Out-of-country claim forms
Are you currently experiencing a medical emergency while travelling?
Call us 24/7 from anywhere in the world for help during a medical emergency.
Have coverage through your employer or plan sponsor? You’re in the right place.
If you have coverage through an advisor, use our personal insurance forms. If you purchased coverage directly through Canada Life, use our Freedom to Choose™ forms.
How to make a claim
Use this form to make a claim for medical expenses you incurred while travelling outside Canada or while more than 500 kilometres from your home within Canada.
Step 1: Enter your policy number
Enter your policy number the field below. You can find your policy number on your mailed statements, on the second page under "Key information".
Step 2: Fill out this form
Download the form and print it, or fill it out in Adobe Reader XI or higherOpens a new website in a new window - Opens in a new window (not your browser) and save.
Step 3: Submit your claim
To submit your claim online, visit www.globalexcel.com/canadalifeOpens a new website in a new window - Opens in a new window and upload your completed Out-of-Country claim form (0442) along with required receipts.
To send your claim via mail, submit your completed Out-of-Country claim form (0442), along with required receipts, to the address provided on the form.
Questions about submitting your claim?
If you have questions or need help with a claim made before April 1 2022, call:
- Canada or the U.S. toll free - 1-800-461-10791 8 0 0 4 6 1 1 0 7 9
- The rest of the world - 1-519-742-28001 5 1 9 7 4 2 2 8 0 0* Footnote *
If you have questions or need help with a claim made after April 1 2022, call:
- Canada or the U.S. toll free- 1-866-530-60251 8 6 6 5 3 0 6 0 2 5
- The rest of the world- 1-905-816-19901 9 0 5 8 1 6 1 9 9 0* Footnote *
TTY to Voice: 7117 7 1
- Footnote *
- * If you’ve incurred any long-distance charges from calls placed outside of Canada and the US, you can request reimbursement by including the receipt as part of your claim.
Step 2: Fill out this claim form
Download the form and print it, or fill it out in Adobe Reader XI or higherOpens a new website in a new window - Opens in a new window (not your browser) and save.
Step 3: Fill out the provincial authorization form for the province you live in.
Alberta Health requires all claim documents be received within 12 months from the date the medical treatment was provided.
In addition to the Statement of Claim – Out-of-Country Expenses (M5432) form , British Columbia residents are required to submit the following 3 forms to Canada Life:
- #2814 (out-of-country claim)Opens a new website in a new window - Opens in a new window
- #2806 (Schedule A; medical travel assignment of payment)Opens a new website in a new window - Opens in a new window
- #2807 (Schedule B; authorization to provide medical information)Opens a new website in a new window - Opens in a new window
These Medical Services Plan (MSP) Forms should be downloaded from the official websiteOpens a new website in a new window - Opens in a new window of the Government of British Columbia, completed in full, and submitted as part of your claim. The MSP of British Columbia requires all claim documents be received within 90 days from the date of service, except for in-patient hospital services, which must be received within six months from the date the medical treatment was provided.
Manitoba Health requires all claim documents be received within 6 months from the date the medical treatment was provided.
The New Brunswick Medicare Plan requires all claim documents be received within 12 months from the date the medical treatment was provided.
In addition to the Statement of Claim – Out-of-Country Expenses (M5432) form , Newfoundland and Labrador residents are required to submit the out-of-province claim form available from the Government of Newfoundland and Labrador websiteOpens a new website in a new window - Opens in a new window .
Newfoundland and Labrador requires all claim documents be received within 12 months from the date the medical treatment was provided.
The Nova Scotia Medical Services Insurance Plan requires all claim documents be received within six months from the date the medical treatment was provided.
The Ontario Health Insurance Plan (O.H.I.P.) requires all claim documents be received within 12 months from the date the medical treatment was provided.
The Health and Community Services Agency of Prince Edward Island requires all claim documents be received within 6 months from the date the medical treatment was provided.
The Régie de l’assurance-maladie du Québec (RAMQ) requires all claim documents be received within 1 year from the date the medical treatment was provided, except for in-patient and out-patient hospital services, which must be received within 3 years from the date the medical treatment was provided.
Quebec residents are also required to provide a completed Application for reimbursement formOpens a new website in a new window - Opens in a new window .
Saskatchewan Health requires all claim documents be received within 1 year from the date the medical treatment was provided.
Step 4: Submit your claim
Log in to your Canada Life online account to submit your completed claim form. We’re not able to process these claims on the app right now.
When you’ve logged into your account, click Make a claim, and then follow the steps under Start a paper claim.
Questions about submitting your claim?
If you have questions or need help with a claim, call 1-800-957-9777.1 8 0 0 9 5 7 9 7 7 71 Footnote 1
TTY to Voice: 7117 7 1
- Footnote 1
- 1 If you’ve incurred any long-distance charges from calls placed outside of Canada and the US, you can request reimbursement by including the receipt as part of your claim.