{"id":29191,"date":"2025-07-11T05:10:34","date_gmt":"2025-07-11T05:10:34","guid":{"rendered":"https:\/\/aqtn.ca\/questions\/?p=29191"},"modified":"2025-07-04T20:53:51","modified_gmt":"2025-07-04T20:53:51","slug":"reclammations-assurances-insurance-claim","status":"publish","type":"post","link":"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/","title":{"rendered":"Que faire si une compagnie d\u2019assurance refuse une r\u00e9clammation par erreur"},"content":{"rendered":"<h2 style=\"background-color: #dfe8c5; color: #371d1a; padding: 20px; border: 2px solid #095f83; text-align: center;\">QUE FAIRE SI UNE COMPAGNIE D\u2019ASSURANCE REFUSE UNE R\u00c9CLAMATION<\/h2>\n<p style=\"text-align: justify;\">Lorsqu\u2019un membre de l\u2019association qu\u00e9b\u00e9coise des th\u00e9rapeutes naturels, qu\u2019il soit massoth\u00e9rapeute ou naturopathe, fait face \u00e0 un refus de r\u00e9clamation par une compagnie d\u2019assurance, cela peut \u00eatre une exp\u00e9rience stressante. Quoique l&#8217;association est reconnue par essentiellement tous les assureurs au Canada, ce n&#8217;est pas tous les assureurs qui reconnaissant la naturoth\u00e9rapie ou encore qui ont la couverture dans leur police d&#8217;assurance. De plus, certains assureurs maintiennent des listes de fournisseurs exlcus &#8211; et cette liste est dynamique. <strong>Voici donc un guide \u00e9tape par \u00e9tape pour vous aider \u00e0 g\u00e9rer la situation de mani\u00e8re efficace :<\/strong><\/p>\n<div class=\"su-row\">\n<div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\">\n<h2 style=\"background-color: #9d5644; color: #ffffff; padding: 10px;\"><img data-recalc-dims=\"1\" decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-29211\" style=\"display: inline;\" src=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-review.png?resize=32%2C35&#038;ssl=1\" alt=\"insurance review\" width=\"32\" height=\"35\" srcset=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-review.png?w=348&amp;ssl=1 348w, https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-review.png?resize=278%2C300&amp;ssl=1 278w\" sizes=\"auto, (max-width: 32px) 100vw, 32px\" \/> 1. REVOIR LES D\u00c9TAILS DE LA R\u00c9CLAMATION<\/h2>\n<p style=\"text-align: justify;\">Commencez par examiner attentivement la r\u00e9clamation ainsi que la raison invoqu\u00e9e par la compagnie d\u2019assurance pour justifier le refus. Parfois, il peut simplement s\u2019agir d\u2019une erreur administrative ou d\u2019un renseignement manquant. V\u00e9rifiez que toute la documentation et tous les d\u00e9tails sont exacts. Il y aura toujours une raison indiqu\u00e9e sur le relev\u00e9 des prestations (EOB \u2013 \u00ab Explanation of Benefits \u00bb). Ce document est g\u00e9n\u00e9ralement transmis par voie \u00e9lectronique via le portail de la compagnie d\u2019assurance, ou sous forme papier si l\u2019assur\u00e9 a choisi de recevoir ses relev\u00e9s par la poste.<\/p>\n<\/div><\/div>\n<div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\">\n<h2 style=\"background-color: #5c818c; color: #ffffff; padding: 10px;\"><img data-recalc-dims=\"1\" decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-29209\" style=\"display: inline;\" src=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-phone.png?resize=35%2C35&#038;ssl=1\" alt=\"insurance phone\" width=\"35\" height=\"35\" srcset=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-phone.png?w=271&amp;ssl=1 271w, https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-phone.png?resize=150%2C150&amp;ssl=1 150w\" sizes=\"auto, (max-width: 35px) 100vw, 35px\" \/> 2. CONTACTER LA COMPAGNIE D\u2019ASSURANCE<\/h2>\n<p style=\"text-align: justify;\">Communiquez avec le service \u00e0 la client\u00e8le de la compagnie d\u2019assurance pour discuter du refus. Demandez une explication d\u00e9taill\u00e9e et faites clarifier tout \u00e9l\u00e9ment qui vous semble ambigu. La plupart du temps, un simple appel t\u00e9l\u00e9phonique permet de r\u00e9gler les probl\u00e8mes mineurs rapidement, il s&#8217;agit souvent d&#8217;une erreur de liste ou de r\u00e9cents changements de status de fournisseur.<\/p>\n<\/div><\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"su-row\">\n<div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\">\n<h2 style=\"background-color: #005f85; color: #ffffff; padding: 10px;\"><img data-recalc-dims=\"1\" decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-29208\" style=\"display: inline;\" src=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-document.png?resize=30%2C35&#038;ssl=1\" alt=\"insurance document\" width=\"30\" height=\"35\" srcset=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-document.png?w=650&amp;ssl=1 650w, https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-document.png?resize=262%2C300&amp;ssl=1 262w\" sizes=\"auto, (max-width: 30px) 100vw, 30px\" \/> 3. RASSEMBLER LES DOCUMENTS JUSTIFICATIFS<\/h2>\n<p style=\"text-align: justify;\">Rassemblez tous les documents pertinents selon votre \u00e9change avec\u00a0 l&#8217;assureur. Ces documents peuvent \u00eatre utiles.<\/p>\n<\/div><\/div>\n<div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\">\n<h2 style=\"background-color: #1e7d00; color: #ffffff; padding: 10px;\"><img data-recalc-dims=\"1\" decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-29207\" style=\"display: inline;\" src=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-consult.png?resize=42%2C35&#038;ssl=1\" alt=\"insurance consult\" width=\"42\" height=\"35\" srcset=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-consult.png?w=473&amp;ssl=1 473w, https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-consult.png?resize=300%2C249&amp;ssl=1 300w\" sizes=\"auto, (max-width: 42px) 100vw, 42px\" \/> 4. CONSULTER L\u2019ASSOCIATION<\/h2>\n<p style=\"text-align: justify;\">Si le probl\u00e8me n\u2019est toujours pas r\u00e9gl\u00e9, contactez l\u2019association pour obtenir de l\u2019aide. L\u2019association dispose d&#8217;un agent virtuel, Jonathan, qui peut vous guider, vous fournir des mod\u00e8les de lettres pour faire appel, ou m\u00eame intervenir en votre nom.<\/p>\n<\/div><\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"su-row\">\n<div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\">\n<h2 style=\"background-color: #8d050c; color: #ffffff; padding: 10px;\"><img data-recalc-dims=\"1\" decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-29210\" style=\"display: inline;\" src=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-records.png?resize=37%2C35&#038;ssl=1\" alt=\"insurance records\" width=\"37\" height=\"35\" srcset=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-records.png?w=754&amp;ssl=1 754w, https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/insurance-records.png?resize=300%2C281&amp;ssl=1 300w\" sizes=\"auto, (max-width: 37px) 100vw, 37px\" \/> 5. CONSERVER TOUS LES DOSSIERS<\/h2>\n<p style=\"text-align: justify;\">Consignez toutes vos communications avec la compagnie d\u2019assurance, y compris les appels t\u00e9l\u00e9phoniques, courriels et lettres. Cette documentation pourrait \u00eatre pr\u00e9cieuse pour rectifier l&#8217;erreur. Assurez-vous de garder une photocopie (ou image avec celllulaire) de tous les re\u00e7us d\u2019assurance avant de les envoyer par la poste, afin d\u2019avoir une copie au dossier au cas o\u00f9 un document se perdrait en chemin.<\/p>\n<\/div><\/div>\n<div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\">\n<p>&nbsp;<\/p>\n<div class=\"su-list\" style=\"margin-left:0px\">\n<ul style=\"text-align: justify; font: 14px\/20px arial !important;\">\n<li><i class=\"sui sui-chevron-circle-right\" style=\"color:#000\"><\/i> En suivant ces \u00e9tapes, les membres peuvent mieux g\u00e9rer le processus et augmenter leurs chances d\u2019obtenir une issue favorable.<\/li>\n<li><i class=\"sui sui-chevron-circle-right\" style=\"color:#000\"><\/i> L\u2019association est toujours disponible pour soutenir ses membres dans ce genre de situation.<\/li>\n<li><i class=\"sui sui-chevron-circle-right\" style=\"color:#000\"><\/i> La premi\u00e8re \u00e9tape consiste toujours \u00e0 v\u00e9rifier le message de refus et \u00e0 identifier la compagnie d\u2019assurance concern\u00e9e<\/li>\n<\/ul>\n<p>L&#8217;AQTN est reconnue par tous les assureurs au Canada dans toutes les provinces ou ses membres exercent l\u00e9galement.<\/p>\n<\/div>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>QUE FAIRE SI UNE COMPAGNIE D\u2019ASSURANCE REFUSE UNE R\u00c9CLAMATION Lorsqu\u2019un membre de l\u2019association qu\u00e9b\u00e9coise des th\u00e9rapeutes naturels, qu\u2019il soit massoth\u00e9rapeute ou naturopathe, fait face \u00e0 un refus de r\u00e9clamation par une compagnie d\u2019assurance, cela peut \u00eatre une exp\u00e9rience stressante. Quoique l&#8217;association est reconnue par essentiellement tous les assureurs au Canada, ce n&#8217;est pas tous les [&hellip;]<\/p>\n","protected":false},"author":36,"featured_media":29192,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[1],"tags":[],"class_list":["post-29191","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-association-quebec-aqtn-other-posts"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Que faire si une compagnie d\u2019assurance refuse une r\u00e9clammation par erreur - Association Professionnelle - Massoth\u00e9rapeutes, Naturoth\u00e9rapeutes et Naturopathes<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Que faire si une compagnie d\u2019assurance refuse une r\u00e9clammation par erreur - Association Professionnelle - Massoth\u00e9rapeutes, Naturoth\u00e9rapeutes et Naturopathes\" \/>\n<meta property=\"og:description\" content=\"QUE FAIRE SI UNE COMPAGNIE D\u2019ASSURANCE REFUSE UNE R\u00c9CLAMATION Lorsqu\u2019un membre de l\u2019association qu\u00e9b\u00e9coise des th\u00e9rapeutes naturels, qu\u2019il soit massoth\u00e9rapeute ou naturopathe, fait face \u00e0 un refus de r\u00e9clamation par une compagnie d\u2019assurance, cela peut \u00eatre une exp\u00e9rience stressante. Quoique l&#8217;association est reconnue par essentiellement tous les assureurs au Canada, ce n&#8217;est pas tous les [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/\" \/>\n<meta property=\"og:site_name\" content=\"Association Professionnelle - Massoth\u00e9rapeutes, Naturoth\u00e9rapeutes et Naturopathes\" \/>\n<meta property=\"article:published_time\" content=\"2025-07-11T05:10:34+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/InsuranceClaim.jpg?fit=450%2C262&ssl=1\" \/>\n\t<meta property=\"og:image:width\" content=\"450\" \/>\n\t<meta property=\"og:image:height\" content=\"262\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Agent Admin AQTN Editor\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Agent Admin AQTN Editor\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/aqtn.ca\\\/questions\\\/association-quebec-aqtn-other-posts\\\/reclammations-assurances-insurance-claim\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/aqtn.ca\\\/questions\\\/association-quebec-aqtn-other-posts\\\/reclammations-assurances-insurance-claim\\\/\"},\"author\":{\"name\":\"Agent Admin AQTN Editor\",\"@id\":\"https:\\\/\\\/aqtn.ca\\\/questions\\\/#\\\/schema\\\/person\\\/c7aeaa97d04c5dbbc898e96f6e7c895f\"},\"headline\":\"Que faire si une compagnie d\u2019assurance refuse une r\u00e9clammation par erreur\",\"datePublished\":\"2025-07-11T05:10:34+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/aqtn.ca\\\/questions\\\/association-quebec-aqtn-other-posts\\\/reclammations-assurances-insurance-claim\\\/\"},\"wordCount\":605,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/aqtn.ca\\\/questions\\\/association-quebec-aqtn-other-posts\\\/reclammations-assurances-insurance-claim\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/i0.wp.com\\\/aqtn.ca\\\/questions\\\/wp-content\\\/uploads\\\/2025\\\/06\\\/InsuranceClaim.jpg?fit=450%2C262&ssl=1\",\"articleSection\":[\"Blog\"],\"inLanguage\":\"en-CA\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/aqtn.ca\\\/questions\\\/association-quebec-aqtn-other-posts\\\/reclammations-assurances-insurance-claim\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/aqtn.ca\\\/questions\\\/association-quebec-aqtn-other-posts\\\/reclammations-assurances-insurance-claim\\\/\",\"url\":\"https:\\\/\\\/aqtn.ca\\\/questions\\\/association-quebec-aqtn-other-posts\\\/reclammations-assurances-insurance-claim\\\/\",\"name\":\"Que faire si une compagnie d\u2019assurance refuse une r\u00e9clammation par erreur - 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Association Professionnelle - Massoth\u00e9rapeutes, Naturoth\u00e9rapeutes et Naturopathes","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/","og_locale":"en_US","og_type":"article","og_title":"Que faire si une compagnie d\u2019assurance refuse une r\u00e9clammation par erreur - Association Professionnelle - Massoth\u00e9rapeutes, Naturoth\u00e9rapeutes et Naturopathes","og_description":"QUE FAIRE SI UNE COMPAGNIE D\u2019ASSURANCE REFUSE UNE R\u00c9CLAMATION Lorsqu\u2019un membre de l\u2019association qu\u00e9b\u00e9coise des th\u00e9rapeutes naturels, qu\u2019il soit massoth\u00e9rapeute ou naturopathe, fait face \u00e0 un refus de r\u00e9clamation par une compagnie d\u2019assurance, cela peut \u00eatre une exp\u00e9rience stressante. Quoique l&#8217;association est reconnue par essentiellement tous les assureurs au Canada, ce n&#8217;est pas tous les [&hellip;]","og_url":"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/","og_site_name":"Association Professionnelle - Massoth\u00e9rapeutes, Naturoth\u00e9rapeutes et Naturopathes","article_published_time":"2025-07-11T05:10:34+00:00","og_image":[{"width":450,"height":262,"url":"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/InsuranceClaim.jpg?fit=450%2C262&ssl=1","type":"image\/jpeg"}],"author":"Agent Admin AQTN Editor","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Agent Admin AQTN Editor","Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/#article","isPartOf":{"@id":"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/"},"author":{"name":"Agent Admin AQTN Editor","@id":"https:\/\/aqtn.ca\/questions\/#\/schema\/person\/c7aeaa97d04c5dbbc898e96f6e7c895f"},"headline":"Que faire si une compagnie d\u2019assurance refuse une r\u00e9clammation par erreur","datePublished":"2025-07-11T05:10:34+00:00","mainEntityOfPage":{"@id":"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/"},"wordCount":605,"commentCount":0,"image":{"@id":"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/#primaryimage"},"thumbnailUrl":"https:\/\/i0.wp.com\/aqtn.ca\/questions\/wp-content\/uploads\/2025\/06\/InsuranceClaim.jpg?fit=450%2C262&ssl=1","articleSection":["Blog"],"inLanguage":"en-CA","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/","url":"https:\/\/aqtn.ca\/questions\/association-quebec-aqtn-other-posts\/reclammations-assurances-insurance-claim\/","name":"Que faire si une compagnie d\u2019assurance refuse une r\u00e9clammation par erreur - 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