I am having a bunch of trouble with my case worker at Desjardin’s Insurance at least 1/3 of my monthly cheques have been late because she just decides to hold them. She never calls me to tell when or why she is doing it and when I call her to ask any type of question it can take days to weeks for her to reply if she actually replies. After I do get a hold of her she didn’t send it because she is waiting on something from my Psychiatrist, but when I talk to my Psychiatrist he gets whatever forms she is talking about the same day I phone her asking where my money is at. I am wondering can she do that? If not what is the best to handle it?
You can ask for a new case manager. You can also send a letter saying how not being informed of any delays in receiving your benefits on time is distressing and affecting your health. If you have any NSF fees I would send a copy and ask them to reimburse as they failed to notify you of payment delays so you were unable to make other arrangements for payments. Send by email or fax with proof of receipt.
Be polite, to the point in communication.
You may want to request a copy of your claim file to further understand the delays.
This happened to my husband in 2013. He sent an email about all the stress of not receiving benefits on time was causing him, Then he had to send another letter a few days letter as he still had not received his funds, again letting them know how much stress it was causing. Two days later I had to send a letter that my husband was in cardiac intensive care due to a heart attack on unknown cause but likely due to stress.
We have never had a problem after that. ( Except for now his benefits are reduced by an estimated CPP-D)
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Thank you very much for the information I am actually phoning right now because once again she didn’t release my payment which is set for the 13th of each month(even though I still don’t understand why on the 13th lol)
It is inappropriate for insurance companies to pay befenfits in such an erratic matter UNLESS there is a real issue with you or your doctors not providing reasonable information necessary for them to determine your right to payments under the plan. Courts have said this type of behaviour by insurance adjusters and companies can constitute bad faith. You can request a new claims manager but this is also a situation where a filing a complaint with the insurance regulator for your province can be effective.
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 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. Answers from lawyer moderators are provided for informational purposes only, you should consult with your own legal counsel before taking any action that could affect your rights or legal obligations.
It isn’t an issue with my Psychiatrist sending her the information she requests at all even though that’s what I had though in the beginning. The last 3 or 4 times she had held the payment and I had to phone her to see what’s happening and when she want other information besides the regular updates she hasn’t been sending requests for the additional information. She ends up making the first request for the additional info after I call because I started asking my doctor on what day he was receiving the requests and every time it was either the day I would first phone and inquire on the status of my payment or the day after. It’s almost like she puts a hold on the payment because she wants to send the request, but forgets to send it and also forgets the hold is in place and unfortunately her reminder is when I don’t receive my payment and have to phone. Then of course she tries to cover her own butt by saying it was sent and yet the date on her requests is always after the payment is supposed to be here and after the calls I make to her. I have spoken to her to Supervisor and have been assured it won’t happen anymore, but should I still log the complaint with the Insurance regulator?
If it happens again then definitely file the complaint. You could still send in a complaint to your regulator, advising them of the situation, how it has affected adversely your health. Include the name of the supervisor who has assured this will not occur in the future. Thank them for their time and say you wanted their office to be aware in case others are having similar issues. Let them know you reach out for any and all assistance if you have any further problems.
Might be wise to start a paper trail as this claim has not started off right. Hopefully it is now resolved.
Sounds like classic disorganization of the claims rep causing these problems. If it isn’t resolved as manager promised, then file a complaint. This is unacceptable for them to cause this stress with your month to month payments
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 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. Answers from lawyer moderators are provided for informational purposes only, you should consult with your own legal counsel before taking any action that could affect your rights or legal obligations.