Please read these Terms carefully, as by using our Online Services, you are agreeing to them.
These Terms may change so we recommend you review them regularly.
If you disagree with these Terms, don't use our Online Services.
Certain Online Services have additional terms and conditions that apply to their use, which are
provided at registration.
You are granted a limited license to display the contents of the Online Services and you can print, download and use the materials on our Online Services only for informational and educational purposes, and for doing business with us.
You agree you won't directly or indirectly misuse our Online Services in any way, including by:
You’ll be responsible for and indemnify (reimburse) us for any costs, losses, expenses, damages, legal fees, liabilities, claims, demands, actions and settlement amounts resulting from or related to your misuse of our Online Services.
All products and services are subject to the terms and conditions of any applicable contracts
Our products and services and those of other companies described on our Online Services are available only where they are allowed to be offered within Canada.
No personalized or professional advice provided
Our Online Services aren’t intended to provide you with any personalized financial or any other
professional advice unless we specify.
Our Online Services are not intended to provide legal, accounting, tax, medical or other
professional advice unless we specify.
The applicable laws of Ontario and Canada govern the use of our Online Services. Any legal
actions arising out of the use of the Online Services must be started in Ontario.
Personal information is information that either on its own or combined with other information allows you to be identified. Examples include your name and address, as well as more sensitive information such as your health and banking information.
User authentication and access
In order to verify your identity when requesting access to the Online Services, the Online
Services may prompt you for certain personal information.
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 it necessary to receive additional personal information before accepting a transaction or transmission, or before granting access to an Online Service, you agree to provide such additional personal information. ClaimSecure may, at its sole discretion, alter, enhance, or amend the type and nature of the access information required to access any Online Service.
As an Online Service user, you are responsible for keeping all access information confidential and preventing its unauthorized use or disclosure. It is vital that you immediately notify the
ClaimSecure Customer Response Centre, 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 an Online Service may be occurring.
If you access an Online Service on behalf of another party, you confirm you are authorized to do so. You are responsible for, and you will indemnify (reimburse) us if the party you are acting on behalf of claims you were not authorized, or you submitted inaccurate information.
ClaimSecure will not be held responsible for any losses or damages which may be incurred by any person as a result of the use of access information that is not explicitly authorized by
ClaimSecure. This includes any direct, indirect, special, consequential or exemplary damages, even if ClaimSecure has been advised of the possibility, including but not limited to lost profits, lost opportunities or business revenues, loss of goodwill, or failure to realize expected savings.
ClaimSecure eProfile™ and benefits plans
If your association with your employer/plan sponsor terminates, you understand that your access to services previously provided by ClaimSecure and paid for by your employer/plan sponsor may change, subject to the terms and conditions imposed by your employer/plan sponsor and/or ClaimSecure. You may possibly be permitted to continue to use ClaimSecure eProfile to access services that you previously registered for and/or paid for.
ClaimSecure reserves the right to revoke or change the condition of your ClaimSecure eProfile account without notice.
Benefits Plans and Claims Submission
For the purposes of this section, the terms “Abuse,” “Fraud” and “Waste” 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 a benefit plan member or eligible dependent, benefit plan or otherwise, including payments for benefits or services that are not medically necessary, fail to meet the standard for healthcare or which were not (wholly or partially) eligible health benefits for the benefit plan.
In addition to these Terms generally, your use of your ClaimSecure eProfile account or the submission of online claims 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 or submitting an online claim, you agree to be bound by and comply with such rules and procedures.
As a user of an Online Service, and where you are a member of a benefit plan administered (wholly or partially) by ClaimSecure, you agree to submit to ClaimSecure only legitimate claims,
containing only true and complete information and that are absent of any Fraud, Waste or Abuse. Claims not adhering to these Terms generally or the immediately foregoing sentence specifically may be denied and your coverage may be terminated.
You certify that you are authorized to disclose and receive information about your spouse and/or dependents for the purposes of assessing and paying a benefit, if any. You acknowledge
that any reimbursement of the changes and explanation of such amounts paid will be provided to the benefit plan member.
ClaimSecure will conduct audits of claims submitted for purposes that include preventing and detecting Fraud, Waste and Abuse. ClaimSecure, and persons acting for ClaimSecure, may disclose information about claims, or any personal information contained in such claims, to employers/plan sponsors for the purposes of reporting Fraud, Waste and Abuse or suspicious claims. ClaimSecure, or persons acting on ClaimSecure’s behalf, may disclose information about claims to others without your knowledge or consent or the consent of the individual to whom the information relates, as permitted by law.
As a member of a benefit plan administered (wholly or partially by ClaimSecure), you are responsible for:
Banking information and direct deposit
By accessing the Online Services and by providing us with banking information, including financial institution number, transit number and bank account number, you represent and warrant that this information is accurate, complete and has been voluntarily supplied to us. ClaimSecure is not responsible for inaccurate or delayed payments resulting from incorrect banking information provided to us.
The timing of all direct deposit payments will be in accordance with the payment release schedules 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 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 is updated to reflect the correct and most up to date banking information. ClaimSecure is not responsible for missed payments to you or payments deposited into an incorrect bank account as a result of inaccurate information provided by you or the actions of third parties using your access information.
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: (a) access your ClaimSecure eProfile account; (b) contact the ClaimSecure Customer Response Centre as set out below; or (c) contact your bank to determine your accurate banking information.
ClaimSecure reserves the right to cancel or suspend your enrollment in direct deposit for any reason, including as a result of a Fraud, Waste and Abuse investigation.
Where required by law, including as a result of court order, legal proceeding or similar action, ClaimSecure may redirect payments owing to you to alternate bank accounts. In such circumstances, deposits into such alternate bank accounts represent full payment to you.
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 any direct deposit payment. Subsequent payments will be made by cheque.
Our Online Services, in whole or in part, may occasionally be unavailable because of maintenance, updates or other causes that may be beyond our control. Any or all of our Online
Services may change at any time without notice. ClaimSecure may suspend any Online Services for any reason.
Our Online Services were developed by ClaimSecure and are our property. All information and materials contained in our Online Services are protected by copyright, trademark and/or other intellectual property laws of Canada and other countries and are the property of their respective owner(s).
Subject to the limited license to use our Online Services, no one may copy, redistribute, reproduce or republish in any form, or link to our Online Services or its contents in any manner whatsoever, including by way of hyperlinks or framing, unless that person has obtained the prior written consent of ClaimSecure. Any infringement of the rights of ClaimSecure may result in legal action.
If there’s any difference between the information on our Online Services and the terms of a product or service, we or a third-party offer, the terms for that product or service prevail.
We always try to make sure our Online Services are working at their best, but we can’t guarantee you won’t experience errors, interruptions or browser issues.
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.
ClaimSecure may utilize third-party service providers to provide certain tools 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 Online Services, 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 Online Services are subject to all the terms and conditions set out on such third-party websites, and ClaimSecure is not responsible for any loss that results from such access or use.
We cannot guarantee that communication to or from our Online Services is private, confidential or secure. We don’t make and expressly disclaim any representations or warranties whatsoever relating to or arising from your use of our Online Services.
You agree neither ClaimSecure nor any third party (including their employees, officers and directors) shall be liable to you for loss of data, computer time or any loss or damage of any nature whatsoever attributable to your use or inability to use the Online Services for any reason whatsoever or to any action or inaction on the part of ClaimSecure.
This includes any direct, indirect, special, consequential or exemplary damages, even if ClaimSecure has been advised of the possibility, including but not limited to lost profits, lost opportunities or business revenues, loss of goodwill, or failure to realize expected savings.
This agreement is binding on you, your heirs, executors, administrators, legal representatives, successors and assigns.
If anything in this agreement turns out to be unenforceable or invalid, the rest of it still applies.
You may contact the ClaimSecure Customer Response Centre as follows:
© 2023 CLAIMSECURE INC. ALL RIGHTS RESERVED.