Public servants frustrated after health plan switched to Canada Life

A growing number of current and retired public servants are speaking out about unpaid benefits claims just two months after the federal government switched insurance providers.

On July 1, approximately 1.5 million federal employees covered under the Public Service Health Care Plan (PSHCP) moved from Sun Life Financial to Canada Life Assurance Company.

Since the Canada Day transition, dozens of individuals have told CTV National News that their claims aren’t being processed and their calls are going unanswered due to what has been described as overwhelmed call centres.

Chris Aylward, president of the Public Service Alliance of Canada (PSAC), which represents more than 150,000 federal public servants across the country, added that there has been “nothing but problems.”

“It’s very frustrating,” Aylward told CTV National News. “[The federal government] didn’t do it right and now members are suffering because of that.”

In a statement, the Treasury Board called the wait times and delays “unacceptable” and urged the insurer to make improvements.

“We believe that Canada Life should take further immediate steps to address the continued challenges that claimants are facing in reaching a call centre agent,” a department spokesperson said.

A Facebook page setup for affected federal public servants has already garnered thousands of members.

Canada Life’s response

To address the issue, Canada Life claims on its website that it’s taking a number of steps, including:

• Significantly increasing staff in its PSHCP Members Contact Centre
• Temporarily extending the operating hours of the PSHCP Members Contact Centre
• Accelerating the enrolment process

“A sincere thank you to all plan members for your continued patience as we complete this transition,” a message on the insurer’s website reads. “We appreciate your patience during this period, and we’re committed to getting things right.”

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I’m waiting to be reimbursed by Canada Life, should I file a legal claim?

Since it’s possible that federal public servants will be reimbursed by Canada Life within the next few weeks or months, it’s not recommended that claimants file a legal claim at this time.

If an individual was to pursue compensation due to the delay, it would be a nominal claim at best.

However, if legitimate claims for benefits aren’t paid, that could give rise to legal claims and potentially a class-action lawsuit (subject to any limits imposed by the governing collective agreement).

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• Disability Law Show: Top 5 mistakes when dealing with an insurance company
• Invisible Illness and Long-term Disability Claims
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Canada Life denied my disability claim, what should I do?

If your short-term disability (STD) or long-term disability (LTD) claim is denied by Canada Life, ask the insurer to provide you with their reasons for the decision in writing. This is known a denial letter.

In addition to explaining why your claim was rejected, this document should explain:

• How to appeal the decision
• The two-year limitation period within which you can pursue a legal claim

WATCH: Disability lawyer James Fireman explains the three things you need to know when your disability claim is denied on an episode of the Disability Law Show.

Once you receive the denial letter, gather any other relevant documents (i.e. your policy, application forms, etc.) and contact an experienced disability lawyer at Samfiru Tumarkin LLP.

We can review your situation, assess your legal options and help you secure the compensation you deserve.

Even if you don’t have a denial letter, reach out to our firm as soon as possible. We provide free consultations for issues involving disability benefits and can answer any questions you have.

ADDITIONAL RESOURCES
• Canada Life long-term disability claim denied: Your rights
• Denied LTD due to your insurer’s medical consultant: Next steps

Should I appeal Canada Life’s decision to deny my disability claim?

Appeals rarely work. If Canada Life refuses to provide you with access to disability benefits, you are better off filing a legal claim instead.

In Canada, the appeals process is typically handled by the same insurance company that denied you disability benefits in the first place.

It’s used by insurers to stall out the two-year window, or limitation period, that you have to take legal action after your claim has been denied.

Once the two years are up, your insurance company doesn’t have to pay your claim and you can’t file a legal claim to get the money you are owed.

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• Disability Law Show: Why you shouldn’t appeal a denied LTD claim
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I already appealed, what should I do now?

If you appealed Canada Life’s decision to reject your disability claim, and were unsuccessful, you may still have options.

As long as it hasn’t been two years since your claim was denied, an experienced disability lawyer at Samfiru Tumarkin LLP can review your situation and help you secure the compensation that you are entitled to.

Your top priority should be your health and recovery. Once we are formally hired to represent you, we will communicate with the insurer on your behalf.

Insurer rejected your claim? Contact us

If you are denied or cut off from disability benefits for any reason, reach out to the experienced disability law team at Samfiru Tumarkin LLP before appealing your insurance company’s decision.

Our lawyers in Ontario, Alberta, and B.C. regularly resolve issues involving STD, LTD, life insurance, critical illness and mortgage insurance claims across all provinces (excluding Quebec).

Over the years, we have helped thousands of Canadians, including Julie Austin and Sandra Bullock, secure the compensation that they are legally entitled to.

We provide consultations at no cost to you and we don’t get paid unless we get results.