Claim denied waiting for my appointment with psychiatrist

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!

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.

1 Like

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

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