Proof of Claim provision for the Disability Insurance (DI) Plan and Proof of Loss provision for the Public Service Management Insurance Plan-Long Term Disability (LTD)

Date: October 1, 2012

To: Compensation Managers; Heads of Human Resources; Participating Separate Employers

The purpose of this notice is to inform you of the need to counsel employees on the time limit for completing and submitting claim forms and related medical evidence to the insurers no later than 90 days after the end of their elimination period for;

1. the Disability Insurance Plan (DI); and
2. the Long Term Disability (LTD) Plan.

Starting January 1, 2013, the time limit for providing Proof of Claim for the DI Plan or Proof of Loss for the LTD Plan to the insurer will be strictly enforced. The Proof of Claim/Loss provisions refer to the DI and LTD claim forms and related medical evidence that employees are required to submit to the insurers. As of January 1, 2013, late submission of this information could result in the denial of a claim.

You are requested to inform employees who are in the process of applying for DI or LTD, that effective January 1, 2013 all claim forms and related medical evidence must be received by the insurers no later than 90 days after the end of their elimination period.  The elimination period is 13 continuous weeks of disability, or upon the expiration of paid sick leave, whichever is later. Ideally they should be received by the insurers at least 2 months before the end of their elimination period.

The DI Plan requires three claim forms to be completed:

• Claim for Disability Insurance Employee's Statement Policy No. 12500-G
• Claim for Disability Insurance Employer's Statement Policy No. 12500-G
• Claim for Disability Insurance Employee's Medical Information and Attending Physician's Statement Policy No. 12500-G

LTD Plan requires two claim forms to be completed:

• Public Service Management Insurance Plan Claim for Long-Term Disability Benefit (5945, 5946)

Employees should also be advised that should they fail to abide by this time limit, they may not be entitled to some or all benefit payments where the delay impedes the Insurer's ability to assess their claim.

Please be advised that all Compensation letters being used by your department/agency should be revised accordingly.

Should you have any questions or concerns, please contact Evelyn Bolduc at 613-954-5064.