CPPD Lump Sum Question


#1

Hello,

Thank you for this site and for the advice it offers. I am deeply grateful. Here is my issue:

While I did read the information regarding lump sum retroactive payments from CPPD being taken by the long term disability insurance company, my situation is a bit unique … so am not sure how to proceed.

My insurance policy is a ‘premium’ policy, meaning that: as long as the monthly CPPD + Disability Benefit (insurance company payment) do not exceed what my monthly salary ‘was’, then no deduction will be made = I receive both amounts with no deduction from the insurance company. And this is the case, both monthly payment sums do NOT total what my salary was on a monthly basis.

So, now I have received a retroactive CPPD payment for a collective of 17 months. The insurance company wants to take it. My argument is that - if you look at each payment received by CPPD (for each of the 17 months) and add that to the monthly amount from the insurance company - there is NO overpayment as each monthly totals do NOT exceed what my monthly salary would have been. Therefore I owe NOTHING.

This is my logic (I am a former auditor).

I am desperately seeking some advice here. I will seek legal counsel if needed, but do not want to so, yet.

Thank you SO Much!

J


#2

I am not a lawyer–you may need one! 100% I believe you are correct (unless somewhere in your policy it specifically speaks to a lump sum retroactive pay) Ask them to show you where in the policy wording or in the policy they are relying on to make that request.

Good Luck-I think you got this


#3

This is good to hear! Thank you so much, your response is so appreciated.

Janine


#4

Did you come to this conclusion because they didn’t deduct CPP-D amounts from your LTD payments yet? Or did you actually see the wording in your policy?

Write a formal letter requesting a copy of your LTD policy (not a brochure). Your policy will clearly outline what they can deduct and what they can’t in detail.

You should always discuss your concerns with your Insurer.


#5

Thank you so much for your email, Elaine.

My insurer (case handler) told me that the cppd would not be deducted unless the combined monthly payments were more than my monthly salary was. She assured me this was the case and said I was lucky. I will ask for a copy of the full policy.

Thank you again!


#6

No problem :slightly_smiling_face:

If that’s the case they must’ve made a mistake asking you to pay retro back.

You should clarify that with your case manager.


#7

Hi Janine, you would need to get legal advice on the policy. It is possible your interpretation is correct, but it is also possible you are not interpreting it correctly. What you are describing would be very unusual, but certainly I have seen many unusual LTD Policies.

Please contact our office if you would like more information on how we could help you with this.


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.


#8

Hello David,

Thank you kindly for your email. As it turns out, a well written email to
both GWL parties, explaining my position and the detailed (puppets and
crayons) reasons that tie to my policy, won the day. I received a phone
call where there was a Œsort of apology¹ and explanation that he was unaware
that such LTD premium policy existed (so he was just following regular
protocol - young and learning). So, there was never an Œoverpayment¹ and no
monies will be owed. I cannot begin to tell people how grateful I am. I
nearly dropped to the floor.

So my comments to others:

  1. KNOW YOUR POLICY!
  2. Have a copy of the policy itself (not the brochure).
  3. Use caution in ANYTHING you say or write - over the phone or via email.
    Some people are Œtoo nice and are too helpful¹ and want to Œplease¹. Never
    do that ­ raw honesty is best. Never have an issue with being honest about
    your pain, struggle and limitations (but don¹t lie either).
  4. Ensure that you have a good relationship with your Dr. - this is
    critical! If you don¹t have a good relationship with your Dr., find one who
    looks after you in all Œcapacities¹ and will Œgo to bat¹ for you.
  5. Keep records of everything, and if anything is ŒKEY¹, ensure it is stated
    in an email.
  6. I was told years ago that insurance companies will never just hand
    anything over (they are a money making business and the Œbottom line¹ is
    their goal) Š you will need to fight (for what you have been paying for, and
    rely on for any type of medical urgency).
    I consider myself very lucky here, and am very grateful that my insurance
    case worker is honest and did her job.

Wishing you all good luck in your own personal case.

J


#9

Janine, we love to hear good news. Your situation shows why it is important that people never make assumptions because the rules are vary from insurance policy to insurance policy.


#10

How do people get that in Ontario?