Benefits cut off 3 weeks early


#1

Hello, my husband insurance claim got cut off short by 3 weeks.
He’s been on disability for 10 months. He’s got the ok from his doctor to return to work. During this period of time. The insurance company asked my husband to go see their own doctor. He canceled the insurers doctors appointment 72 hours prior because he was going through the procedure to return to work.
The insurance company wants to charge him for the canceled doctor’s appointment. They say they didn’t get 48hours notice (it was the long weekend) nor does it say in the letter he received, that he would be charged if he didn’t attend the appointment.
They also cut off his payments short by 3 weeks.

Is this legal? What can he do? He is unionized, can the union help?


#2

I am not a lawyer but I think he has a duty to see any doctor the insurance company wants.

Get the free consult:


#3

I would just file a claim in small courts. Not worth a consult.

As he is unionized it depends if the LTD is writen into the union/employer contract.


#4

The insurer can require a person to attend a doctors appointment even if that person is returning to work. Normally insurance companies will advise you of cancellation fees when notifying you about a scheduled medical appointment. If that didn’t happen, then you may have some grounds to argue against paying the cancellation fee. If you did give them notice, just not enough notice then that would work in your favour as well. If they take the cancellation fee out of your benefits, then you could seek to recover the payment by filing a grievance or small claims court action depending on what is the proper forum for resolving disputes for you situation.


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 1-877-282-5188 to speak with a member with our disability claim support team.