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The Advice Centre

Understanding the Disability Claims Process

Tuesday, January 13, 2015
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Insurance Basics, How to make a claim

Understanding the Disability Claims process

A disability insurance plan provides you with financial security in case you suffer a health condition that prevents you from working and earning an income. Essentially these plans cover a portion of your wages in the event you’re unable to work.

If you’re experiencing a health issue that turns into a disability, your insurer will work with you, your health care provider and any other support systems such as your plan sponsor to support you through the process from the initial disability claim to your successful return to work. Success depends on everyone working together. So what can you expect?

First, the paperwork; A disability claim package is available from your plan administrator. A claim package typically has a variety of forms to complete. There’s a form for you and separate forms for your plan sponsor and a medical form to be completed by your health care provider like a family doctor, or another practitioner with clinical notes about your condition. It’s important to get all these forms to your insurance company as soon as possible so your claim can be assessed without delay.

Once all the forms have been received your claim can usually be reviewed within 5 to 7 business days. Your insurance company may contact you if more information is required about your condition. Additional information may be gathered from your plan sponsor or your doctor to determine how your current condition affects your ability to do your occupation.

Once your claim is approved, your benefits start after your plan’s qualifying period is over or on the first date you were seen by your health care provider, whichever is later. The length of the qualifying period and the amount of your benefit payment will depend on the coverage chosen by your plan sponsor. This information is available in your benefit booklet or by contacting your insurer.

From here the attention is focused on your recovery. Once you are able to do some portion of your job duties consider discussing options with your employer about possible accommodations that may help with return to work. Your insurer can help in that process. Having a health issue can be difficult. The goal is always to ensure you recover from your condition and plan for a safe return to work as soon as it is possible.

Remember, everyone involved in your claim, including your insurance company, is here to support you through this process.

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