Insurance for dentists - Claim Process

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The Claim Process

To give you a general understanding of how the claim process works, the following are steps you’ll go through if you need to file a claim* under your Canadian Dentists’ Insurance Program coverage:

Step 1: Call CDSPI’s Claim Support Centre
During a claim, CDSPI’s Claim Support Centre will act as a liaison between you and the insurer to help make the claim process go as smoothly as possible. When you call, we’ll take some preliminary information about your claim, and then send you a Claim Kit that includes forms you’ll need to complete for the insurer, along with other helpful information. We will then notify the insurer of your intent to make a claim.

Step 2: Submit Your Claim Forms to the Insurer
Shortly after you receive your Claim Kit, CDSPI will contact you to see if you require assistance in filling out the claim forms. Depending on the type of claim, you may also have to submit other documents to the insurer — such as financial and medical information in the case of a disability claim.

Step 3: A Decision is Made About Your Claim
For most types of insurance, a decision about your claim is made by the insurer about two weeks after they have received all the necessary documents. If your claim is approved, you’ll receive payment(s) in accordance with the terms of the insurance contract. If your claim is denied by the insurer and you disagree with that decision, insurers have procedures through which your claim may be reviewed. In the event of a claim dispute relating to Long Term Disability Insurance or Office Overhead Expense Insurance, dentists have the option of using ADR.

To learn more about the claim process, contact CDSPI’s Claim Support Centre. To read more about the claim process for specific Canadian Dentists’ Insurance Program plans, download the three claim process booklets shown below. You can also request mailed copies of these brochures through the Claim Support Centre.

• The Claim Process and You: A Guide for Malpractice and Personal Umbrella Liability Insurance Claimants
• The Claim Process and You: A Guide for TripleGuard™ Insurance Claimants
• The Claim Process and You: A Guide for Long Term Disability and Office Overhead Expense Insurance Claimants.

To view these brochures, you will need to have Adobe Acrobat Reader installed on your computer.

* In the case of a Travel Edge Insurance claim, CDSPI provides you with a 24-hour emergency hotline. For CDSPI Home & Auto Insurance claims, your policy includes 24/7 Claims Emergency Assistance. Should the unexpected happen, simply call The Personal at 1-888-785-5502 and your claim will be handled quickly and efficiently.