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Insurer

An insurer is the insurance company or organization that provides financial protection to individuals or groups in exchange for premium payments. The insurer assumes the risk of potential loss and agrees to pay benefits for covered claims according to the terms of the policy. Insurers evaluate applications, determine premiums, issue policies, and manage claims through underwriting and administration processes.

In health, dental, life, and disability insurance, the insurer is responsible for ensuring that claims are paid fairly, benefits are applied correctly, and policyholders receive accurate information about their coverage. Insurers may offer both individual and group insurance products and are regulated by federal and provincial authorities to maintain solvency, transparency, and compliance with consumer protection laws.

Example:

If you purchase a personal health insurance policy from Sun Life or Manulife, that company is the insurer. They review your application, collect premiums, and pay eligible claims according to your policy’s terms.

What to Watch For:

Work only with licensed insurers that are recognized and regulated in your province. Review your policy documents to confirm the insurer’s name, contact information, and complaint resolution process. If you are covered under a group plan, your employer is not the insurer - they are the policyholder or plan sponsor, while the insurer administers and guarantees the benefits.

Related Terms

Policy (Contract)

A policy, also referred to as a contract, is the legally binding agreement between an insurance company (the insurer) and the policyholder that defines the terms, conditions, and obligations of coverage. It outlines what is insured, the benefits provided, the premium amount, exclusions, and the responsibilities of both parties. Once the insurer accepts the application and the first premium is paid, the policy becomes active and enforceable.

Claim Submission Deadline

The claim submission deadline is the final date by which an insured person must submit a claim to their insurance company for reimbursement of eligible expenses. After this date, the insurer is not obligated to pay the claim, even if the expense itself would have been covered. This deadline ensures timely processing, accurate recordkeeping, and proper financial reporting for both the insurer and the policyholder.

Premium

A premium is the amount of money an individual or organization pays to an insurance company in exchange for coverage under an insurance policy. It is the cost of maintaining protection against financial loss and ensures that the insurer can pay claims, manage risk, and cover administrative expenses. Premiums can be paid monthly, quarterly, semi-annually, or annually, depending on the policy and payment arrangement.

Insured Person

An insured person is the individual covered under an insurance policy who is entitled to receive benefits for eligible claims. In a personal policy, the insured person is typically the policyholder who owns the coverage. In a group insurance plan, the insured person is the employee or member enrolled in the plan, and their eligible dependents may also be covered under the same contract.

Plan Member

A plan member is an individual who is enrolled in and eligible to receive benefits under a group insurance plan. Typically, the plan member is an employee of a company or a member of an organization that sponsors the group policy. The plan member is covered for the benefits outlined in the plan - such as health, dental, life, and disability insurance - and may also extend coverage to eligible dependents, including a spouse or children.

Relevant Plans

Plans that relate to Insurer

Manulife - FlexCare - ComboPlus Basic

Manulife - FlexCare - ComboPlus Basic

Can apply at anytime.

Manulife - FlexCare - ComboPlus Enhanced

Manulife - FlexCare - ComboPlus Enhanced

Can apply at anytime.

Manulife - FlexCare - ComboPlus Starter

Manulife - FlexCare - ComboPlus Starter

Can apply at anytime.

Manulife - FollowMe - Basic

Manulife - FollowMe - Basic

Must apply within 90-days of employee group benefits terminating.

Have questions about your insurance coverage?

Our licensed advisors can help you understand your options and find the right plan for your needs.