Making a Claim

When accessing the Health and/or Dental claim form please use the below information as a guide to complete the required sections of the form:

• Plan Number: 177890
• Division Number: Not Applicable Leave Blank
• Plan Name: University Students’ Council of Western University
• Employee Identification Number: Your Student ID
• Employee Name & Address: Your Name & Current Mailing Address

You are required to submit an original claim form, receipts and doctor's referral (if required) when sending in your claim to the insurance carrier. Remember to always keep a copy for your records.

Please note: You have 15 months from the date the eligible expense is incurred to submit claims to Canada Life for consideration under your student plan.

Claims for services eligible under your Student Health & Dental Plan, made from your home country, with a date of service prior to December 31, 2021, are eligible for reimbursement.

The benefits will be paid based on the existing insurance policy according to the terms of the contract with all reimbursements, maximums, physician requirements, fee guide, frequencies, policy details, etc. remaining in force. Eligible expenses incurred with a date of service prior to December 31, 2021 will be eligible for reimbursement. Claims with a date of service after December 31, 2021 incurred outside of Canada will not be eligible for reimbursement.

There are two options for submitting claims as an insured International Student studying from your home country.
1) Submit a paper claim with receipts upon arrival in Canada.
2) Submit a claim through your Groupnet account with Canada Life.

To submit claims while outside of Canada you must be registered for Groupnet and have a Canadian Bank Account. All Claims incurred outside of Canada are considered Out of Country claims which require using the online Paper Claim process; this process uses electronic documents.

Health related claims including prescription drugs require:
· A completed health claim form including the patient’s name.
· An official receipt signed by the provider/pharmacist showing a breakdown of the charges and the currency billed, along with proof of payment.
· Detailed listing of the service provided.
· The service providers complete name, address, and phone number.

Dental related claims require:
· A completed dental claim form including the patient's name.
· A receipt signed by the dentist showing a breakdown of charges and the currency billed, along with proof of payment.
· The dental providers complete name, address, and phone number.

Eligible services are included in the myBenefits section of the plan website. Forms for submitting claims are in the Making a Claim section of the plan website.

Additional Notes:
- All claims will be paid in Canadian Funds.
- Applicable to the Student only.
- Family members are not eligible.
- Claims with a date of service after December 31, 2021 incurred outside of Canada will not be eligible for reimbursement.

Below are details on how to access the online Paper Claim process; this process utilizes electronic documents.

Step 1: Sign in to Groupnet.


Step 2: Click on “Make a Claim”.


Step 3: Click on “Start Paper Claim”. (This process uses electronic documents.)


Step 4: Follow instructions for “How to submit paper claim forms and documents online”.

Pay-direct claims allow for direct billing of eligible costs between your pharmacy and/or dental office and the insurance company. Pharmacy claims are processed immediately so that students are not out of pocket the full expense at the time of purchase. Dental claims are processed based the individual dental offices billing practices. These claims are accessed with the myBenefits Card.

Visit the myBenefits Card page to access your personalized myBenefits Card.

Through GroupNet you can submit claims, check balances, investigate claim status and history, and setup Direct Deposit of claim payments by completing the eDetails section. Once you’ve set up your account, you will then be notified by e-mail when a claim has been processed and that claim details are available for viewing online.

Click here to go the registration page.

When registering for GroupNet you will need to provide:

• Plan Number: 177890
• ID Number: Western Student ID

Watch a short video about how to submit an online claim.


* If you are a member on more than one policy with Canada Life, you are currently only able to access one policy through the new Groupnet portal. You can still access multiple policies through the old Groupnet portal, which can be found by clicking here.

To submit a manual claim, complete an insurance Health Claim Form, attach the original receipts and documents, and mail to the insurer. Remember to keep a copy of all original documents for your records.

The following information is required on the claim form:

Plan Number: 177890
Division Number: Not Applicable Leave Blank
Plan Name: University Students’ Council of Western University
Employee Identification Number: Your Student ID
Employee Name: Your Name
Address: Your Current Mailing Address

To submit a manual claim, complete an insurance Dental Claim Form, attach the original receipts and documents, and mail to the insurer. Remember to keep a copy of all original documents for your records.

The following information is required on the claim form:

Plan Number: 177890
Division Number: Not Applicable Leave Blank
Plan Name: University Students’ Council of Western University
Employee Identification Number: Your Student ID
Employee Name: Your Name
Address: Your Current Mailing Address

Watch a short video about how to review your benefits and claims history.