Waiting periods before submitting your claim
For certain illnesses, there is a period during which you must have symptoms or there is a survival period after diagnosis or surgery. You will have to wait until these periods have passed before you can submit your claim. Here are some examples; exact times may vary depending on the policy.
- For a heart attack, there is a 30-day survival period following diagnosis.
- For type 1 diabetes, you must have symptoms for a period of 3 months.
- Following a stroke, neurological symptoms and deficits must last for at least 30 days from the date of diagnosis.
INFORMATION ON CRITICAL ILLNESSES AND THE CLAIMS PROCESS
We are very sorry to hear that you are facing a serious illness that is impacting your life. Our thoughts are with you during these challenging times. We are here to assist you as best we can.
Before you complete the online claim form, please take a few moments to carefully read the following information on critical illnesses and the eligibility conditions. This information is key to helping you understand the claims process and what is required for your claim to qualify for payment.
Determine whether your condition qualifies for a claim
First, take some time to carefully read through your insurance coverage, including the definitions and any critical illness exclusions and limitations. This will help clarify what your insurance covers and what it does not, and whether you qualify for benefits for your critical illness condition.
You are eligible to make a claim if:
Your insurance policy is still in force.
Your diagnosis is one of the conditions covered by your policy.
The severity of your illness meets the definition in your policy, which may include specific exclusions and limitations. A diagnosis from your doctor is not sufficient to guarantee payment of benefits.
If your illness is not in the list of covered illnesses, you should not submit a claim because you will not qualify to receive benefits. However, you may be able to file a claim for disability benefits if you have disability insurance with iA and your condition prevents you from working or performing activities of daily living.
For certain critical illnesses, there may also be waiting periods before you can submit your claim.
If your illness meets all these conditions
Before you begin, make sure you have the following information at hand:
- The names and addresses of your specialists and your family doctor
- The history of the illness for which you are submitting a claim (dates of symptoms, consultations, surgery, diagnosis, etc.)
- Any treatment you have received for your condition
- Consultations in the last 5 years that are not related to your illness
- Your family history
- Your policy number (if available)
The information you enter cannot be saved or kept in draft form, so please complete the form in one go. If you leave the session before completing the form, you will have to start over.
Make a claimFrequently asked questions
What are the steps for submitting a critical illness insurance claim?
- First, fill in all the required information in the online claim form and submit the form.
- We will perform an initial analysis of your claim and then contact you about the additional documents we will need (e.g. statement from your attending physician).
- We will start the full analysis of your claim once we have received all the required documents.
- We'll keep in touch with you through a claim tracking tool.
Is my claim paid automatically if my diagnosis is one of the conditions covered by my policy?
Not necessarily. To receive benefits, the insurance policy must be in force and your diagnosis must correspond to the definition in the insurance policy. Certain limitations, exclusions and waiting periods may also apply.
Why would my claim not be eligible?
Here are some reasons why a claim could be denied:
- You submit a claim for a condition not covered by your insurance policy. Examples include fibromyalgia, angina, type 2 diabetes and concussions.
- The diagnosis does not meet the conditions of the policy, or no definite diagnosis has been made.
- You have been diagnosed with cancer, experienced symptoms or begun a medical investigation within 90 days of the date the policy took effect.
- You had stroke symptoms and neurological deficits that did not last for at least 30 days following the date of diagnosis.
- You did not survive the mandatory 30-day survival period after a heart attack.
What are the steps for submitting a critical illness insurance claim?
You will be able to check the status of your claim online. When you submit your claim, you will receive a link with a tracking number. You can also go directly to ia.ca and click on Make a Claim or Track a claim.
If I also have other insurance, can I send you a copy of that claim?
There is no need to send your other claim to us if you have submitted it to another insurance company because you will still have to complete the online form for iA Financial Group.
If I have both disability and critical illness insurance—do I need to submit two claims?
Yes, you need to submit two online claims because we require different information for each type of claim.
Why do you always request medical information, whether related to the diagnosis or not, for insurance policies issued in the last 5 years?
All insurance companies perform this type of check to ensure that the information provided was accurate and complete at the policy effective date. The purpose is to prevent attempts at insurance fraud.
Will you need my medical file to process my claim?
Yes, we will need additional medical information to help us verify that your condition is eligible and that it meets the definition in your insurance policy. Depending on the condition, we may only require a statement from your attending physician. In other cases, we will need your complete medical file and test results. We'll let you know exactly what we need after we receive your claim request.
In that case, do I need to provide the original medical documents?
In most cases, copies of original documents are acceptable. However, some healthcare facilities require an original authorization. We will let you know if this situation applies to you.
For cancer or a benign brain tumour, we will always ask you for a pathology report. What is a pathology report?
A pathology report is a medical document that describes the appearance of tissues, cells or body fluids collected during a medical procedure such as a biopsy or surgery. This report is written and signed by a pathologist, who is a medical specialist.
The pathology report must be the most recent report following a medical procedure. You can request the report from the hospital's medical records or from your family doctor.
If I live abroad, am I still able to receive my critical illness benefit?
Yes. For a qualifying critical illness, funds can be deposited in a Canadian financial institution or wired to a foreign bank. Additional documents will be required to process the payment.
Can I receive a critical illness benefit even if my diagnosis was made in another country?
Yes, it is possible to receive your critical illness benefit if your diagnosis was made outside Canada or the United States. However, there will be additional requirements.