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Canadian Athlete Insurance Program (CAIP)

The Canadian Athlete Insurance Program (CAIP), provided by SSQ Insurance and facilitated by M Kirsch Financial Services, has become well recognized in providing the most comprehensive insurance protection for sport accident and overuse injuries to Canada’s athletes while “In Canada” and “Outside Canada”.

The Canadian Athlete Insurance Program (CAIP), provided by SSQ Insurance and facilitated by M Kirsch Financial Services, has become well recognized in providing the most comprehensive insurance protection for sport accident and overuse injuries to Canada’s athletes while “In Canada” and “Outside Canada”.

Wrestling Canada Lutte subscribes to both “In Canada” and “Outside Canada” coverage for National Team athletes. Athletes have individualized renewal dates for a one year enrollment period (one full calendar year), based on the first enrollment date in the program. At the completion of the one year period, coverage limits may be reset based on athlete status and access to services may begin again.

Please email Scott Vass directly for information on your individual start-finish dates for the year.

Information regarding CAIP is outlined below, including: coverage limits, links to accidental medical and dental forms and how to properly utilize the service. The limits detailed below are for one calendar year.

More detailed information and all forms can be found on the CAIP website.

What does CAIP cover?
With bronze coverage, you are eligible for the following coverage:

(a) Overuse Injury Treatment:
Physio/AT/Massage: $500
Chiropractic: $500

Orthotics: $150

(b) Accidental Dental Coverage:

– In the case of an accidental blow to the mouth during practice or competition the insurance will cover up to $1,500 in dental expenses. (chipped tooth, knocked out tooth, etc)

– will NOT cover regular cleaning or check-ups


(c) Significant Injury Coverage

in case of significant injury (ie, broken bone, all rupture, etc) CAIP will cover additional costs such as braces, lab exams (ie. MRI), etc
– contact Scott Vass if you have a significant injury and he will assist you with this.
1. Overuse Insurance: Physiotherapy, Chiropractic and Orthotics
What is ‘Overuse Injury Treatment’?
Overuse injury treatment relates to treatment involving minor injuries or overuse muscular soreness or joint pain.  This could include: massage therapy, physiotherapy/athletic therapy or chiropractic treatments.
CAIP will reimburse you up to $50 per treatment.  Before you receive treatment you will have to fill out the following form and get it signed by a physio/AT or doctor:

https://mkirsch.ca/wp-content/uploads/2016/09/Proof-of-Loss-Overuse-Injuries-1.pdf

Submitting a claim using the ‘Proof of Loss – Accidental Medical’ Form:

1. Print and fill out ‘Proof of Loss – Overuse Injuries’ form:
(a) Athlete Section – to be filled out and signed by athlete
(b) Sport Body Authorization Section – to be filled out and signed by coach
(c) Attending Physician Section
– For physio, AT or massage: this section can be filled out by a physiotherapist or AT; have them call it an ‘overuse injury’
– For Chiropractic treatment: this section MUST be filled out by a doctor; have the doctor note the injury and number of sessions needed  (generally have them put 10 or more)
2. Pay for treatment.  Make sure you receive a copy of the receipt.
3. Submit form and receipt to CAIP for reimbursement
– Form only needs to be filled out once per year
– WCL recommends filling out and also submitting a ‘Direct Deposit Authorization’ request at the same time as they will deposit the money into your account and you will receive it a lot faster:
Options for submitting claims:
(i) Email:  You can scan the completed claim form together with receipts and send by e-mail to one of the following addresses:
– ensure that the scan of the claim form and receipts is clear and easily readable.
(ii) FAX:  You can send the completed claim form together with the receipts by Fax to 1-855-690-9895
(iii) Mail: You can send the completed claim form together with the receipts by mail to:
SSQ Insurance Company
1225 St-Charles Street West Suite 200
 Longueuil, Québec
J4K 0B9
4. Receipts for subsequent treatments :
– Email, fax or mail a copy of the receipt to the company along with the following information
– In the email or letter include:
Name
Complete address
Phone Number
Email Address


Notes on using ‘Overuse Insurance’:

  1. Only one claim form needs to be submitted per calendar year.  Once you have submitted one claim form for the year, you can continue to send in receipts without having to have multiple forms filled out.
  2. If you are submitting for chiropractic therapy or orthotics, the ‘Attending Physician Statement’ MUST be filled out by a physician.  If you are just submitting for physio or massage, this section can be filled out by a physiotherapist or athletic therapist.

Proof of Loss Form:  Accidental Medical Sports Insurance (Massage/Physio/Orthotics)

2. Accidental Medical Insurance – MRI and Braces

In the case of a traumatic injury, other services such as hospital charges, prescription drugs, medical equipment (braces, etc.) and other paramedical services may be covered or partially covered.  Please contact Scott Vass directly if more information is needed or read pages 4 and 5 of the ‘Insurance Policy – In Canada’ document on the CAIP website.

The two most common claims by our athletes are for (1) private MRI and (2) post-surgical bracing.  For bronze coverage, medical imagining (MRI, CAT/Bone scan, x-ray, etc) is covered to a maximum of $500 and braces are covered to a maximum of $1,000.  In both of these cases, a ‘Proof of Loss – Accidental Medical’ Form should be submitted following the steps in the ‘Overuse Insurance’ section.  However, the ‘Attending Physician’ section can only be filled out by a medical doctor and must clearly state the nature of the injury and the specific need for the scans and/or bracing.

3. Accidental Dental Insurance

In the case of an accidental blow to the mouth during practice or competition the insurance will cover up to $1,500 in dental expenses.


Submitting a claim using the ‘Proof of Loss – Accidental Dental’ Form:

  1. Athlete fills out and signs the ‘Claimant Section’
  2. Coach fills out and signs ’Sport Body Authorization Section’
  3. Dentist fills out and signs Part 1 & Part 2 of the dentist report on back of page.
  4. Athlete pays for service rendered.
  5. Athlete sends in receipt(s) and claim form to SSQ Insurance address on top right of form OR claims can be scanned and submitted electronically to: [email protected]

Proof of Loss Form:  Accidental Dental Claim

4. Out of Canada Insurance

Out of Canada insurance is 24 hours a day insurance protection for emergency medical and hospital care, emergency dental treatment, evacuation, repatriation and family transportation & accommodation benefits as the result of an injury or sickness.

Outside Canada coverage also includes The Travel Assistance Program, which provides international emergency assistance to CAIP members when travelling outside Canada.

The medical card should be carried by all athletes when travelling outside of Canada.

Other important points
  • Please do not wait to submit claims to SSQ Insurance Company.  They would prefer if you can to submit the completed claim form together with the receipts within 90 days from the date of accident / overuse injury or the date you received the first treatment for your injury.
  • If there are additional receipts relating to the same claim, the claim form does not have to be completed again.  You can simply send the subsequent receipts to SSQ Insurance Company with a covering letter noting all your contact information.  This will allow the insurance company to easily locate your file and process your claim in a timely manner.  You can use the attached (Additional Receipt Letter) form if you wish.
  • At some point, the claims adjuster may ask for an updated claim form.  The claims adjuster will advise.
  • Please try to keep copies of the claim form and receipts before submitting to SSQ Insurance Company.
  • Please note that the “Consent to collect, use and disclose personal information form” may be required by the claims adjuster to obtain personal information for a particular claim.  The claims adjuster will advise if this form is needed.
  • DIRECT DEPOSIT:  You can receive your payment by direct deposit, otherwise payment will be mailed to you via cheque. In order to take advantage of this you will need the following:
    • The original of the ‘Direct Deposit Form’ completed and signed
    • Copy of your cheque marked ‘VOID’
    • Both sent with the claim form and receipts to SSQ by mail
  • PAYMENT DIRECTLY TO WRESTLING CANADA LUTTE: There may be instances where Wrestling Canada Lutte needs to pay your invoices for you.  In this situation you will be required to furnish SSQ Insurance with a “Letter of Authorization” allowing them to reimburse Wrestling Canada Lutte directly to recoup expenses.
  • More information on how to make claims and receive reimbursement can be found here: http://mkirsch.ca/claims/

If you have any questions about using CAIP, please contact:

Scott Vass MHK, RK, CSCS
Integrated Support Team Coordinator
Cell: (778) 385-2540
Email: [email protected]