DSAI Features and Benefits
Overview
- Mandatory participation per employee classification
- No medical questionnaire, no medical underwriting or evidence of insurability required
- Employees are eligible to age 74 with optional spouse and children coverage
- Pre-existing conditions are covered after two years
- Payments are made directly to the service provider
- Lifetime benefit maximum of $1,000,000
- Affordable monthly premiums payable in Canadian dollars
Details
Covered Benefits and Services
1. Diagnostic Procedures: If approved by the DSAI Claims Department, Medically Necessary Diagnostic Procedures related to conditions or treatment not otherwise limited or excluded under the policy. Covered Diagnostic Procedures are limited to the following:
- Magnetic Resonance Imaging (MRI)
- Computerized Axial Tomography (CAT or CT scans)
2. Medical Referrals: Once a procedure for an Insured Person has been approved by Us, the DSAI Claims Department will schedule appointments, coordinate the Diagnostic Procedure and make any travel arrangements if necessary.
Requests for a specific Medical Clinic or Physician may be considered and must be approved in
advance by Us.
3. Transportation: Transportation costs incurred by an Insured Person while travelling to and from the approved diagnostic facility will be reimbursed upon completion of an authorized Diagnostic Procedure or medical referral.
This benefit is calculated by measuring the round-trip travel distance from the Insured Person’s
Canadian Residence to the approved diagnostic facility according to the most recent Rand McNally
geographical data available to Us. The maximum benefit per Diagnostic Procedure or medical
referral is calculated at the rate of $.25 per mile up to a maximum benefit of $500.00 per Occurrence.
LIMITED SPECIALIST COVERAGE BENEFIT
If an Insured Person is referred by their general practitioner (G.P.) to a specialist Physician for assessment while insured under this benefit and the specialist Physician confirms that the assessment cannot be provided within 21 consecutive days of the referral by the G.P., the policy will pay benefits for the cost of an assessment by a specialist Physician approved by Us, subject to the following:
(a) the referral by the G.P. is to a specialist Physician in one of the following medical specialties:
Cardiology, Ear, Nose and Throat, Gastroenterology, General Surgery, Neurology, Ophthalmology,
Orthopedics, Rheumatology, Spine Team, and Urology;
(b) the assessment is for the purpose of determining a condition which may result in a diagnostic test.
DSAI Claims Department will make the first available appointment with the appropriate specialist Physician at the geographical location closest to the Insured Person and make every effort to schedule the special Physician assessment within 21 days from the referral by the G.P. and/or approval of the request.
Travel expenses to the specialist Physician approved by Us are not included under this benefit.
For an Insured Person, the Limited Specialist Coverage Benefit provides for a maximum of two
assessments per Insured Person per Coverage Period. Each assessment includes an initial and follow-up consultation.
For full details, download a copy of the