Frequently Asked Questions About Group Insurance
It can take as little as 48 hours, but if it takes a little more time don’t worry. You should receive your refund no more than 72 hours following the processing of your claim.
We all make mistakes. If you made one on your claim, simply submit a new claim with the correct information. Go to Submit a claim and select the category Other. We'll sort it out on our end.
Coordination of benefits applies when someone is covered by more than one insurance plan. For instance, a claim could be covered under a person’s employee benefits plan and a public plan.
In this case, a claim may be submitted to both insurers to maximize coverage. The primary insurer would act as the first payer and the remaining amount may be covered by the second plan. Coordination of benefits helps insurers manage claims properly to avoid reimbursements that exceed the actual amount paid by the insured person.
The simplest way is to consult your insurance booklet in the Client Centre.
Short term disability insurance:
As soon as possible once your leave of absence begins
Long term disability insurance:
- Benefits starting within the first 6 months of your leave of absence: 30 days prior to the end of the waiting period indicated in your contract.
- Benefits starting more than 6 months after your leave of absence: 90 days prior to the end of the waiting period indicated in your contract.
To ensure your claim is processed as quickly as possible, all the documents required must be completed and sent in together.
Your claim will be sent to our disability insurance team, who will review the documents provided and determine, based on your plan, whether you are eligible for disability insurance benefits.
We will then send you a letter to inform you of our decision.
Your benefits will be deposited directly into your bank account.
We consider the information provided in the Statement of attending physician. A member of our disability insurance team may also contact you to get more information. The purpose of this call is to understand your situation to ensure a better follow up of your claim and make sure you get the support you need for a successful recovery.
The contract with your employer may include a waiver of premiums clause. This exempts you from paying insurance premiums during a disability leave while still benefiting from the coverage. However, the period before the waiver applies can vary from one contract to another. Please consult your insurance booklet, which is available in the Client Centre, for more information on this clause.
A doctor’s diagnosis is not the only factor that determines disability. Your medical condition must also meet the disability definition in your contract.
Generally speaking, this definition has two components. The first component applies to your regular employment and the second to all other gainful employment. See your insurance booklet in the Client Centre for more information.
You’ll need to sign up for direct deposit to receive your benefits and include a void cheque. This ensures we can quickly deposit your benefits once your claim is approved.
To learn whether your benefits are taxable or not, refer to your insurance booklet available in the Client Centre.
If you don’t find this information in your booklet, please refer to your employer.
When submitting your claim, you are responsible for sending us all the required documents, duly completed.
Once on disability, you must provide, upon request, all additional medical documentation or relevant information requested of you to maintain your disability leave.
During your disability leave, a member of our team may touch base with you to ask about your health, functional capacities and progress.
Understanding your situation allows us to continue paying your disability benefits.
This call also gives us the opportunity to refer you to specialized healthcare services or professionals to help you recover.
The waiting period is the amount of time that must elapse from the date on which your disability leave starts until the date on which you begin to receive disability insurance benefits.
You can refer to your group insurance booklet in the Client Centre to learn the waiting period that applies under your plan. You can also ask your group plan’s administrator.
The definition of disability is specific to each plan. Please refer to your insurance booklet available in the Client Centre.
In short term disability insurance, the waiting period can range from a few days to a few weeks. Disability benefits serve as income replacement over the weeks or years of disability as stipulated in the contract.
Long term disability insurance benefits are normally provided over months or years. These benefits serve as income replacement for years, even up to age 65, as per the contract.
See your insurance booklet in the Client Centre for more information.
La Capitale and SSQ Insurance
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