A super visa insurance claim starts with a phone call. Ring the insurer’s 24-hour assistance line, printed on the certificate, before treatment where possible and within 24 hours of a hospital admission at the latest. The assistance team confirms cover, arranges direct billing with the hospital, and requests the parent’s medical records to check that any pre-existing condition was stable. A denial can be appealed to the insurer and then to the OLHI ombudsman.
Super visa holders are visitors and do not qualify for provincial health insurance; Ontario’s OHIP page states that visitors from outside Canada do not qualify. A hospital stay is billed at full cost. The $96,311 Hamilton bill for three weeks in hospital is the scale.
What is the 24-hour notification rule?
Most policies require the insured or someone on their behalf to contact the assistance line before seeking treatment, or within 24 hours of admission in an emergency. Late notification without a medical reason usually reduces the benefit, commonly to 70 or 80 per cent of eligible expenses, or applies a fixed penalty. Being unconscious is a medical reason; not knowing the rule is not.
| Step | Who | When |
|---|---|---|
| Call the assistance line | Host, parent or hospital staff | Before treatment, or within 24 hours of admission |
| Give policy number, hospital, diagnosis, admitting doctor | Caller | On the first call |
| Receive a file number | Caller | On the first call; write it down |
| Assistance team contacts the hospital | Insurer | Same day, usually |
| Cover confirmed or records requested | Insurer | Hours to days |
Store the assistance number in the host’s phone under a name that is easy to find at 2 a.m. Put it on a card in the parent’s wallet. Tell the parent to show the card to the ambulance crew or triage nurse.
How does direct billing work?
Once cover is confirmed, the insurer’s assistance company gives the hospital a guarantee of payment, and the hospital bills the insurer rather than the family. Most Canadian hospitals deal with the major travel-insurance assistance companies routinely. Until confirmation, the hospital may ask for a credit card or a deposit.
If the family pays anything, keep every receipt and itemized bill, and claim it back. The deductible, if any, is collected by the hospital at discharge or netted from a reimbursement; see deductibles. Where a claim is for a clinic or pharmacy rather than a hospital, the family usually pays first and submits a reimbursement claim with receipts.
What does the insurer check at claim time?
Whether the policy was in force, whether the condition is covered, whether any pre-existing condition was stable for the stability period, and whether the questionnaire was answered correctly. To do that it requests the parent’s medical records, including from the home-country doctor, and compares them to the answers given.
| Check | What the insurer asks for | What goes wrong |
|---|---|---|
| Policy in force | Certificate, payment record | Lapsed monthly plan; expired term |
| Condition covered | Policy wording, exclusions | Home-country trip; excluded activity |
| Stability | Prescription history, consultation notes, test results for the period before the effective date | Dose change inside the period; pending test |
| Questionnaire accuracy | The answers given, compared to records | Undisclosed diagnosis, even one the family did not know about |
| Notification | Call log | Late call without medical reason |
The Hamilton case turned on the stability check. The insurer found congestive heart failure in the records of an 88-year-old on a no-questionnaire plan and denied the claim; it later reversed after press coverage. The pre-existing conditions page explains how to buy so that this check passes.
How do you appeal a denial?
Ask for the denial in writing, citing the policy clause. Gather new evidence: a letter from the home-country doctor confirming no change in treatment during the stability period, the prescription history with dates, and any test results. Submit a written appeal to the insurer. If it is upheld, use the insurer’s complaint process and then the OLHI ombudsman.
| Stage | Who decides | Cost | Typical time |
|---|---|---|---|
| Initial decision | Insurer’s claims team | None | Weeks |
| Internal appeal with new evidence | Insurer’s claims review | None | Weeks |
| Insurer’s complaints officer or ombudsman | Insurer | None | Up to 90 days |
| OLHI (OmbudService for Life and Health Insurance) | Independent | None | Months |
| Court | Judge | Legal fees | Years |
OLHI is the independent dispute-resolution service for Canadian life and health insurers. It is free, but the insurer’s internal process must be exhausted first. Keep a dated log of every call and email from the first notification onward; it is the record OLHI will ask for.
What does the THIA Bill of Rights promise?
The Travel Health Insurance Association’s Bill of Rights commits member insurers to fair and prompt claims handling with “timely and transparent communication.” It gives a right to escalate and appeal with new information, 24/7 worldwide assistance, and a copy of the medical screening answers before the policy starts. It requires a policy that names the underwriter and explains the complaint process, and a 10-day free look.
It also sets the insured’s responsibilities: complete the application accurately, read and understand the policy, carry proof of insurance and the emergency number, and notify the insurer promptly and provide requested documents. Each of those maps to a denial reason above. Meeting them is how a claim gets paid.
What should the host prepare before anything happens?
The certificate and policy wording, the assistance number, the parent’s medication list with dates, the home-country doctor’s contact details, and a signed consent allowing the insurer to obtain records. Keep them together in one folder, physical and digital. If the parent cannot speak for themselves, the host will be the one giving the insurer everything it asks for.
Claims service differs between insurers. TuGo (iA Financial Group) has drawn Trustpilot complaints about 10-week waits, with a 4.0 rating. Secure Travel’s claims are administered by MSH. GMS caps repatriation at $5,000, which matters if the parent needs an air ambulance home. The 2026 comparison sets these out, and the sample certificate page shows where the assistance number and policy number sit on the document.
Questions people ask
What do I do first if my parent is taken to hospital?
Call the insurer's 24-hour assistance number on the certificate as soon as possible, and within 24 hours of admission at the latest. Give the policy number, the hospital name and the admitting diagnosis. The assistance team opens the file, confirms cover and contacts the hospital to set up direct billing.
What happens if I call after 24 hours?
Most policies reduce the benefit, often to 70 or 80 per cent of eligible expenses, or apply a penalty, if notification is late without a medical reason. A parent unable to call because they were unconscious is a medical reason; a family that did not know to call is not. Put the number in the host's phone the day you buy.
Does the hospital bill the insurer directly?
Usually, once the insurer confirms cover. Canadian hospitals bill visitors at full cost and most have arrangements with the major travel insurers' assistance companies. The hospital may ask for a credit card on admission; direct billing replaces it once cover is confirmed. Keep every receipt for anything paid out of pocket.
Why does the insurer ask for my parent's medical records from home?
To check that any pre-existing condition was stable for the stability period and that the questionnaire was answered correctly. This is where most denials arise. Have the home-country doctor's letters and prescription history ready; a delay in records delays the decision.
What can I do if the claim is denied?
Ask for the denial in writing with the policy clause relied on. Appeal to the insurer with any new evidence, such as a doctor's letter confirming stability. If the insurer upholds the denial, escalate through its complaint process to the OLHI ombudsman, which is free. The THIA Bill of Rights guarantees the right to appeal.
How long does a claim take to be paid?
Direct-billed hospital claims are settled between the insurer and the hospital over weeks to months. Reimbursement claims typically take four to eight weeks after all documents are received. TuGo has drawn complaints about 10-week waits on review sites. Chase in writing and keep a log.
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