Exceptional Benefits & Superior Service

Claim FAQ

What do I do if I have an emergency or claim?
In the event of an emergency, StudentGuard™ is ready to assist you 24 hours a day. Please call our Emergency Assistance line at 1-888-756-8428 (Toll Free in North America) or collect to our Claims Staff in Toronto, Ontario, Canada at (905) 731-8291.

StudentGuard™'s Claim team can help you to arrange the following:

• Verification of coverage and policy benefits to physician, or hospital when necessary
• Coordination of payments with doctor or hospital
• Communication with relatives and school as appropriate
• Arrangement of emergency medical evacuation when necessary

Do I have to call you before I see a doctor?
No, for minor emergencies you do not need to call. Just complete a Claim Form, making sure to tell us WHY you saw the doctor and send it in with the original bills or receipts.

Do I have to call you before I go to the Hospital?
You do not need to call before going to the Emergency Room, but you may wish to call us so we can speak to the hospital regarding payment. If you are admitted to the hospital (staying overnight or longer), please call us.

When DO I have to call?
You need to call for the following:

• When you are being admitted to the hospital to stay
• When you are having major tests called 'CAT scans' or 'MRI's'
• When you are at the dentist
• When you need to have surgery

What do I do when I need to see a doctor?
Please go to a local walk-in clinic or doctor's office. If your condition requires a visit to the Emergency Room at the Hospital, the doctor at the clinic will tell you.

For major medical emergencies such as broken arms/legs, accidents, or when you need to be taken to the hospital by ambulance, please go to the nearest hospital. Please call us at 1-888-756-8428 (Toll Free in North America) or call collect to our Claims Staff in Toronto, Ontario, Canada at (905) 731-8291 as soon as possible.

Where is the closest doctor's office?
Please see the Medical Providers section of our website. If you go to one of these clinics and show your StudentGuard™ ID Card, you usually will not be asked to pay.

You may also visit any medical clinic or doctor's office. In the event of a serious injury please go to the closest hospital and seek medical attention immediately.

Why did I have to wait 9 hours at the Hospital Emergency Room (ER)? And why did people who got there after me go in to see the doctor first?
In Canada, Emergency Rooms are for people with severe injuries or illnesses. A nurse will see you when you arrive to find out if your condition is considered an 'emergency'. If the nurse decides your condition is not an emergency, and feels you could have gone to a walk-in clinic or doctor's office, you will have to wait until all the people who are sicker than you are seen first.

Why am I asked to pay for medical services?
Certain Canadian clinics/doctors/hospitals will ask you to pay for services you receive. Hospitals will generally ask you to pay. (Average costs for going to an Emergency Room begin at approx. $500 Canadian dollars.) If you are asked to pay, please ask for a receipt. Original receipts must be submitted with a completed claim form in order to receive your refund. Please make copies of all documentation submitted to us for your own personal file.

How do I fill out a Claim Form?
You must submit a fully completed and signed Claim Form in order for us to pay for your expenses. The Claim Form must clearly state WHY you went to the doctor. If there is no indication of WHY you saw the doctor, your claim cannot be processed. You must also include all original receipts or bills for your expenses. You may want to keep a photocopy for your records, but we MUST receive the originals. Please refer to the ' How to Claim' section. You may download a Claim Form here.

What is an original receipt or bill?
The piece of paper showing the charges for your treatment and any payments made that the doctor or hospital gives you at the time of your visit is your original.

IMPORTANT: for prescription medications (the kind that you get from the Pharmacist at the back counter in a pharmacy or drug store) we must have the receipt that has the following information:

• Your name
• The name of the doctor who prescribed the medicine
• The name and 'DIN number' of the drug

Does the Doctor need to fill out or sign my claim form?
If you have paid for medical services, then the doctor does not need to sign the form. You can complete and sign the claim form yourself. Please see the 'How to Claim' section for instructions.

Do I need to send in my claim form or does the Doctor send it for me?
If you have paid for the medical services yourself then you are responsible for submitting your claim. Please see the 'How to Claim' section for instructions on sending your claim to us.

When should I submit my claim?
Please send your completed Claim Form with all your original invoices or receipts as soon as possible. You should notify us within 30 days that you have a claim to submit.

How long does it take to process my claim?
When your claim is submitted with ALL the information required to process your request (Including a fully completed Claim Form that states WHY you went to the doctor, and who we should pay plus original bills or receipts), your claim will be processed within 7 working days. For eligible claims, we will mail a refund cheque to the address provided on your Claim Form. In some circumstances, we may refund your claim payment directly to your credit card.

How do I check on the status of my claim?
Please call our claims department during regular business hours 9:00 a.m. to 5:00 p.m. EST, Monday to Friday at 1-888-756-8428 (Toll Free in North America). You may also check on the status of your claim by emailing us at claims@studentguard.com. Please make sure to include your name, date of birth, policy number, daytime phone number, evening phone number, email address and your Canadian mailing address.

Why do I keep receiving invoices from the hospital?
Canadian hospitals automatically send out invoices or bills on a regular basis. Make certain that you have already sent us the invoice with a fully completed Claim Form so that we can process the expenses. Should the hospital continue to send you additional invoices, please send them to our claims office with a letter explaining that you are continuing to receive invoices. Include your name, date of birth, policy number, daytime phone number, evening phone number, email address and your Canadian mailing address. Please make copies of all documentation submitted to us for your own personal file.

Why do I have two different policy numbers?
Different policy numbers are given for each coverage period. Please use your current policy number when submitting claims.

What is considered a pre-existing condition?
The web site information provides a summary of coverage; please read the StudentGuard™ Policy carefully for complete details (page 7-8), or contact us for clarification.

Can I visit the doctor for a check up?
If you are planning to see a doctor for an annual check-up certain limitations apply. Please refer to the following benefit 'Annual Physician Visit - Inbound Insureds Only' which is on page 5 of your StudentGuard™ Policy:
When you have purchased 6 or more months of consecutive coverage, we will pay up to $100 Canadian dollars per year for one visit in Canada for a non-emergency exam and associated tests.

Can I see an Eye Doctor?
Please refer to the following section in the StudentGuard™ Policy: Eye Exams - Inbound Insureds Only (certain limitations apply):
When you have purchased 6 or more months of consecutive coverage, one eye exam per year for students coming to Canada.
Note: The costs for glasses or contact lenses are NOT covered.

Can I get new glasses?
Glasses or contact lenses are NOT covered.

Can I visit the dentist?
Please refer to the following sections in the StudentGuard™ Policy for details 'Accidental Dental' and Emergency Dental' on page 5 of your policy (certain limitations apply):
Accidental Dental Care- When you are hit in the mouth, we will pay for expenses to fix your teeth in the 90 days after you are injured.
Emergency Dental Care- When you have purchased 6 or more months of consecutive coverage, up to $300 Canadian dollars for emergency dental treatment.