Inland applications are also paper based, and as mentioned before, the payment receipt was all we needed to qualify. I'm also betting your problems are with the outland application.
A requirement of BC Medical is that you reside in BC. If you have an inland application you are claiming that you are living in Canada during your application. When you apply outland you are claiming you are residing outside of Canada during your application, regardless if you have a TRV and are actually visiting inside Canada.
Sorry for your troubles.