17-03 Annex A - Insurance Claim Administration Guidelines
Cadet Administrative and Training Orders (CATOs)
1. In the event there is a requirement to file a claim against the Special Risk Accident Insurance Plan, claim forms and associated documents are to be sent to the RCSU for onward transmission to D Cdts & JCR.
2. Upon receipt of the claim form and associated documents, D Cdts & JCR staff will ensure liaison with insurance company.
3. The following documents would be required in cases of accidental death:
- claimant’s statement to be completed by the Executor of the Estate;
- administrator’s statement to be completed by the Policyholder (D Cdts & JCR);
- attending physician’s statement or coroner’s report;
- police report; and
- death certificate.
4. The following documents would be required in cases of injuries not leading to accidental death:
- claimant’s statement to be completed by injured party;
- attending physician’s statement; and
- administrator’s statement (D Cdts & JCR).
5. The insurer will only accept original documents. The insurer does not accept photocopy or faxed claim forms. Upon receipt of the documents, the insurer will assign a claim examiner who will start the review of the claim and advise the insured member or executor accordingly.
6. To file a claim against the Accidental Para-Medical Expense Reimbursement Benefit or Accidental Dental Reimbursement the claim form at appendix 1 shall be completed. The insured member must have incurred the medical expense as the result of an accident while participating in an authorized cadet activity.
7. This coverage supplements Federal, Provincial or private health plans. Medical receipts or invoices are to be included. The original claim form with attachments must be forwarded to the RCSU for review and resolution by D Cdts & JCR and the Insurer.
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