How Canada Life processes disability claims

Be sure to let your plan sponsor know of your absence from work.

For a short-term or long-term disability, choose the correct form.

What are the submission timelines?

To allow for prompt assessment, you should submit initial notice of a short-term disability claim no later than 10 days after you stop working.

To allow for prompt assessment, initial notice of a long-term disability claim should be submitted no later than 8 weeks before the end of the waiting period.

My form is complete. Now what?

We’ll collect information about your coverage, job details and earnings from your plan sponsor.

We’ll let you know either by mail or phone if there’s any outstanding information required to assess your claim.

Once all information is received, we’ll review the available medical and functional information against the demands of your regular job/occupation as well as your group disability plan’s contractual provisions.

When will a decision be made about my claim?

For a short-term disability claim, a decision will be made 7 calendar days from the date we receive all necessary information.

For a long-term disability claim, a decision will be made 14 calendar days from the date we receive all necessary information.

Please note: These timelines are intended for standard plans only. Actual timelines might vary based on plan design and claim complexity. Missing information or incomplete applications for benefits may impact processing timelines. We may need to extend the timeline if additional review is needed.

How will I notified about the decision?

We’ll provide you with written confirmation of the claim decision (including claim details and next steps).

What else do I need to know?

We’ll contact you and your treatment providers throughout the duration of your claim for updated information on your status, functional abilities and treatment plan.

It’s important that you keep us informed of any changes in your medical condition or functional status.

If there are any changes to your claim status (including an extension of benefits), we’ll provide you with written or verbal notification.

In the case of a long-term disability, we’ll keep in touch throughout the duration of your claim.

Appeal details for short-term and long-term disability claims

If benefits are denied, you’ll receive a detailed letter with an explanation for the decision. The letter will also include:

Details on how to appeal the decision
What information should be included if an appeal
Where to send the appeal

Appeal level 1

Once we’ve received all necessary appeal level 1 information, communication will be made within 7 calendar days for short-term disability benefits and 14 calendar days for long-term disability benefits.
We’ll review the appeal level 1 information submitted and provide written notification of the appeal outcome.
If the decision is maintained, information regarding options for the next level appeal will be provided.

Appeal level 2

Once we’ve received all necessary appeal level 2 information, communication will be made within 7 calendar days for short-term disability benefits and 14 calendar days for long-term disability benefits.
We’ll review the appeal level 2 information submitted and provide written notification of the appeal outcome.
If the decision is maintained, information regarding options for the next level appeal will be provided.

Appeal level 3

Once we have received all necessary appeal level 3 information, communication will be made within 10 calendar days for both short-term disability and long-term disability benefits.
We’ll review the appeal level 3 information submitted and provide written notification of the appeal outcome.
The appeal process is deemed final once the third appeal decision is made.
Any further concerns may be escalated through our customer complaint process.

What’s next?

Get the disability claims forms you need.

This information is general in nature and is intended for informational purposes only. For specific situations you should consult the appropriate legal, accounting or tax advisor.

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