Complaint Resolution

Step 1: Let us know

First, discuss your concerns with the person or department involved. Not sure who to talk to? Many issues can be resolved quickly and easily by speaking with a Member Experience representative. Contact us here.

Health or dental claim

Our Member Experience representatives will do their best to provide an explanation of the decision processes used within the rules established by your plan or policy. For more efficient service, please have your group or policy number and ID number available along with your Explanation of Benefits statement.

Life or disability claim

If your concern is related to a life or disability claim, your case manager can assist you.
Email: sbcdisabilityinquiry@sk.bluecross.ca

Emergency travel claim

If you are unsatisfied with the outcome of a travel claim, our travel assistance and claims management provider can help. For more information, please visit our Travel Assistance & Claims FAQ.

Privacy complaint

If your complaint involves a suspected privacy breach, please contact our chief privacy officer.
Email: privacyofficer@sk.bluecross.ca

Address:
516 2nd Avenue N, PO Box 4030
Saskatoon, SK S7K 3T2
Phone: 1-800-667-6853

Step 2: Speak with a specialist or supervisor

If the employee you initially spoke with is unable to resolve your concern to your satisfaction, ask to speak with a specialist or supervisor in that area.

Step 3: Still not satisfied?

If your concern is still not resolved after consulting with a specialist or supervisor, you may file a written complaint or appeal for review by the appropriate business manager or leader.

If you wish to appeal a claim refusal or reimbursement decision, your written request should be submitted within three months of the date of the initial claim decision. Please outline the basis for your appeal and provide any additional documentation in support of the claim that you would like considered. All written complaints or appeals will be carefully reviewed, and a written decision and explanation will be provided, in most cases within 30 days from receipt of the request and all supporting information. A claims appeal should be addressed as follows:

Attention: Appeals, Health and Dental Claims
or
Attention: Appeals, Life and Disability Claims
516 2nd Avenue N, PO Box 4030
Saskatoon, SK S7K 3T2

At all times throughout the complaint handling process, with any questions or comments relating to the process, product or service, you may contact our complaints officer at:

Complaints Officer
Email: SBCcompliance@sk.bluecross.ca
Address:
516 2nd Avenue N, PO Box 4030
Saskatoon, SK S7K 3T2
Phone: 1-800-667-6853

Step 4: External recourse

The OmbudService for Life & Health Insurance (OLHI) deals with concerns about life and health insurance products and services that have not been resolved through the Saskatchewan Blue Cross dispute resolution process. OLHI may accept your case for review if, after receiving our final response, you would like to pursue the matter further, or if you have not received our final response within a reasonable time. OLHI has a set of criteria under which they will accept an application. Please refer to their website for further information.

OmbudService for Life & Health Insurance (OLHI)
401 Bay Street, Suite 1507
P.O. Box 7 Toronto, Ontario
M5H 2Y4
Toll-free telephone number: 1-888-295-8112
Website: www.olhi.ca