• Claims MUST be submitted to your provincial plan and THEN submitted to Manulife Financial with a copy of the statement of payment (or decline). All our travel insurance plans for travelling Canadians start with a $0 deductible. MEDICAL INSURANCE CLAIM FORM FOR VISITORS TO CANADA Case No. Copy of the Insured’s or Claimant’s NRIC or passport 4. We may need more time to process the claim if further clarification is needed, and will inform you if this occurs. Please retain copies for your files as original receipts will not be returned. : MLVTC012016E Send the completed claim form to: Active Care Management P.O. : _____ Form No.

Prefer to speak with us? Life and Health Insurance Plans are underwritten by The Manufacturers Life Insurance Company. Travel Insurance Plans are underwritten by The Manufacturers Life Insurance Company and First North American Insurance Company (FNA), a wholly owned subsidiary of Manulife. Individual insurance claims procedure At Manulife, we provide a fast and simple individual insurance claims process along with the proper safeguards to meet your urgent needs, so you can enjoy outstanding protection as well as peace of mind. Medical information: Complete either the injury or illness section, whichever is applicable to your claim. Sometimes, your planned trip needs to be cancelled or interrupted due to a family illness, a travel companion injury, a natural disaster or many other unexpected events. Box 1237 Station A Windsor Ontario N9A 6P8 General Claim Inquiries: 1-877-251-5108 Info@Active-care.ca www.Active-Care.ca SUBMITTING YOUR CLAIM
Administration and Claim Forms for Manulife’s Individual Health Plans Flexcare Health Insurance Follow Me Health Insurance CoverMe Health Insurance Leaving a Group Plan Health Insurance. If your form is complete and accurate, you will generally receive payment within six business days. Go to Top Eligibility and Rate Qualification To be eligible for insurance under the Manulife Travel Insurance Policy, you must be a resident of Canada and covered under a provincial health insurance plan. 25,000 more delivery riders to receive free insurance coverage from Manulife Philippines amid COVID-19 pandemic Manulife Philippines provides COVID-19 support to customers Manulife Philippines provides free insurance coverage to delivery riders during community quarantine The Manufacturers Life Insurance Company Page 1 of 2 GL3655E (11/2006) CII Group Benefits Extended Health Care Claim To be completed by the plan member unless otherwise indicated.


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