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FinancialNavigator

Health Insurance and Benefits


Making a Claim 

Insurance

Critical Illness Insurance

If you have access to a critical illness insurance policy or credit insurance policies on your loans/mortgages/credit cards, you can start the process of making a claim on each one AFTER your diagnosis is confirmed.  You do not have to wait for a treatment plan to be in place, but it is helpful if a specialist (surgeon, oncologist) has been assigned to you and has confirmed the diagnosis. 

The process for making a claim on a critical illness policy will be outlined in your insurance information booklet or by your employer.  Usually, the employer will have the claim form for you to fill out.  There will be a portion for your physician or the specialist to complete as well.  The insurer may want the physician or specialist to attach verification of the stage and type of disease through pathology or diagnostic reports.

Once the paperwork is submitted, the insurer will review the claim to ensure it meet the terms of the policy.  The insurer may check your medical history to see if there was an indication that you may have had treatment or signs of the disease prior to the policy.  Some critical illness policies are specific to the stage of cancer they cover, and the insurer may want more information on the extent of your cancer.   It can take several weeks for an insurer to review your claim for critical illness insurance.  Once approved, you will receive payment based on the terms of the policy, which is usually in a lump sum amount.

Credit or Mortgage Payment Insurance

If you have insurance on your mortgage payments, credit cards, car loan, etc., you can contact the lender(s) for instructions on how to apply to each one.   The lender will guide you to the appropriate claim documents.  The process for making a claim will be like the one for critical illness insurance (see above). It can take several weeks to process.  In the meantime, you might still be responsible for monthly payments – check with the lender. 

Once approved, the terms of payment will depend on the policy.  Usually it means payments will be continued for you by the insurer for a certain period.  For credit cards, it can mean anything from payment of the balance to a set minimum payment made each month.

Each insurer may request an update on your health status at certain periods to review whether the claim should be continued. 

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If you have additional information that would be helpful to include in this tool please email cbcn@cbcn.ca or call us at 1-800-685-8820.

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