Active Care Management | Submit a Claim
Global Excel is a worldwide premium medical cost containment company, providing services to a broad range of market segments. Our partners trust our expertise in controlling healthcare costs for the management of their claims dollars as well as our ability to provide a superior member experience.
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Submit a
Claim

01

Start a claim

Select one of the following ways to start your claim:

Online

You can now easily submit your claim online. Click here to start.

Email or Phone

Email: [email protected]

Toll free from North America:
1-855-297-4371

Collect from anywhere outside North America:
1-519-251-1581

Our customer service agents will open your claim and a claims package will be sent to you by either email or standard mail, based on your preference.

02

Submit your forms

Return your completed claims forms and all documents related to your claim including invoices and receipts by one of the following:

Email

Scanned copies of all completed & signed claims forms and applicable attachments can be submitted to ACM by email to [email protected]

or

Online

You can now easily submit your forms online. Click here to start.

Standard Mail

All original forms, along with all documents noted above can be sent to our claims office:

Canadian Mailing Address
Active Care Management
P.O. Box 1237
Station A
Windsor, ON N9A 6P8

U.S.A. Mailing Address
Active Care Management
535 Griswold Ave.
Ste 111-605
Detroit, MI 48226

Please save copies of all original claim forms, receipts and supporting documentation. ACM reserves the right to request original documentation as needed to adjudicate your claim.

For help with completing your claim form, additional claim and language options or general inquiries, please contact the ACM Assistance Centre.

Need help?

Prefer to speak with us?
Call us at 1-855-297-4371.

Complete the sections on your forms as follows:

  1. Claimant information: Complete this section in full.
  2. Medical information: Complete either the injury or illness section, whichever is applicable to your claim.
  3. Other insurance coverage: Complete this section if you have additional or similar out-of-province travel insurance, through an employee, credit card, etc. If you do not have other insurance, indicate this by selecting the option ‘I do not have any other out of province medical insurance coverage.’
  4. Certification & Authorization: Complete and sign this section.
  5. Departure Date: For annual policy plans, attach proof of departure from your province of residence. The type of proof depends on whether you travelled by air or automobile. Any one of the following documents is acceptable:
    • Originals or copies of airline tickets/boarding passes
    • Original gas receipts
    • Original meal receipts
    • Letter from employer stating your last day of work
    • Copy of credit card statement showing purchases made in province of residence before and after your trip
    • Itinerary
    • Original hotel receipts
    • Original toll highway receipts
  6. Arrival Date: For Visitor to Canada travel policies attach proof of arrival into Canada. The types of acceptable proof depend on whether you travelled by air or automobile. Any one of the documents listed below are acceptable:
    • Originals or copies of airline tickets
    • Itinerary
    • Originals or copies of boarding passes
    • Original gas receipts
    • Original hotel receipts
    • Original duty-free shop receipts
    • Letter from employer stating your last day at work
    • Copy of your passport showing the date you arrived in Canada
  7. Documents to support your claim:
    • Original itemized bills and receipts. Be sure to keep a copy for your records.
    • Any and all medical records/certificates, etc., given at the time of treatment that include a diagnosis, such as:
      • A copy of the emergency room (ER) report
      • Clinical documentation or a letter from your treating physician
    • For hospitalization claims, we require a copy of your medical records from the treatment facility.
    • Any additional information relevant to your claim.
Policy Holder
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Member of the Global Excel family
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