How to File a Claim for Long Term Disability Benefits

After approximately 44 weeks of receiving combined weekly wage replacement and Employment Insurance sickness benefits, the Claims Office will send you the appropriate forms for completion (with instructions), so that you may apply for benefits under the Long Term Disability benefit portion of the Plan.

When the forms have been fully completed by your employer, yourself, and your Physician, forward the forms to the Claims Office. Your claim will be validated and forwarded to the Insurance Company for assessment. Your benefit cheques will be mailed directly to you.

Remember! You must be under the continuous personal care of a Physician to qualify for Weekly Disability Income and Long Term Disability benefits.

Proof of Loss

Written proof stating the occurrence, character and extent of loss must be submitted to the administrator within 6 months after the end of the qualifying period for Long Term Disability Insurance.  The qualifying period is 52 weeks, therefore you must apply within one year of leaving work due to disability.

Written proof of the continuance of disability must be furnished to the Insurer at such intervals as it may reasonably require.  As part of the proof, the Insurer shall have the right to require satisfactory evidence that the Member has made application for all benefits referred to in the reductions provision and that he has furnished all required proofs for such benefits.  If the Member did not make such application, he must provide satisfactory evidence that he was not eligible for such benefits.  The Insurer shall also have the right to require satisfactory evidence of the amount of such benefits payable.

The Insurance Company shall have the right and opportunity to examine any person whose injury or illness is the basis of claim, when and as often as it may reasonably require during the pending and payment period, if any, of such claim