- Pre-Existing Conditions
Generally, pre-existing conditions are defined as any sickness, injury or medical condition for which the insured consults a physician, having symptoms, is hospitalized or medications are prescribed within a certain period before the effective date of coverage. Each insurance company treats pre-existing conditions differently and this is the major reason for declined claim under Super Visa. The look back period may vary from 3 months to one year. Please, read the exclusion section in the insurance policy booklet for exact definition. Make sure you understand the policy wording as it applies to their condition. A reduction in medication, even if your client’s health is improving, may mean the pre-existing condition is no longer stable and controlled. If you are unclear about their condition, refer them to their family physician.
- What Should Your Client Do in the Event of a Medical Emergency?
In the event of a medical emergency the client must call the Emergency Assistance Provider. The phone number is usually found in the policy or on the confirmation of coverage (COC). Take notice of the timeline for notifying the Emergency Assistance Provider. Failure to call within the given time frame may result in financial penalties. This information is typically found in the policy as well.
- Side Trips Outside of Canada
If a person visiting Canada intends to travel to America or Caribbean or any other country as a side trip outside of Canada, one must check in the policy wording booklet when and for how long your client can travel outside of Canada as well as any travel destination restrictions. For example, some policies may end when the traveller returns to their home country or the policy may only cover travel destinations within North America. The duration of stay outside Canada can not be more than 50% of the total trip. One must have stayed in Canada for a while before the trip outside Canada can be taken. The calculation of number of days is very crucial and must be properly understood and one must refer to policy booklet or call your agent or company for clarification.
- Date Changes
Date changes are common for super visa applicants as it is hard to predict when an applicant’s visa will be approved or denied. An arbitrary travel date (policy start date) is usually chosen and may need to be changed several times throughout the application process.
Some companies charge an administration fee for changes made after the start date of the policy. To avoid administration fees, check in with your clients to make sure applicable date changes are made prior to the start date of the policy.
- When does coverage begin?
The coverage start date varies by policy. Typically, coverage begins on either the client’s departure date, purchase date or effective date. If the insured’s start date is their departure date, some policies may offer the insured coverage enroute to Canada while other policies only offer coverage once the insured arrives in Canada. If the policy start date is after the departure date, benefits under the policy may only be available after a waiting period which also varies by policy. Be sure to read the policy for details.
- Payment and Refunds
Visitors to Canada emergency medical plans are typically paid for up front for the entire duration of the policy. Deductible options are commonly available to help reduce the overall cost of the premium. Take notice if deductibles are paid per claim or per policy.
If the insured returns home early most companies will refund unused days less an administration fee. Some companies will refund the remaining premium regardless of how many days are left in the policy while other companies may limit the refund by the number of days remaining. For example, if there are only 15 days left in the policy one company may refund those days while another may not because there are less than 30 days left in the policy.
We always advise our clients that they must understand fully all the terms and conditions of the policy before purchase. They should not be in rush while buying policy and they must pay attention to all the sections mentioned here but not limited to: Eligibility criteria, exclusions, benefits, claim process etc.