How to file a visitor insurance claim: A step-by-step guide

Visitor insurance offers financial protection against unexpected medical expenses when you are in Canada. Whether you are dealing with a sudden medical emergency, lost belongings, or a cancelled trip, filing a visitor insurance claim correctly ensures you get reimbursed for eligible costs. 

In this article, we’ll take you through the step-by-step process of filing a visitor insurance claim efficiently.

What is visitor to Canada insurance?

Visitor to Canada (VTC) insurance covers medical emergencies for travellers who are not covered by Canada’s public healthcare system. It helps pay for hospital stays, doctor visits, and other medical services.

Who needs it?

A visitor insurance policy is required by:

• Tourists and family members visiting Canada
• Super visa applicants (mandatory for entry)
• New immigrants waiting for provincial health coverage
• International students and temporary workers

Eligibility criteria for visitor insurance

• Must be a non-resident of Canada

• Coverage must be purchased before or shortly after arrival

• Age and pre-existing condition restrictions may apply (varies by provider)

Understanding your policy: A pre-claim checklist

Filing a visitor insurance claim can be smooth if you’re well-prepared. Before you even begin, it’s important to understand your policy’s terms, coverage limits, and required documentation.

Many claims are delayed or denied simply because travelers aren’t aware of exclusions, deadlines, or the proper steps to follow. By reviewing your policy details in advance and gathering necessary documents, you can ensure a seamless claims experience.

Here’s what you need to check before starting your claim:

• Policy inclusions & exclusions: You should be aware of what is covered and what is not

• Claim reporting deadlines: Some insurers require claims to be reported within a specific time frame

• Required documentation: You must ensure you have medical receipts, doctor’s notes, and any other necessary paperwork

• Direct billing vs. reimbursement: You must check if the insurer pays the medical provider or if you need to cover expenses upfront and seek reimbursement

• Emergency assistance contact: You must have the insurer’s emergency contact details handy in case immediate support is needed

What are the steps to file a visitor insurance claim?

The steps to file a visitor insurance claim include reviewing your policy, gathering important documents, filling out forms, and more. To file a visitor insurance claim, you need to:

• Review your insurance policy to understand coverage, limits, and exclusions
• Gather necessary documentation like medical bills, receipts, and proof of payment
• Download or access claim forms from the insurer’s website or customer portal
• Submit your claim via the preferred method (online, email, mail, or fax)
• Follow up on your claim to track its progress and provide additional information if required
• Understand the outcome whether the claim is approved, partially approved, or denied
• Appeal if necessary in case of a denial, by submitting additional documentation

Review your insurance policy

Before filing a claim, you need to carefully examine your visitor insurance policy to understand:

• Coverage limits: Maximum amount reimbursable for specific expenses
• Exclusions: Situations not covered, such as pre-existing conditions
• Deductibles and copayments: Amounts payable before insurance covers expenses
• Claim deadlines: The time frame within which claims must be submitted

Gather necessary documentation

Our advisors recommend organizing documents in advance to prevent claim delays. Depending on your claim type, you’ll need the following documentation:

• Personal identification: Copy of your passport or visa
• Medical claims: Hospital bills, doctor’s notes, and pharmacy receipts
• Trip cancellations: Proof of cancellation, airline tickets, and payment records
• Lost or stolen items: Police reports and receipts for lost valuables
• Proof of payment: Credit card or bank statements verifying your expenses

Download or access claim forms

Most insurance providers offer claim forms on their websites or customer portals. You can also request them through customer service. To make the process easier, we have compiled links to claim forms/portals for some of the insurance providers we work with:

• Allianz: Claim form/portal
• Manulife: Claim form/portal
• Blue Cross: Claim form
• Destination Canada: Claim form/portal
• GMS: Claim form/portal
• Travelance: Claim form
• 21st Century: Claim form

You must make sure to:

• Download the latest version of the form from the official site
• Read the instructions carefully to avoid mistakes
• Check if additional forms, such as a physician’s statement, are required

Remember, using the correct and most up-to-date claim form helps prevent delays in processing your claim.

Submit your claim

Claims can usually be submitted through multiple channels:

• Online portal: Upload scanned documents to the insurer’s website
• Email: Send a digital copy to the claims department
• Mail: Send physical documents (keep copies for records)
• Fax: Some insurers still accept faxed claims, but confirm beforehand

Follow up on your claim

After submission, track your claim’s progress by:

• Checking the insurer’s online claim tracking system.
• Contacting customer service for real-time updates.
• Reviewing email notifications regarding claim status.

Processing times typically range from 7 to 30 days, depending on the complexity.

Understand the outcome

Once your form is reviewed, your claim may result in:

• Approval: Reimbursement is issued via check, direct deposit, or card refund
• Partial approval: Some expenses may not be covered due to policy limits
• Denial: The claim is rejected, accompanied by an Explanation of Benefits (EOB) outlining the reason

If denied, carefully review the EOB to understand the reason.

Appeal if necessary

If your claim is denied, you may appeal by:

1. Reviewing the reason for denial in the EOB
2. Gathering additional documentation like missing records or clarifications
3. Submitting a formal appeal letter along with supporting evidence
4. Following up with the insurer to ensure the appeal is processed

Filing a visitor insurance claim may seem overwhelming, but staying organized, accurate, and proactive makes the process smoother. By following these steps and keeping thorough records, you can maximize your chances of a successful claim. If you encounter issues, contact your insurer for assistance.

What is an Explanation of Benefits (EOB)?

An Explanation of Benefits (EOB) is a document that your insurance provider sends after processing your claim. It details what was covered, the amount paid by the insurer, and any remaining balance you may owe. 

If a claim is denied or partially approved, the EOB will specify the reason for the decision, helping you understand whether you need to provide additional information or appeal the denial.  

What are the steps to file a Super Visa insurance claim?

To file a Super Visa claim accurately, you need to review your policy carefully, fill out the required forms, and submit your claim. Here are the steps you can follow:

• Review your policy and check inclusions, exclusions, and claim submission deadlines
• Collect your passport, Super Visa, medical bills, receipts, doctor’s reports, and proof of payment
• Download the claim forms from your insurer’s website or request them directly
• Fill out all details accurately, including policy number and treatment information
• Submit the form and documents via the insurer’s online portal, email, mail, or fax
• Track the claim status through your insurer’s website or customer service
• If your claim is approved, reimbursement is issued; however, if it is denied, you’ll need to review the Explanation of Benefits (EOB)

To avoid delays, always submit your claim within the required deadline and ensure all documents are accurate and complete. 

What are the most common reasons for visitor insurance claims being denied?

Visitor insurance claims are often denied due to policy exclusions, insufficient documentation, and missed deadlines. Many travellers don’t realize that pre-existing medical conditions, high-risk activities like extreme sports, or travel to restricted regions may not be covered. 

Additionally, failing to submit required documents, such as medical reports or proof of trip cancellation, can lead to a denial. Another common issue is filing the claim too late since most insurers have strict time limits for submission. So, you must carefully review your policy and ensure you meet all requirements to help avoid claim rejection.