Emergency Health Insurance Plan Claim Form
To submit a claim, you will need to download and complete the form and ensure the form is signed and dated before submitting it to Intrepid 24/7™. Please include any documents to support your claim. You must email your documentation to Intrepid 24/7™ at claims@intrepid247.com.
You must include a copy of the emergency room report and all hospital records if the treatment was received at a hospital. Remember to keep a copy of all documents emailed for your records.
Download the International Student Medical Insurance Plan Claim Form
Important:
- All claims must be reported to Intrepid 24/7™ within 30 days of occurrence.
- Written proof of claim must be submitted to Intrepid 24/7™ within 90 days of occurrence.
- You are responsible for all fees charged for any supporting documentation.
- Failure to complete and sign the form in its entirety or submit supporting documentation will delay claim processing.
How to submit claims
- Complete a Claim form
- Download the Claim form
- Complete the form electronically or print and fill out each section
- Fill out all required fields
- Once complete, print completed form, Sign and Date in Pen (all claim forms must be signed and dated to be processed)
- Gather your information related to your medical visit
- Collect all medical reports, documents, ER Tests, Referrals, follow up required; Confirmation of Receipt(s); anything that you received during your appointment
- Make a clear photocopy of your documents and scan (keep your originals)
- Submitting the Claim:
- Submitting a claim form when claims@intrepid247.com has requested that you complete one following a direct billing submitted on your behalf; or
- Submitting a claim form when you have paid out of pocket for your medical visit.
- Once your form is completed and applicable documents copied, email them at claims@intrepid247.com
- Follow up Status:
- Check your email for follow up documentation from claims@intrepid247.com that may be required by the Claims Department to process your claim. They will explain to you exactly what is missing from your submission.
- Provide any requested information as soon as possible.
- Call 1.866-883-9485 if you have any questions about your claim or to clarify what else is needed
- Follow up email: claims@intrepid247.com
- If your claim is denied, an explanation about the exclusion(s) will be provided by email.
Tip* Before leaving the clinic, or medical visit request a copy of your medical records, tests, referrals, follow up or doctors’ notes that were applicable. This will help in processing your claim, otherwise Intrepid 24/7™ or your case manager will have to request you to complete an authorization form signed by you to obtain your medical records to process your claim.
Direct Billing Networks - Preapproved Clinics
You are not required to use the clinics listed under the Direct Billing Network Clinics provided (those within the list) however those clinics listed are set up to bill directly to the insurer once you have arranged and confirmed your appointment to the clinic via the support of the Intrepid 24/7™ call center.
Members will only receive communication if they reach out to assistance for medical care and a case number; or have submitted a claim to the Intrepid 24/7™ claims team, or in cases where additional information is required, the student member will receive a follow up email directly from the case manager.
In the event you are issued a medical bill and/or must pay for a clinic visit it is recommended to request a copy of all the medical records related to your visit before you leave the clinic or hospital and follow the instructions under Plan Claims.
Should you require immediate medical attention due to an illness, injury, or accident, please contact Intrepid 24/7™ immediately at the following numbers - +1 833-366-0873 or +1 416-987-2247 toll-free from Canada and the USA collect where available, unless you have an emergent medical occurrence, please dial 911.
Calling Intrepid 24/7™ before seeking medical care or visiting a walk-in clinic will help you to manage the clinic choices and allow the call center to confirm your booking with the specified clinic and provide them with a Verification of Benefits (VOB), allowing for your visit to be direct billed to the insurer. You may also email the Intrepid 24/7™ call center assistance team at: intrepid@intrepid247.com