Desjardins

Step-by-Step Guide to Filing Claims with Desjardins

1. Choose Your Submission Method

Desjardins offers four primary claim submission options:

• Online via Secure Portal (Fastest)
• Mobile App (Omni or Desjardins Insurance Home-Auto app)
• Direct Billing with Payment Card (Instant reimbursement at eligible providers)
• Mail or In-Person (For paper forms or complex claims)

2. Online Submission (Secure Portal)

1. Log In or Register:
   • Visit Desjardins Secure Portal and sign in using your credentials. New users must register with their policy/certificate number
2. Select Claim Type:
   • Choose Health, Dental, Paramedical, Prescription Drugs, or Travel Insurance
3. Enter Claim Details:
   • Provide service date, provider name, and cost. Upload digital receipts (JPEG/PDF/PNG)
4. Add Supporting Documents:
   • Include original receipts, prescriptions, or treatment plans (required for expenses over $500)
5. Review and Submit:
   • Confirm details and submit. Most claims are processed within 48 hours

3. Mobile App Submission

1. Download the App:
   • Use the Omni app (for group insurance) or Desjardins Insurance Home-Auto app
2. Submit Claims:
   • Navigate to “Submit a Claim”, enter service details, and upload receipt photos
3. Track Status:
   • Monitor real-time updates under “Claims History”

4. Direct Billing with Payment Card

1. Use Your Desjardins Payment Card:
   • Present your card at participating pharmacies, dentists, or paramedical providers (e.g., physiotherapists)
2. Pay Only the Uncovered Portion:
   • The provider bills Desjardins directly; you pay co-pays or non-covered fees

5. Mail or In-Person Submission

1. Download Forms:
   • Use the Health/Dental Claim Form or Disability Claim Form
2. Complete and Mail:
   • Include original receipts and mail to:
     Desjardins Insurance Claims Department
     [Address listed on your policy documents]
3. Retain Copies:
   • Keep duplicates of all documents for 12 months

6. Special Cases Long-Term Disability (LTD) Claims

1. Gather Forms:
   • Employee Statement, Employer Statement, and Physician’s Statement
2. Submit via Portal or Mail:
   • Upload forms online or mail to Desjardins’ disability department
3. Wait for Approval:
   • Processing takes 5–20 days

Life Insurance Claims

1. Call Desjardins:
   • Dial 1-888-558-5525 to initiate the claim and request forms
2. Submit Documentation:
   • Include a death certificate and policy details. Death benefits are paid within 30 days of approval

Key Requirements

• Deadline: Submit claims within 12 months of the service date
• Original Receipts: Photocopies are not accepted for manual submissions
• Direct Deposit Enrollment: Required for online claims

Tracking Your Claim

• Online Portal: Check status under “Claims History”
• Contact Support:
  • Group Insurance: 1-800-263-1810 10
  • Auto/Home: 1-888-776-8343 13

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Frequently Asked Questions (FAQs): Desjardins Insurance

1. Does Desjardins cover paramedical services like massage therapy or acupuncture?

Yes! Most Desjardins group plans cover massage therapy, physiotherapy, acupuncture, and chiropractic care. Check your policy’s “Extended Health Benefits” section on the Desjardins Secure Portal for annual limits (e.g., $500/year).

2. Can Panda Clinic bill Desjardins directly?

Yes, if your plan allows direct billing. Provide your Desjardins payment card (for pharmacy/dental) or confirm with our front desk for paramedical services. If direct billing isn’t available, we’ll give you a detailed receipt for manual claims .

3. What documents do I need to submit a claim?

• Original receipts (photocopies not accepted) with:
  • Provider name, license number, and address.
  • Service date, description, and total cost.
• Completed claim form (download from Desjardins’ Forms Page).
• Referral (if required by your plan, e.g., for physiotherapy).

4. How long does Desjardins take to process claims?

• Online/mobile submissions: Processed within 48 hours.
• Mail submissions: Allow 7–10 business days plus mailing time.
  Tip: Enroll in direct deposit via the Secure Portal for instant reimbursements.

5. What if my claim is denied?

‍Common reasons include:

• Missing receipts or incomplete forms.
• Exceeding annual coverage limits.
• Services not eligible under your plan.
  Resubmit with corrections via the Secure Portal or call 1-800-263-1810 (Group Insurance) for assistance .

6. Can I use Desjardins with another insurance plan?

‍Yes! Desjardins supports coordination of benefits:

1. Submit to your primary insurer first (e.g., your employer’s plan).
2. Submit remaining costs to Desjardins.
   For dependents, start with the plan of the parent whose birthday falls first in the year .

7. Does Desjardins cover mental health services like counselling?

‍Most group plans include coverage for psychologists or social workers (e.g., $1,000/year). Check your policy’s “Mental Health Services” section on the Secure Portal .8. How do I check my remaining coverage?

• Log in to the Secure Portal → Go to “My Coverage”.
• Call Desjardins’ Group Insurance line: 1-800-263-1810.
• Ask our Panda Clinic team—we can help verify your balance during appointments!

9. What’s the deadline to submit claims?

‍Claims must be filed within 12 months of the service date. For travel insurance, submit within 90 days of returning home .

‍10. Do I need a referral for RMT, chiropractic care or acupuncture?

‍Most Desjardins plans do not require referrals for paramedical services. Confirm with your HR department or policy documents .

‍11. How do I submit travel insurance claims?

1. Before traveling: Call 1-800-463-1838 (Allianz Global Assistance) for emergencies.
2. After returning: Submit receipts and a completed Travel Claim Form online or by mail .

12. How do I track my claim status?

• Log in to the Secure Portal → Navigate to “Claims History”.
• Use the Omni mobile app for real-time updates .

Still Need Help?

‍Contact Desjardins directly:

• Group Insurance Support: 1-800-263-1810 (Mon–Fri, 8 AM–8 PM ET).
• Travel Insurance: 1-877-699-9922.
• Panda Clinic Assistance: Email health@pandaclinic.ca for help with receipts or forms.

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