covered expenses and benefits are subject to the policy’s exclusions and limitations.

We will cover benefits 5 to 10 only if they have been authorized and arranged by the Assistance Centre.
Eligible covered expenses include:

1. Expenses to receive emergency medical attention –
Reasonable and customary charges for medical care received from a physician in or out of a hospital, the cost of a hospital room (semi-private room when available or an intensive care unit when medically necessary); the services of a licensed private duty nurse while you are in hospital; the rental or purchase (whichever is less) of a hospital bed, wheelchair, brace, crutch or other medical appliance; tests that are needed to diagnose or find out more about your condition; and drugs that are prescribed for you and are available only by prescription from a physician or dentist. Follow-up visits are covered until the attending physician or our medical advisors declare the end of the medical emergency

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WHAT IS NOT COVERED UNDER EMERGENCY MEDICAL INSURANCE?
We will not pay any expenses or benefits relating to:
1. Any illness, sickness, or disease suffered during the waiting period.
2. For Plan A –
a) any medical condition, diagnosed or undiagnosed, which existed or for which you sought or received medical advice, consultation, investigation, or for which treatment was required or recommended by a physician, within the 180 days prior to the effective date.

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To make a claim due to illness or in jury during your trip,
please call the Assistance Centre at:
1 877 878-0142
Toll free from the USA and Canada.
1 519 251-5166
Collect to Canada from anywhere else in the world.
Immediate access to the Assistance Centre is also available through its TravelAid mobile app. To download the app, visit: http://Active-Care.ca/TravelAid.
Call within 24 hours of hospitalization.
If you do not contact the Assistance Centre before receiving medical treatment, you will have to pay 20% of the medical expenses we would normally pay under this insurance. If it is medically impossible for you to call when the emergency happens, the 20% co-insurance will not apply. In this case, we ask that you call as soon as you can or that someone call on your behalf..

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CoverMe™ Claims Information

Are you looking for information about your claim? Do you have a question about how to make a claim? This section has a collection of tools and forms to help keep you informed.

If you wish to speak to someone, our customer service representatives will be happy to help you. The claims contact information for each product is also listed below in Claims Inquires.
Manulife
Consumer Solutions
P.O. Box 4214, Stn A
Toronto, Ontario
M5W 5M4
Phone: 1-800-COVER ME®
(1-800-268-3763)

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Allianz

1. Emergency Hospital
We agree to pay for hospital accommodation, including semi-private room, and for reasonable and customary services and supplies necessary for your emergency care during confinement as a resident in-patient.
2. Emergency Medical
We agree to pay for the following services, supplies, or treatment, resulting from a covered sickness or injury, when provided by a health practitioner who is not related to you by blood or marriage:
a) The emergency services of a legally licensed physician, surgeon, or anaesthetist.
b) Follow-up visits as prescribed by the attending physician at the time of the emergency. Follow-up visits must occur during the period of coverage and be directly related to the emergency. The emergency must occur during the period of coverage and have been reported to AGA. Follow-up treatment needed as a result of any sickness or injury that took place while you were in your country of origin during the period of coverage will be covered only on prior approval by AGA. On-going expenses resulting from such sickness or injury will not be covered, unless approved in advance by AGA. AGA reserves the right, as reasonably required and at its expense, to transport you to your country of origin following an emergency.
c) Diagnostics, lab tests and/or X-ray examinations as ordered by a physician for the purpose of diagnosis. d) The services of the following legally licensed practitioners for treatment of a covered sickness or injury:
i. chiropractor;
ii. osteopath;
iii. podiatrist/chiropodist;
iv. physiotherapist, when ordered by the attending physician;
v. acupuncturist.
Not to exceed $500 per profession.
e) Private duty services of a Registered Nurse when approved in advance by AGA.
Not to exceed $10,000.
f) The use of a licensed local air, land, or sea ambulance (including mountain or sea evacuation) to the nearest hospital, when reasonable and necessary.

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VTC1 Pre-existing Conditions Exclusion
a) If you are 59 years of age or under on the effective date:
Benefits are not payable for costs incurred due to or resulting from your medical condition or related condition that was not stable at any time during the 90 days immediately before the effective date.
b)If you are 60 to 79 years of age on the effective date:
i. Benefits are not payable for costs incurred due to or resulting from any of the following pre-existing conditions, unless you have completed a Medical Questionnaire, have been approved in writing by AGA and have paid the required premium:

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Claims forms are available by calling AGA’s Claims Department.
SEND YOUR CLAIMS TO:
Allianz Global Assistance Claims Department
250 Yonge Street, Suite 2100
Toronto, Ontario M5B 2L7
Canada
Collect worldwide: 416-340-8809
Toll-free Canada/USA: 1-800-869-6747
Call within 24 hours of hospitalization.
If you do not contact the Assistance Centre before receiving medical treatment, you will have to pay 20% of the medical expenses we would normally pay under this insurance. If it is medically impossible for you to call when the emergency happens, the 20% co-insurance will not apply. In this case, we ask that you call as soon as you can or that someone call on your behalf..

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How can we help?

Are you an existing customer and have a question about your travel insurance policy? Are you a company seeking a partnership, a medical facility treating one of our customers or do you simply want to give us feedback about your experience with us? Whatever your question or concern, submit it to us using the form below and we will do our best to get back to you very promptly.

Allianz Global Assistance
250 Yonge Street, Suite 2100
Toronto, Ontario M5B 2L7
Canada
Phone: Toll-free Canada/USA: 1-800-995-1662
Toll-free worldwide: 00-800-842-08420
or
Country code + 800-842-08420

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  21st Century   GET A QUOTE

Emergency Assistance: 1-877-882-2957 toll free Canada & USA; 519-251-7856 collect call

Claim Assistance: 1-866-228-6386 toll free Canada & USA.

Mail all original documents to:

21st Century Visitors Claims

c/o Manulife Financial

P.O. Box 4262, Stn. A

Toronto, ON, M5W 5T4

21st Century Claim Form PDF

  TIC   GET A QUOTE

Emergency Assistance: 1-800-995-1662 toll free Canada & USA; 416-340-0049 collect call

800-842-08420 or 00-800-842-08420 Toll Free Worldwide.

Claim Assistance: 1-800-869-6747 toll free or 416-340-8809 collect call.

Mail all original documents to:

TIC Claims Department

2100-250 Yonge Street

Toronto ON, Canada M5B 2L7

TIC Visitors Claim Form PDF

TIC International Student CLAIM FORM PDF

  RSA   GET A QUOTE

Emergency Assistance: 1-800-715-8833 toll free Canada & USA; 819-566-8839

Collect Call.

Claim Assistance: 1-800-336-9224 toll free Canada & USA;819-566-8698 collect call.

Mail all original documents to:

Global Excel Management Inc.

73 Queen Street

Lennoxville, Quebec

J1M 1J3

RSA Visitors Claim Form PDF

RSA Students Claim Form PDF

Benefit Period

This is the maximum time period up to which the plan will pay benefits for any one eligible condition. Some policies have a 12 month benefit period while others have a 6 month benefit period; usually this period can extend beyond the date of policy expiration.

Carrier

Insurance Company that actually underwrites and issues the insurance policy. The term refers to the fact that the company carries (or assumes) certain risks for the policyholder.

Child

Insurance Company that actually underwrites and issues the insurance policy. The term refers to the fact that the company carries (or assumes) certain risks for the policyholder.

Claim

Request by the insured (or his/her provider) to an insurance company to pay for services obtained from a health care provider. The claim is usually submitted in a pre-determined format or a claim form.

Co-Insurance or co-payment

After your deductible is met, co-insurance is the percentage of the covered medical expenses that you, the insured person, must pay. For instance, if your health plan has an 80/20 co-insurance rate, your insurance plan pays for 80% of your eligible medical expenses and you are responsible for the remaining 20%. Example: If you buy an insurance policy with $50,000 policy maximum, $250 deductible per policy period and 80/20 co-insurance for the first $5,000 and 100% coverage thereafter. Suppose you incur medical claim for a covered condition of $10,250. You pay first $250 deductible; then out of the remaining $10,000 covered expenses, you pay 20% of the first $5,000 (i.e., $1,000); the insurance policy pays for the remaining expenses (i.e. $9,000). That means, you pay $250 + $1,000 = $1,250 total; and insurance company pays $4,000 + $5,000 = $9,000

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