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Submitting a Claim

Extended Health Claims

1. Green Shield Canada provides a Claim for Extended Health Benefits form for all health claims (e.g., prescription drugs, paramedical practitioners, supplies, etc.) Claims can also be submitted electronically with Green Shield Canada at www.greenshield.ca/en-ca/plan-members/how-to-submit-a-claim.

2. This form must be completed and signed by the plan member

3. Attach original receipts when submitting a claim (photocopies are not accepted)

4. Submit claims directly to Green Shield Canada

Note: For orthotics and certain paramedical practitioners, an authorization from a physician is required – please refer to the your policy provisions for additional details.

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Out of Country Claims

1. Green Shield Canada provides an Out-of-Country Claims Form for all out-of-Province/Country claims (excluding prescription drugs claims--please contact Morneau Shepell to obtain a claim form)

2. This form must be completed and signed by the plan member

3. Attach original receipts/bills accompanied with payment/denial by the provincial medical program when submitting a claim

4. Submit claims with supporting documents directly to Green Shield Canada

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Dental Claims

1. Dental claims are submitted using Green Shield Canada's Claim for Dental Benefits Form (a standard dental claim form available at most dental offices may also be used)

2. This form must be completed and signed by the plan member

3. Attach original receipts when submitting a claim (photocopies are not accepted)

4. Submit claims directly to Green Shield Canada

Note: For any extensive course of treatment involving crowns, bridgework, etc., which may exceed $500, it is recommended the employee ask the dentist to complete a cost estimate before the work is completed. Send estimates to Green Shield Canada, attention of Dental Claims Department, to determine how the expenses will be reimbursed prior to incurring the expense.

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Disability Claims

Weekly Indemnity (Short Term Disability)

  1. The employee must complete an Application for Group Weekly Indemnity
  2. There are three sections which must be completed on a short term disability claim form:
  3. Section I: Physician's Statement
    Section II: Employer Statement
    Section III: Employee Statement

  4. Once completed by the appropriate individuals, the employee mails all sections of the original form to The Co-operators

Note: Claims should be submitted as soon as possible after the date of disability for a short term disability claim. Benefits commence on the 15th calendar day of disability.

Long Term Disability

  1. The employee must complete an Application for Long Term Disability. Benefits start on the 120th day of continuous disability.
  2. There are three sections that must be completed on a long term disability claim form:
  3. Section I: Employee Statement
    Section II: Physician's Statement
    Section III: Employer Statement
  4. Once completed by the appropriate individuals, the employee mails all sections of the original form to The Co-operators
  5. Claims should be submitted six to eight weeks before the end of the elimination period for a long term disability claim
  6. If the employee is eligible for WSIB benefits, the employee will receive a Worker's Compensation claim form from his/her physician

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Life and Dependent Life Claims

  1. The plan sponsor and beneficiary must complete the applicable sections of the Life Claim Form
  2. Attach the original death certificate
  3. Once all sections of the form are completed by the appropriate individuals, it should be forwarded to Morneau Shepell along with the Plan Member's original Enrolment Form

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Living Assistance Benefit

The living assistance program is made available as an advanced life insurance payment to help meet the expenses of terminally ill individuals who are covered by the group life insurance plan. Please refer to your employee handbook for further information regarding this benefit.

  1. The employee must complete an Application for Living Assistance
  2. The Co-operators will contact the individual’s doctor requesting medical information regarding his/her condition
  3. The decision made by The Co-operators is final and binding and cannot be appealed. However, if the condition worsens, the employee may re-apply

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Accidental Death & Dismemberment Claim

Please contact Morneau Shepell for assistance with an Accidental Death or Accidental Dismemberment claim.

For assistance regarding any aspect of a claim, please contact Morneau Shepell.

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