MAKING A CLAIM (Claiming expenses that have incurred in Canada and in your Province of Residence)

Provincial Union / Rugby Canada Extended Medical Coverage Injury Reporting And Claims Process

To make an insurance claim after sustaining an injury prior to May 1st, 2023 but only within 365 days of said injury – please complete the following steps:
  1. Fully complete an injury report form
  2. Fully complete a witness report form
  3. Fully complete questions 1-5 on a medical expense claim form (or if dental have your dentist complete the dental statement of claim)
  4. Send a doctor note and/or prescription (or physician referral for treatment)
  5. Fully complete the authorization to disclose information form
  6. Invoices
  7. Explanation of Benefits from your primary insurance (if applicable)
  8. Email all of the above to injuryclaims@rugby.ca

Please note that all documents must be fully completed.  Documents that are not fully completed could lead to a delay in processing the claim. You must be covered under a Provincial Government Health Insurance Plan to be eligible for the Accident Medical Expense benefit.

*Only Provincial Unions and Clubs that have opted into the Accident Medical Expense Benefit will be eligible to submit a claim under this policy. For the 2022 Season this includes only members from Rugby Alberta, PEI Rugby, Rugby Nova Scotia and the Toronto Buccaneers and Sarnia Saints and BC Rugby for the 2022-2023 season*

General enquiries regarding making a claim can be sent to injuryclaims@rugby.ca.

Download Injury Report Form Click Here

Download Witness Report Form Click Here

Download Medical Expense Claim Form Click Here 

Download Dental Statement of Claim Form Click Here 

Download Authorization to Disclose Information Form Click Here

To make an insurance claim after sustaining an injury after May 1st, 2023, please complete the following steps:
  1. Fully complete an injury report form
  2. Fully complete a witness report form
  3. Fully complete the Accident Reimbursement Plan Form for claiming expenses that incurred in Canada and in your current Province of residence
  4. Send a doctor note and/or prescription (or physician referral for treatment)
  5. Invoices
  6. Explanation of Benefits from your primary insurance (if applicable)
  7. Email all of the above to injuryclaims@rugby.ca

Please note that all documents must be fully completed.  Documents that are not fully completed could lead to a delay in processing the claim. You must be covered under a Provincial Government Health Insurance Plan to be eligible for the Accident Medical Expense benefit.

*Only Provincial Unions and Clubs that have opted into the Accident Medical Expense Benefit will be eligible to submit a claim under this policy. For the 2023 Season this includes only members from Rugby Alberta & Rugby Nova Scotia and BC Rugby for the 2023-2024 Season*

Please see the Accident Medical Expense Benefit Executive Summary here.

General enquiries regarding making a claim can be sent to injuryclaims@rugby.ca.

Download Injury Report Form Click Here

Download Witness Report Form Click Here

Download Accident Reimbursement Plan Form (English) Click Here

Download Accident Reimbursement Plan Form (French) Click Here

TRAVEL MEDICAL PROCEDURE (Claiming expenses that have incurred outside of Canada or Province of Current Residence)

Travel Medical Process (tours)

Only sanctioned tours will be able to make a claim against the national insurance program. Players who have been cleared to play international can not be exposed to the National Insurance Program.

Registered Participants of Member Organizations have extensive travel coverage under the National Insurance Program. This coverage will apply while on sanctioned and approved tours for member organizations. It does not provide coverage for expenses incurred upon returning home to Canada/Province of Residence.

You must be covered under a Provincial Government Health Insurance Plan to be eligible for the travel medical policy.

Industrial Alliance provides 24/7 emergency/travel assistance. Members will be able to complete the following process if injury or sickness occurs:

  1. Call 911 or country emergency phone number for an ambulance (if necessary)
  2. Refer to Industrial Alliance Emergency Medical/Travel Assistance Card with dedicated phone and member number, call and begin the process (Download Emergency/Travel Assistance Card – Industrial Alliance)
  3. The travel assistance provider utilized by Industrial Alliance, called TuGo, will direct you as needed
  4. Coach, Manager, Parent, Volunteer or individual themselves will liaise with the travel assistance provider utilized by Industrial Alliance, called TuGo, who will advise what benefit payment options are available to the patient with respect to the potential medical expenses, tests or procedures related to their unique case. Payment options will vary from case to case depending on geographic location, provider policy and the patient’s medical issue
  5. The hospital or medical clinic will work with Industrial Alliance and the travel assistance provider, TuGo, to support the medical situation as it evolves
  6. The patient will receive treatment.
  7. Complete necessary paperwork (injury and witness reports and submit to Rugby Canada at injuryclaims@rugby.ca)
  8. Fully complete Out of Province/Country Form if submitting a claim upon returning home from tour for expenses that incurred on tour to Rugby Canada at injuryclaims@rugby.ca. Please include your Industrial Alliance claim number if a claim was opened through the Emergency/Travel Assistance

Download Injury Report Click Here

Download Witness Report Form Click Here

Download Out-of-Province/Country Form (English) Click Here

Download Out-of-Province/Country Form (French) Click Here