Privacy

The collection and use of personal information is an important factor in our ability to provide health benefit plan management and administration services to clients and benefit plan members.

Generally, personal information that is provided to ClaimSecure is used to determine eligibility under various benefit plans, to adjudicate and process claims and to meet regulatory or contractual requirements. Personal information also includes records and data relating to the claims experience and history of benefit plan members.

We have established the following Privacy Guidelines to govern the actions of ClaimSecure, our employees, and our agents and subcontractors as they relate to the collection, use, retention and disclosure of personal information.

Information Collection and Retention

ClaimSecure will only collect personal information that is required to enable us to complete the services that we have been contracted to provide.

The length of time that we retain personal information may vary depending on the product or service that we have been contracted to provide. The retention of personal information for a specific length of time may be required by law. ClaimSecure will only retain personal information for as long as it is needed for the identified purposes or as required by law.

When personal information is utilized, retained or destroyed, ClaimSecure uses appropriate safeguards to prevent unauthorized parties from gaining access to the information.

An individual may, upon reasonable written notice, withdraw his/her permission to ClaimSecure to collect, use or disclose his/her personal information. ClaimSecure will comply with this request, subject to legal and contractual restrictions.

Sources of Personal Information

Most personal information is supplied to us by our client, the benefit plan sponsor, or by the benefit plan member directly. If additional personal information is required from any other source, we shall not request such information without notifying the benefit plan member.

Recording of Telephone Calls

ClaimSecure records telephone calls for quality assurance, training and conflict resolutions purposes. Recorded telephone calls will involve the collection of an individual’s personal information, and ClaimSecure will use, disclose, protect and retain such personal information in accordance with this privacy policy.

Security

The privacy and protection of personal information is extremely important to us. This information can take a number of forms, including paper or electronic records. In view of the nature, types, and forms of the personal information we receive, ClaimSecure has developed a series of security procedures to safeguard and protect personal information in our possession against, theft, unauthorized disclosure, and unauthorized use or modification. We will continue to maintain these safeguards and to upgrade our security procedures for personal information as required.

Internal Use of Personal Information

Each of ClaimSecure’s employees, agents, and subcontractors must abide by these Privacy Guidelines in handling of personal information of our clients and plan members. ClaimSecure employees, agents, and subcontractors will use personal information only in accordance with this Policy, our contractual rights and obligations, and the law.

We will do our best to base our decisions on accurate and up to date personal information. However, we rely on our clients, the benefit plan sponsor, and the benefit plan member to disclose all material information to us, and to inform us of any changes.

External Disclosure

Personal information will be accessible by or provided to those external third parties that have been granted access by the plan member, except as required by insurers or claims processors, medical or healthcare providers, or as required by statutory authority, legal process, contractual obligations or widely accepted and ethical business practice.

Claims Submission

ClaimSecure will process electronic health benefit claims that are submitted by healthcare providers on behalf of benefit plan members and eligible dependents.

ClaimSecure will process paper health benefit claims that are submitted by benefit plan members on approved, properly completed claim forms. These claim forms are available on our website.

By utilizing the ClaimSecure pay-direct card to authorize an electronic claim submission by a healthcare provider; by contacting ClaimSecure to obtain information regarding a benefit plan or a benefit plan claim; or by submitting a benefit claim to ClaimSecure, the claimant and benefit plan member authorize ClaimSecure, healthcare professionals (including but not limited to, pharmacists, dentists, physicians), insurance companies, administrators of government benefits or other benefit programs and other service providers inside and outside of Canada working with ClaimSecure to exchange and retain any necessary information regarding the claim, the claimant, and the benefit plan member for purposes of administering the health benefit plan.

Personal Access

Upon request, ClaimSecure shall make available to an eligible benefit plan participant the personal information maintained in our files relative to this individual, subject to any applicable legal or ethical prohibition or privilege. Personal medical information will only be made available through an appropriate healthcare professional.

Opportunity to Correct

Any individual has the opportunity to request that we correct or clarify personal information that we have retained for that individual. ClaimSecure shall correct or amend the individual’s information to the extent that the original information was incorrect.

Consent to the Terms of this Privacy Policy

By using the ClaimSecure website, products and services (collectively, the “Services”) and providing ClaimSecure with your personal information, you agree that ClaimSecure may collect your personal information, and you voluntarily consent to the collection, use, disclosure and transfer of your Personal Information in accordance with this privacy policy. If you do not agree with any terms of this privacy policy, please do not use the Services or provide ClaimSecure with any personal information. If you do not understand the nature, purpose and consequences of collecting, using and disclosing personal information to ClaimSecure, please do not use the Services or provide ClaimSecure with any personal information, and you may contact ClaimSecure at the contact information set forth below to address your questions and concerns.

Inquiry

A privacy-related inquiry may be made by contacting ClaimSecure’s Privacy Officer. The Privacy Officer will investigate all inquiries and complaints. If a complaint is justified, we will take appropriate steps to correct the situation, including changing our policies and procedures if necessary.

For more information, please contact ClaimSecure’s Privacy Officer by email at privacy@ClaimSecure.com or by mail at:

ClaimSecure Inc.
Privacy Officer
1 City Centre Drive, Suite 620
Mississauga, Ontario
L5B 1M2