Common use of HOW TO MAKE A CLAIM Clause in Contracts

HOW TO MAKE A CLAIM. A Medical Emergency should always be reported immediately, as described in section 8, or benefits will be limited. If You or, if applicable, the Insured Person did not report the Claim immediately as required. If, without contacting our Administrator for assistance and claim management, an Insured Person incurs Eligible Medical Emergency Expenses, then he or she must first submit receipts and other proof to: • GHIP; • then to any group or individual health plans and/or insurers. Any Eligible Medical Emergency Expenses that are not covered by such GHIP, health plans or insurance should then be submitted to our Administrator with proof of claim, receipts and payment statements. In this case, claims forms can be obtained from our Administrator’s Customer Service representatives at the number set out in section 10. The Insured Person will also be required to provide evidence of his or her actual date of departure from his or her province or territory of residence. If You or, if applicable, the Insured Person did report the claim. If Hospital or other medical charges have been guaranteed or paid by our Administrator on behalf of an Insured Person then You and, if applicable, the Insured Person must sign an authorization form allowing our Administrator to recover these charges: • from the Insured Person’s GHIP; • from any health plan or other insurance; • through subrogation rights against any responsible third party. If our Administrator has paid for Eligible Medical Emergency Expenses covered under other insurance or another plan, You and, if applicable, the Insured Person must assist our Administrator in obtaining reimbursement, where necessary. The Insured Person will also be required to provide evidence of his or her actual date of departure from his or her province or territory of residence. Note: If an advance payment is made for expenses and it is later discovered that they were not covered under this Certificate, then You and/or the Insured Person must reimburse Us.

HOW TO MAKE A CLAIM. A Medical Emergency should always be reported immediately, as described in section 8, or benefits will be limited. If You or, if applicable, the Insured Person did not report the Failure to Report a Claim immediately as required. Immediately If, without contacting our Our Administrator for assistance and claim management, an Insured Person incurs Eligible Medical Emergency Expenses, then he or she must first submit receipts and other proof to: • GHIP; • then to any group or individual health plans and/or insurers. Any Eligible Medical Emergency Expenses that are not covered by such GHIP, health plans or insurance should then be submitted to our Our Administrator with proof of claim, receipts and payment statements. In this case, claims forms can be obtained from our Our Administrator’s Customer Service representatives at the number set out in section 10. The Insured Person will also be required to provide evidence of his or her actual date of departure from his or her province or territory of residence. If You or, if applicable, the Insured Person did report the claim. Reporting a Claim Immediately If Hospital or other medical charges have been guaranteed or paid by our Our Administrator on behalf of an Insured Person then You and, if applicable, the Insured Person must sign an authorization form allowing our Our Administrator to recover these charges: • from the Insured Person’s GHIP; • from any health plan or other insurance; • through subrogation rights against any responsible third party. If our Our Administrator has paid for Eligible Medical Emergency Expenses covered under other insurance or another plan, You and, if applicable, the Insured Person must assist our Our Administrator in obtaining reimbursement, where necessary. The Insured Person will also be required to provide evidence of his or her actual date of departure from his or her province or territory of residence. Note: If an advance payment is made for expenses and it is later discovered that they were not covered under this Certificate, then You and/or the Insured Person must reimburse Us.