CLAIMS

Emergency

Who do I call when having a medical emergency?

If you are experiencing a medical emergency, you should first contact your local emergency services. Please remember that it remains a responsibility to report your emergency to Ontime Care as soon as possible. You or someone on your behalf should call 1-888-988-3268.

What is an Emergency?

Emergency means that you require immediate medical treatment for the relief of acute pain or suffering resulting from an unexpected and unforeseen sickness or injury occurring during the coverage period and that such medical treatment cannot be delayed until your return to your country of origin.

What is a pre-approval and what is the purpose of it?

It is a policy requirement to have certain procedures pre-approved. This means you will need to submit medical records and a referral letter in advance before undergoing surgery/invasive procedure/diagnostic services. The purpose is to ensure the procedure is medically necessary, appropriate for your situation and to confirm that it cannot be postponed until you return to your home country.

Claims

How do I submit my claim?

There are two ways to submit your claim:

1. You can mail your completed claim form, complete medical records (including referrals and test results), original invoices and receipts to us.

2. You can submit your claim online at eclaim.jfgroup.ca if the total claim expenses are under $500. Please upload pdf or readable copies of your medical records, invoices and receipts in your submission.

How can I be reimbursed for my expenses?

There are two ways you can be reimbursed for your expenses:
1. By cheque
Please make sure to include your full mailing address and the payee name on the claim form.
2. By e-mail transfer
The total claim reimbursement amount must be $500 or under for you to select email transfer as a method of reimbursement.
You must also have email transfer set up with your Canadian financial institution in order to receive reimbursement by email transfer.

What is a medical record and why do I need to submit it?

A medical record is a detailed record of your visit with a treating physician that should include information regarding your symptoms and when they appeared, past medical history, procedures done, plan of treatment etc. It is important documentation for our claim examiners to have in order to substantiate illness or accident related claims.

Can the provider directly invoice Ontime Care?

For in-patient service, please let the finance department know all bills can be mailed to us. If possible, please include medical records . For out-patient services, we normally work on a reimbursement basis, meaning you will have to pay out of pocket then submit your claim. However, if you are unable to pay and your treating physician is willing to invoice you, you may submit the invoice with your other claim documents.

E-Claim Portal

What products can be submitted through the E-claim?

Policy numbers that begin with the follow prefix: JFP, JES, JESP, JFC, JFR, OPL and TOP.

Is there a limit on the amount of E-claim I can submit?

For submitting a medical claim the limit is $500 for the total claim amount. If the claim amount exceeds $500, please mail in your claim.

How many E-claims can I submit?

You can submit multiple new claims but please make sure one claim is submitted per medical issue. Duplicate claims will be rejected or combined.​

Can I update an E-claim that I submitted online?

To update an existing claim please contact our Claims department at claim@otcww.com or 905-707-3335​

What does the status mean on my Eclaim?

  • Waiting for process – Eclaim submitted
  • Processing – Eclaim being processed
  • Processed – Claim decision made​
  • Refused – Eclaim refused

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