Intentionally deny claims
by Meg on Sep 15, 2026
1 out of 5 stars
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Their claims process is completely Kafka-esque. When they deny a claim, they dont even provide a reason and you have to mail or email them to get the reason. For my most recent problematic claim, they randomly denied a claim for my regular medication, and when I followed up with them, they said that they didnt have a "pharmacare number" on file. There is no such thing as a "pharmacare number" in BC, its a PHN (personal health number), which was on my original insurance application and never changes. After I resupplied my PHN, the next months claim went through but they refused to go back and fix the existing claim. They told me I had to go back to my pharmacist, request official receipts, then create a new claim for each individual medication. I did this and they denied the claim again, without explanation. For months now, every time we have an exchange, there is some nonsensical bureaucratic rule that means they feel they didnt need to pay. This is all despite them acknowledging the whole time that my claim is valid and should be paid out. Most recently, they said they denied my claim because I left the default option as "use benefits and then personal spending plan" and my personal spending balance was $0. But the medication is supposed to be completely covered under the standard benefits, so whether there is anything in my personal spending plan is completely irrelevant. They also claimed to have mailed me a cheque three weeks ago. I have not received a cheque.