THE CLAIMSECURE WEBSITES
Effective date: November 30th, 2020
- USE OF THE CLAIMSECURE WEBSITE
The ClaimSecure and the ValueHealth Programs and associated websites and services available at claimsecure.com, securindemnite.com, valueHealth.ca and valeur-sante.ca (collectively referred to as the “ClaimSecure Websites”), administered by ClaimSecure Inc. (“ClaimSecure”), is for your personal use and information. Use of the ClaimSecure Websites is subject to the following Terms and applicable laws. By accessing and using the ClaimSecure Websites, you accept the Terms, without limitation or qualification. If you do not agree with any of the Terms, please do not access or use the ClaimSecure Websites. You are responsible to ensure that your access to the ClaimSecure Websites and material available therein are legal in each jurisdiction in which you download or use the ClaimSecure Websites or such material. Not all products and services may be available in all geographic regions. Nothing on the ClaimSecure Websites shall be interpreted as constituting an offer to buy or sell products or services. All products and services shall be subject to the terms and conditions of any applicable agreements.
- CLAIMSECURE ePROFILE™
Your enrollment in ClaimSecure eProfile™ means that you have given us consent to use your Personal Information in accordance with the terms of our Privacy Notice https://www.claimsecure.com/privacy/.
Your use of your ClaimSecure eProfile™ account is subject to ClaimSecure’s rules and procedures, as may be amended from time to time by ClaimSecure. By accessing and using your ClaimSecure eProfile™ account, you agree to be bound by and comply with such rules and procedures. If your association with your employer and/or benefits provider terminates, you understand that your access to services previously provided and paid for by your employer and/or benefits provider may change subject to the terms and conditions with your employer and/or benefits provider. You can continue to use eProfileTM to access services that you have registered and/or paid for.
As a user of the ClaimSecure Websites, you agree to submit to ClaimSecure only legitimate claims absent of any Fraud, Waste and Abuse. ClaimSecure reserves the right to investigate any claims or transactions submitted for processing if ClaimSecure suspects any Fraud, Waste or Abuse. Fraud, Waste and Abuse are defined as:
"Abuse" means practices, services or actions that, although not Fraud, are inconsistent with sound medical, professional or business practice which result in unnecessary costs to the employee or eligible dependent, benefit plan or otherwise, and payments for services that are not medically necessary or which fail to meet the standard for healthcare.
"Fraud" means an intentional act of deception, misrepresentation or concealment in order to gain something of value, including, for example, submitting claims for services not rendered, submitting claims for services at a higher rate than the actual provider costs, deliberately misrepresenting services, resulting in improper or overpayments to providers or benefit members.
"Waste" means an overutilization of healthcare services that, although not fraud and not the result of criminal action, might directly or indirectly result in unnecessary costs to the benefit plan, including, for example, waste arising from billing and payment errors
ClaimSecure reserves the right to revoke or change the condition of your ClaimSecure eProfile™ account without notice. ClaimSecure also reserves the right to cancel all direct deposit rights in the event that ClaimSecure receives a court order, a legal proceeding or other similar action requiring ClaimSecure to redirect such payment to satisfy such court order, legal proceeding or similar action or as a result of a Fraud, Waste and Abuse investigation.
- USER AUTHENTICATION
In order to verify your identity when requesting access to the ClaimSecure Websites, the ClaimSecure Websites may prompt you for certain Personal Information, in accordance with our Privacy Notice: https://www.claimsecure.com/privacy/. If the Personal Information entered is confirmed, access will be granted. You agree that the use of this electronic authentication procedure is equivalent legally to your written signature.
Should ClaimSecure, in its sole discretion, deem necessary to receive additional Personal Information before accepting a transaction or transmission, or before granting access to the ClaimSecure Websites, you agree to provide such additional Personal Information.
ClaimSecure reserves the right to restrict or cancel the access of any user to the ClaimSecure Websites. ClaimSecure may, at its sole discretion, alter, enhance, or amend the type and nature of the access information required to access the ClaimSecure Websites.
As a ClaimSecure Websites user, you are responsible for keeping all access information confidential and to prevent its unauthorized use or disclosure. To prevent unauthorized access of your ClaimSecure eProfile™ account, it is vital that you immediately notify the ClaimSecure Customer Response Centre as set out below if you become aware that any or all of your access information has been disclosed to anyone else, obtained by anyone else, or may be known by anyone else, or that any unauthorized use of the ClaimSecure Websites may be occurring.
ClaimSecure will not be held responsible for any loss or damages which may be incurred by any person as a result of the unauthorized use of access information.
- USE AND OWNERSHIP OF BANKING INFORMATION
By accessing the ClaimSecure Websites and by providing us with banking information, including financial institution number, transit number and bank account number, you represent and warrant that this information has been voluntarily supplied to ClaimSecure. ClaimSecure is not responsible for inaccurate or delayed payments resulting from incorrect banking information provided to us. The supplied banking information is considered to be owned by the intended recipient of the health benefit claim payments.
ClaimSecure will keep all banking information in accordance with its Privacy Notice: https://www.claimsecure.com/privacy/.
- CONDITIONS OF USE OF DIRECT DEPOSIT
Direct deposit is offered by ClaimSecure for your convenience. By enrolling for direct deposit, you expressly agree to have all payments resulting from an approved adjudicated claim paid electronically into your designated bank account.
All direct deposit payments will be made in accordance with the approved adjudicated amount for health benefit claims either submitted by yourself or processed on your behalf and in line with the payment release schedules to be determined by ClaimSecure in its sole discretion from time to time.
If you elect to be paid by direct deposit, no explanation of benefits will be mailed to you. You may view or print your payment details by logging on to your ClaimSecure eProfile™ account. You will be sent an email communication to the email address on your ClaimSecure eProfile™ account that will advise you that a benefit claim/s direct deposit payment has taken place, or that we encountered difficulties in completing a direct deposit payment to you. It is your responsibility to ensure that these email communications are received and reviewed in a timely fashion.
Your correct banking information is required to successfully transfer funds to your designated bank account. If your banking information changes, it is your responsibility to ensure that your ClaimSecure eProfile™ account has been updated to reflect the correct and most up to date banking details. Any overpayments made to you must be returned to ClaimSecure immediately and ClaimSecure reserves the right to set-off any amounts owed to ClaimSecure from the amounts of any future claims owed to you.
In order to protect the security of your personal banking information, we cannot alter your banking information or enroll you in the direct deposit program. If you require additional assistance, you can: (1) Access your ClaimSecure eProfile™ account; or (2) Contact the ClaimSecure Customer Response Centre as set out below; or (3) Contact your bank to determine your accurate banking information.
- OPTING OUT OF DIRECT DEPOSIT
If you elect to change your payment method from direct deposit to cheque, the cheque will be sent to the mailing address that you have provided.
Any previous unsuccessful payments made by direct deposit cannot be completed by cheque. You must correct your banking information in order to allow us to reprocess the direct deposit payment. Subsequent payments will be made by cheque.
- EXCLUSION OF WARRANTIES
ClaimSecure, its affiliated or related companies, its licensors, joint venture partners, agents or subcontractors, officers, directors, or employees, as well as any other person associated with the creation or maintenance of the ClaimSecure Websites (collectively the “ClaimSecure Parties”), make no representation or warranty regarding the functionality, condition or suitability for use of the ClaimSecure Websites. ALL MATERIAL OR INFORMATION ON THE CLAIMSECURE WEBSITES IS PROVIDED TO YOU "AS IS" WITHOUT WARRANTIES OF ANY KIND. THE CLAIMSECURE PARTIES DISCLAIM ALL WARRANTIES OR CONDITIONS, WRITTEN OR ORAL, STATUTORY, EXPRESS OR IMPLIED, INCLUDING WITHOUT LIMITATION, WARRANTIES OR CONDITIONS OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. These exclusions are in addition to any specific exclusion otherwise provided in these Terms.
- LIMITATION OF LIABILITY
THE CLAIMSECURE PARTIES WILL NOT BE LIABLE FOR ANY DAMAGES, EITHER DIRECT OR INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL, FOR USE OF OR INABILITY TO USE MATERIAL, PRODUCTS OR SERVICES OF ANY KIND, DELAY OF OR PARTIAL DELIVERY, TERMINATION OF RIGHTS OR LOSS OF PROFITS, DATA, BUSINESS OR GOODWILL, WHETHER ON A CONTRACTUAL OR EXTRACONTRACTUAL BASIS, OR TO PROVIDE INDEMNIFICATION OR ANY OTHER REMEDY TO YOU OR ANY THIRD PARTY. YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE USING AND ACCESSING THE CLAIMSECURE WEBSITES.
- ACCURACY OF INFORMATION
Although ClaimSecure endeavours to include accurate and up-to-date information on the ClaimSecure Websites, it makes no warranties or representations as to the accuracy or currency of information presented on the ClaimSecure Websites. ClaimSecure shall not be held responsible for any action taken that is based on the information presented on the ClaimSecure Websites, and you agree that all use of the ClaimSecure Websites, its content, or its services, is solely at your own risk.
The ClaimSecure Websites do not, and are not intended to, provide you with any financial, insurance, legal, healthcare or medical advice. The ClaimSecure Websites shall not be used, or relied upon by you, as a substitute for your own independent research or for appropriate advice provided to you by a qualified third-party professional advisor.
Links and references to other websites are provided as a convenience only. ClaimSecure does not expressly or implicitly endorse other websites or any informational content or material, or the accessibility thereof, via such links, and does not assume any responsibility for any such other websites, their content, or products or services offered thereon. ClaimSecure does not make any representations or warranties as to the security of any information, including personal information that you might be requested to give any third party.
Some third-party websites may provide access to the ClaimSecure Websites by hypertext links. These third-party websites are completely independent of the ClaimSecure Websites, and any direction by a third party to the ClaimSecure Websites shall not, in any manner whatsoever be construed as an endorsement by ClaimSecure of such third party's website, products, or services.
ClaimSecure may utilize third-party service providers to provide certain tools and/or programs, some of which may be housed on a third-party server or at a website which has been independently developed by others. While accessing the ClaimSecure Websites, you may be linked to such other third-party servers. Access to these other websites or the use of any third-party tools or programs on the ClaimSecure Websites are subject to all the terms and conditions set out on such third party websites.
- VIRUSES, ETC.
ClaimSecure does not represent or warrant that the services, information or materials accessed on the ClaimSecure Websites will be uninterrupted or free of errors, defects, viruses or other harmful components, or that any such problems which are discovered will be corrected.
- DAMAGE TO OTHERS
You agree not to introduce into or through the ClaimSecure Websites any information or materials which may be harmful to others. Among other things, you agree not to include, knowingly or otherwise, any error or defect in material or information which may, among other things, be false, fraudulent, libelous, slanderous, defamatory or obscene, promote hatred, or otherwise give rise to a criminal offence or civil liability on the part of any person or entity.
- RESERVATION OF RIGHTS
All rights not expressly granted in these Terms are reserved to ClaimSecure. Nothing contained in these Terms shall be construed as conferring by implication, estoppel or otherwise any license or right under any copyright, patent, trade-mark or other intellectual right of ClaimSecure or any other person or entity.
- CHANGES TO TERMS
ClaimSecure may revise these Term from time to time by updating the Terms without notice, and you agree to be bound by the then current Terms when you access the ClaimSecure Websites.
The ClaimSecure Websites are administered by ClaimSecure from Ontario, Canada. ClaimSecure makes no representation that materials on the ClaimSecure Websites are appropriate or available for use in other locations. The Terms are governed by Ontario law and the applicable laws of Canada therein without reference to principles of conflict of laws. You agree to be bound by such laws and to submit to the jurisdiction of the courts of Ontario, regarding the use of the ClaimSecure Websites or the interpretation or application of the Terms.
- COPYRIGHT INFORMATION
The information on the ClaimSecure Websites is protected by copyright. Any infringement of ClaimSecure’s rights may result in appropriate legal action. Users of the ClaimSecure Websites shall be entitled to copy information contained on the ClaimSecure Websites solely for their own non-commercial personal use, but may not republish, copy or reproduce any part without the prior written permission of ClaimSecure. For purposes of this section, republishing, copying and reproducing includes any uploading, downloading or transferring the information on the ClaimSecure Websites onto the Internet or any other local or international computer system. An acknowledgement of the source must be included whenever our materials are copied or published.
The trade-marks and logos displayed on the ClaimSecure Websites, and those used on or in the products and services that we provide are owned by ClaimSecure, its affiliated companies, licensors or the indicated third party. Permission to use any such trade-marks or logos must be granted via written consent by ClaimSecure, its affiliates, licensors or the relevant third party.
ClaimSecure and its affiliated companies disclaim any and all liabilities which may result from any unauthorized reproduction or use of the information contained in the ClaimSecure Websites.
If you require further information on the uses that you may make of the information on the ClaimSecure Websites; or if you wish to obtain permission to reproduce, copy or republish any information contained in the ClaimSecure Websites, please send such requests in writing to:
1 City Centre Drive, Suite 620
Mississauga, Ont. L5B 1M2
- TRADEMARK INFORMATION
The following are trademarks and service marks owned by ClaimSecure Inc. or its affiliates. These marks have either been registered or are pending registration.
- HR 2nd Opinion
- Rx ClaimStat
- Rx Healthnet
- Rx Info
- Rx Update
- RxPlus & Design
- SecurePak & Design
- Wellness Rewards
- SURVIVAL & SEVERABILITY
These Terms apply while you are accessing the ClaimSecure Websites and remain in effect thereafter, subject to section 14. In the event the ClaimSecure Websites are no longer accessible to you, the provisions set out in section 7, 8, 15 and 17 of these Terms shall survive thereafter. If any provision of the Terms is prohibited by or invalid under applicable law, such provision shall be ineffective to the extent of such prohibition or invalidity without invalidating the remainder of such provision or the remaining Terms.
- CONTACT INFORMATION
You may contact the ClaimSecure Customer Response Centre as follows:
- By telephone 1-888-513-4464
- By email at firstname.lastname@example.org
- By regular mail:
1 City Centre Drive, Suite 620
Mississauga, Ont. L5B 1M2
© 2020 CLAIMSECURE INC. ALL RIGHTS RESERVED.