How Canada Life processes out of country claims

Key takeaways

If you experience a medical emergency while travelling, you’ll need to make a claim for out-of-country expenses.
You must submit a form to make your claim.
There is an appeal process if your claim isn’t approved.

How to submit an out-of-country claim

Complete and submit the appropriate out-of-country claim form.

What are the submission timelines?

Claim must be received within the submission period set out by your provincial health care and must not exceed 15 months from the date the service/supply was incurred.

My form is complete. Now what?

Once all information for your claim is received, Canada Life will adjudicate your claim.

We’ll contact you through My Canada Life at Work or by mail if there’s any missing information required to assess your claim.

You can respond to any missing details for your claims online by signing in to My Canada Life at WorkOpens a new website in a new window and going to the contact us section.

How long does it take to process my claim?

Your claim will be processed within 10 calendar days of receipt.

Please note: This timeline is intended for standard plans only. Actual timelines might vary based on plan design and claim complexity. Missing information or incomplete applications for benefits may impact processing timelines. We may need to extend the timeline if additional review is needed.

How will I find out if my claim has been accepted?

We’ll provide you a response either electronically or by mail, depending on your communication preferences.

Appeal details for out-of-country claims

Appeal level 1

Details – You can appeal by either calling our client service specialists at the call center or by resubmitting the claim and indicating it’s an appeal.
Timeline – Appeals will be reviewed within 7 calendar days of receipt.
Communication – Once the appeal is adjudicated, we will provide you a written response.

Appeal level 2

Details – If you aren’t satisfied with the first appeal decision you may send us in writing all claims details with any additional information we may not already have.
Timeline – Appeals will be reviewed within 10 calendar days.
Communication – We will respond by sending a detailed letter with an explanation for the decision.

Complaints

After Appeal level 2, you can ask to have your concerns escalated further. This would flow into our customer complaint process.

What’s next?

Get the out-of-country claims forms you need.

This information is general in nature and is intended for informational purposes only. For specific situations you should consult the appropriate legal, accounting or tax advisor.