How to make a Critical Illness Claim

How do I make a Critical Illness claim?

Contact Pacific Blue Cross for more information or to speak with one of our claims specialists:

Telephone: (Claims specific) 604-419-8040

Toll-free Outside the Greater Vancouver Area: (General Inquiries)
1 877 PAC-BLUE (1 877 722-2583)

Mailing Address:
Pacific Blue Cross
PO Box 7000
Vancouver, BC V6B 4E1

How to submit a Claim

To receive a copy of our claim form, please contact our claims administration department at 604 419-8040. Once the claim has been validated, the appropriate form will be sent to you electronically or via standard mail.

Send us your completed claim forms as soon as possible.

We’ll begin reviewing your claim right away

Assessment of critical illness applications

Once we receive your claim application, a claims specialist will assess and review your critical illness application to determine your eligibility for benefits based on the provisions of your plan. In case of missing information, the claims specialist will call you to discuss your claim, applicable policy provisions and, if necessary, will request medical information from the treating physician to clarify the critical illness condition.

There are specific qualifying conditions, diagnoses criterion, and levels of medical impairment outlined in our definition guide that must be met in order for critical illness benefits to become payable You may refer to your contract for more information about medical conditions covered by your plan.

Because critical illness is defined as a Living Benefit, you must survive the waiting period as indicated in your contract in order for the benefit to become payable.

What happens next?

We may need more information. If we have asked your physician and/or provincial health provider(s) for medical information, it normally takes a few weeks for us to receive these reports. We will continue to process your claim in the meantime.

We’ll deal directly with you.

You’ll have a chance to ask questions and we’ll be able to explain the claims process to you.

Your personal information is secure

At Pacific Blue Cross, your privacy is important to us and we keep the information we gather strictly confidential and use it only for the purposes specified in the application for your policy. These purposes include underwriting and administering your insurance policy and paying claims. Learn more about our Privacy Policy.

TIP: Your claim will go more smoothly if you provide us with as much information as possible – as soon as possible.