Arbitration for LTD claim?

Hi all/David:

I understand that labour arbitrators have jurisdiction over unionized employee claims for their long-term disability (LTD) benefit (e.g. Leisa Hutton v. Manufacturers Life Insurance Company).

Does this essentially mean that the arbitrator’s decision is final and that an employee cannot take legal action against the insurer should their appeal be denied by the 3rd party insurer? Would the arbitrator have the extensive knowledge from a medical perspective to be able to make an informed decision?

Hope the above makes sense.

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Note that this was specific to the agreement negotiated between the specific hospital and this specific union, and the agreement between that hospital its insurer. The setup was considered a weird one so probably atypical? So you will need to check what your own collective agreement says about whether arbitration is binding and final etc. (if you even have arbitration for LTD claims).

More details are here: Is arbitration between hospital and union the only remedy? Court quashes insurance suit | Law Times

Yes, with some LTD Plans the Arbitrator has the final decision. This will only happen with some (but not all) LTD plans that involve unions or non-profit LTD plans. In those cases it is possible that the collective agreement / Plan document will remove the court system’s jurisdiction over the LTD claims and appeals. Courts will allow this when there is specific wording within the insurance plan and collective agreement. So, if the collective agreement has exclusive jurisdiction, then it will designate a final decision-maker, which is often an arbitrator.

David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-917-7050 to speak with a member with our disability claim support team.

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