Adjudication and payment of Long Term Disability (LTD), Group Life (GL), Dependent Life (DL) and Accidental Death and Dismemberment (AD&D) claims is outsourced to Canada Life. Canada Life is also the insurer of the GL, DL, and AD&D coverage. HBT oversees the governance and administration of the overall claim process to ensure fairness and consistency.
More specifically, the role of HBT in administering the Benefit Plans for LTD, GL, DL and AD&D is to:
- Negotiate the terms and conditions of the service contracts and insurance policies with Canada Life
- Provide Canada Life with all related Benefit Plan information for the purpose of adjudicating and paying claims
- Verify eligibility of claimants
- Set rates for LTD, GL, DL and AD&D Benefits
- Enrol beneficiaries
- Bill and collect premiums/contributions from employers that are not billed by PBC
- Provide funds for claims payment
- Provide dispute resolution of escalated issues
- Measure and track overall performance of Canada Life
- Report on claims statistics for all member employers
The role of Canada Life in Benefit Plans for LTD, GL, DL and AD&D is to:
- Insure the GL, DL and AD&D benefits
- Adjudicate and pay claims for GL, DL, AD&D and LTD
- Determine amount of benefits payable
- Provide medical management of claims
- Identify opportunities for disability intervention such as rehabilitation or medical coordination services
- Pay claims as per benefits contracts
- Escalate issues to HBT
Disability Claims Reporting (DCR)
DCR is an online service from Canada Life to assist employers in the gathering and tracking of information and management of disability claims.
DCR reports available to employers are:
- Assessment and Management Summary
- Claim Assessment Listing
- Claim Management Activities Listing
- Financial Listing
- Claimant Management Report
- Time to Decision Service Report
- Service Turnaround Report
- Duration Report
To Appeal a Denied/Terminated Claim
Canada Life may deny or terminate a claim if there is not enough medical evidence to show a claimant cannot work. However, if the claimant does not agree with Canada Life’s decision an appeal process is available.
Click one of the following links to learn more about appealing a decision.
Early Retirement Incentive Benefit (ERIB)
This special early retirement provision is for employees on LTD who have reached the age of 55.