FAQ: Gen 3 Form
Gen 3 Form
What can I claim on my GEN 3 Form?
You may file a Claim for all costs incurred while trying
to establish a Claim, including the following:
- mileage (not gas)
- fees charged by Commissioner of Oaths for TRAN
3 or HEMO
- fees charged by treating physician for completing TRAN
2 or HEMO
The Administrator will not reimburse you for your
lawyer's fees if you asked a lawyer to fill out the Claim
Forms on your behalf.
All your Claims for reimbursement must be accompanied with
receipts, and proof that you saw your doctor on the particular
day in question. Travel expenses have to be HCV-related meaning
you went to the doctor, hospital or laboratory.
In order to obtain proof of your visits, you can have your
doctor sign the logbook provided with this Form. Your doctor
can also write a letter indicating which dates of visits were
HCV-related. You can also obtain hospital records proving
that you were at the hospital for treatment on the day in
How do I file a Claim for mileage?
On the log Form, insert the date of your visit, the name
of the doctor and his or her specialty. Also, please indicate
how many kilometres it is from your home to the HCV-related
destination. Please also indicate the distance roundtrip.
Have your doctor or his/her nurse sign or stamp the logbook.
This will show proof that the visit was HCV-related.
How do I file a Claim for Uninsured Treatments
Please include your receipts for uninsured treatments or
medications with the GEN 3 Form,
along with the following:
- the date of purchase; AND
- the name or a description; AND
- the total cost; AND
- the amount paid by your insurance, or other health plan;
- the amount claimed.
Receipts must be submitted, along with a letter from the
treating physician approving the items claimed.
If you are not aware of what medications are HCV-related,
make a list of the medications you are using, bring the list
to your doctor, and have him/her indicate which ones are HCV-related.
By other Health Plan
What if I no longer have the receipts?
If you do not have your receipts for your initial Claim,
contact your doctor's office and get them to send us a list
of visit dates and to confirm that these visits were HCV-related.
You can try to obtain a printout from your pharmacy for
any past medications purchased. You can also provide copies of credit card receipts or insurance payments.
You must have receipts for any and all Claims made after
your initial claim for Uninsured Medications.
Index of Questions