Claim denied waiting for my appointment with psychiatrist


#1

Hello,
I’ve sent my paper work to my insurance company through work, as well as the doctors prescription to see a psychiatrist.
My insurance company called and said they will not pay out until I’ve seen my psychiatrist.
My first appointment is in 2 months.
Can they withhold paying me until then?
I’ve followed all the necessary steps with doctor, social worker (Clsc) and all paper work is properly filled out.
I have no control over the time period it takes to see the psychiatrist.
This adds even more stress to my mental illness because I have bills to pay.
Is there anything I can do for the company to start paying up with the current information that they have ?

Thank you!


#2

Apply for employment insurance using the sick/illness https://www.canada.ca/en/services/benefits/ei/ei-sickness.html

If your doctor has found you unfit for work and filled the forms -let your Insurer know that the decision to with hold benefits is causing you extreme stress and making your health situation worse.

Ask them to reconsider. Don’t write an essay-keep it honest and simple.

Send it by email, fax or registered mail–so you can use if needed down the road.


#3

#4

Yes, unfortunately insurers can legally withhold payments in a situation like this. They are only required to make a decision based on the medical information you give to them. If there are delays in getting more information, then they can deny the claim. I agree you should apply for EI sickness in the meantime.


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 reliabile 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.