Concern and resolution process

Alberta Blue Cross is part of the Canadian Life and Health Insurance Association (CLHIA), a voluntary trade association which represents the collective interests of its member life and health insurers. All member organizations have undertaken to adhere to the Consumer Code of Ethics as a condition of membership.

This Code focuses on fair treatment of consumers through:

  • A competitive marketplace
  • Clear and straightforward advertising
  • Competent sales and services
  • Respecting the privacy of consumers

When plan members have questions or concerns about the products and services Alberta Blue Cross provides, we do our best to provide an explanation of the decision processes used within the rules established by the relevant plan or policy guidelines and rules.

Government programs

If you have a concern regarding a decision or service related to a government program administered by Alberta Blue Cross, please contact Customer Services to be referred to the appropriate area for assistance.

For more efficient service, please have your group/policy number and ID number available.

Telephone:

Edmonton and area 780-498-8000
Toll-free 1-800-661-6995
Office hours Monday to Friday
8:30 a.m. to 5 p.m. Mountain Time

Mail:

Alberta Blue Cross Attn: Customer Services
Blue Cross Place
10009 108 Street
Edmonton, AB T5J 3C5

Email: Please note that regular email is not a secure method of communication or transmission of personal information. To send us a secure message, please use this form.

Individual health plans or employer group sponsored benefit plans

If you have a concern regarding a decision or service related to your Alberta Blue Cross individual health plan or employer group sponsored benefit plan, you may have the situation reviewed by following the steps listed below:

Step 1 – Bring it to our attention

Please discuss your concern with a representative in Customer Services. Often questions can be answered quickly and concerns can be resolved at this point.

For more efficient service, please have your group/policy number and ID number available.

Telephone:

Edmonton and area 780-498-8000
Toll-free 1-800-661-6995
Office hours Monday to Friday
8:30 a.m. to 5 p.m. Mountain Time

Mail:

Alberta Blue Cross Attn: Customer Services
Blue Cross Place
10009 108 Street
Edmonton, AB T5J 3C5

Email: Please note that regular email is not a secure method of communication or transmission of personal information. To send us a secure message, please use this form.

Step 2 – Contact the Alberta Blue Cross Complaints Officer

If you are unable to resolve your concern through the assistance of a customer service representative, you can escalate your request to the Alberta Blue Cross Complaints Officer.

Mail: Complaints Officer, Fifth Floor, Alberta Blue Cross, 10009 108 Street, Edmonton, AB, T5J 3C5

Email: complaintsofficer@ab.bluecross.ca You can request a telephone call with the Complaints Officer to discuss your concern or receive a status update but please note that regular email is not a secure method of transmission of personal information and therefore the Complaints Officer will not be able to exchange personal information through this form of communication.

Fax: 780-425-4627 Attn: Complaint Officer

The Complaints Officer will not review complaints that have not been through Step 1. When contacting the Complaints Officer, you will need to provide the details of how your concern was dealt with in Step 1 and why you disagree with the outcome.

In the course of our investigation, the Complaints Officer may:

  • Contact you to clarify information you have already provided
  • Contact you to request additional information in writing
  • Share your complaint and supporting documentation with the relevant internal parties related to the initial concern and subsequent interactions
  • Request additional information from other parties involved
  • Provide you with updates throughout the complaint handling process
  • Advise you of any action we will be taking

After the Complaint Officer review, you will receive a written response, usually within 30 days of receiving the formal request and the receipt of all supporting information. If this deadline cannot be met, you will contacted to you know the status of the review and what is being done.

Step 3 – Not satisfied with the decision?

If you remain dissatisfied with the outcome of the Alberta Blue Cross complaint resolution process, a final option is available to you through a neutral, external party.

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 Alberta Blue Cross dispute resolution system. 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 in a reasonable time period. 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 (Canada wide)
Website: www.olhi.ca

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