Common use of Health Insurance and Dental Care Plans Clause in Contracts

Health Insurance and Dental Care Plans. All claims must be submitted to the Insurer within 12 months following the date expenses are incurred. If the contract or the insurance benefit is terminated, claims must likewise be submitted within 12 months following the termination date. The aforementioned time frames are firm. However, the insured person does not lose her entitlement to benefits under the health insurance and dental care plans if she is able to prove, to the Insurer’s satisfaction, that she was unable to take action any sooner. Official receipts or paid invoices must be enclosed with the claim. Expenses are considered as being incurred on the date the services, care, treatment, or supplies were provided. For certain expenses, the insured person is required to enclose the medical prescription with the claim. 3.1. Prescription drugs, extended health care and dental care a) Claims submitted by a health professional In some cases, insured persons may have their claims submitted by certain health professionals who have been pre-approved by the Insurer, such as pharmacists and dentists. The Insurer pays the covered portion of eligible expenses to the health professional at the time of the transaction. The insured person must pay the portion of expenses for which the insured person is responsible to the health professional, according to the provisions of this contract. b) Claims submitted to the Insurer The insured person may pay the total expenses incurred for the services of the health professional. The insured person may then use one of the following methods to forward the claim to the Insurer: i) mobile app; ii) online from the secure site; iii) by mail, by sending the completed form.

Health Insurance and Dental Care Plans. ‌ All claims must be submitted to the Insurer within 12 months following the date expenses are incurred. If the contract or the insurance benefit is terminated, claims must likewise be submitted within 12 months following the termination date. The aforementioned time frames are firm. However, the insured person does not lose her entitlement to benefits under the health insurance and dental care plans if she is able to prove, to the Insurer’s satisfaction, that she was unable to take action any sooner. Official receipts or paid invoices must be enclosed with the claim. Expenses are considered as being incurred on the date the services, care, treatment, or supplies were provided. For certain expenses, the insured person is required to enclose the medical prescription with the claim. 3.1. Prescription drugs, extended health care and dental care a) Claims submitted by a health professional In some cases, insured persons may have their claims submitted by certain health professionals who have been pre-approved by the Insurer, such as pharmacists and dentists. The Insurer pays the covered portion of eligible expenses to the health professional at the time of the transaction. The insured person must pay the portion of expenses for which the insured person is responsible to the health professional, according to the provisions of this contract. b) Claims submitted to the Insurer The insured person may pay the total expenses incurred for the services of the health professional. The insured person may then use one of the following methods to forward the claim to the Insurer: i) mobile app; ii) online from the secure site; ; iii) by mail, by sending the completed form.