Irrevocable Consent to Deduct and Pay an Insurer


#1

Except for retirement benefits, all income is considered payable when a person is entitled to it, whether or not it has been awarded or received. If it has not been awarded, XXXX will have the right to estimate it according to the terms of any plans or legislation involved. Retirement benefits are considered payable when they are actually received.

I do not want to sign the Irrevocable Consent to Deduct and Pay an Insurer but the clause above is what my Insurer is using to say I have too.
My position is that CPP disability determines entitlement-not my Insurer.
Therefore if I apply in good faith they should not reduce my monthly benefit until CPP advises if I will receive benefits.

If they reduce my benefits I do plan to file a statement of claim on this and other issues related to their mishandling of rehabilitaion.

What is your thoughts ( understand I am not asking for legal advice!) on Irrevocable Consent to Deduct and Pay an Insurer form?

I understand they have a right to the retroactive lump sum if awarded-unless they wrongfully cut me off in the future.


#2

The insurance policy clause you quote above is very common and had been upheld as legal by the courts. You can’t successfully sue them for estimating and deducting - they are within their rights to do it.

So, you have the choice not to sign the Form, but if you to that, then the insurance company will estimate your CPP-D payment amount and start deducting it, even though you haven’t been approved for CPP-D.

If you sign the Irrevocable Consent to Deduct and Pay Insurer Form, then they will not deduct any CPP now and will wait and see if you get approved. Once you sign that form, the CPP administration will pay any retroactive payment over to the insurance company.

Insurance companies have been getting much more aggressive about estimating and deducting benefits, so if you don’t want your benefits to lower, then you need to sign the form.


#3

Do you have the case name where it has been challenged in the court. My policy does not have a stipulation that they can require me to apply for CPP and require me to appeal as some policies do.

I did sign a reimbursement agreement as well. The agreement states that they will advance me full benefits if I apply for CCP-D and if I am granted CPP I have to notify them within 15 days and repay within 30.

They believe I am entitled and I believe it is to early to apply as I have ongoing tests and specialists to see. Therefore a denial from CPP-D is likely and applying now is a long shot or could complicate the CPP-D claim.

So I feel that my Insurer may deny my claim later and do not understand why I would now be required to sign the irrevocable form when I have already signed a reimbursement agreement.

If they estimate and reduce my benefit and I am denied how does that work?

The insurer seeking to deduct the payment must demonstrate that the insured qualifies for the proposed payments in every respect, and so far as the future can be made certain, they will be received. Chrappa v. Ohm [1998]


#4

I would need to review your full insurance policy to give an opinion on this. There are no general rules. The rules for your situation will be dictated by the terms and conditions of your insurance policy and any court cases that interpret those terms and conditions in similar cases. The Chrappa v. Ohm case does not apply to your situation because it involved a tort claim and is governed by different law and regulations. If your insurance company reduces your benefit and it turns out that you don’t get CPP disability, then they have to refund the money to you later on.


#5

I could not find any case that stipulated that an insured would have to sign an irrevocable form, save for some Union Contracts that have added specific language to their agreement.
Nor the right to estimate and deduct for CPP-D if a claimant is in good faith applying.
Anyways my husband is including a claim against his Insurer on the above issue.
I will let you know if he wins. I believe he will.
I don’t like that it is irrevocable and no where does it say he is required to sign such an agreement.

So will see how it goes.

To estimate and deduct =well the wording of any such clauses designed to reduce the quantum of the benefit
had better be crystal clear. Entitlement to CPP-D is not decided by an Insurer.


#6

My policy allows the insurance company to estimate and deduct income from a retirement plan funded whole or in part by my employer.
If I actually did get the income, I would have to retire and then the insurance can stop disability payments (as soon as I retire).


#7

It all comes down to policy wording, the contract.
If there is a clause that limits the offsets and benefits then it needs to be clearly spelled out in the policy.

Your entitlement to retirement benefits is a given. An entitlement to CPP-D is not a sure thing.

I am looking for the right of an insurer to estimate and deduct CPP disability amounts prior to a claimant being found entitled to receive such benefits. I can see if an Insured refuses to apply for CPP-D a right to estimate may be found to be reasonable.

Requiring an Insured to sign an irrevocable consent to deduct and pay an insurer puts an Insured in a bad position if the Insurer later wrongfully denies the claim. If an Insurer breaches the contract I believe an argument could be made that they are no longer able to rely on the contract to enforce repayment of retroactive CPP.

At least I would try that position. Unless the Insurer irrevocably guarantees that full benefits will continue while the application is being decided then signing that form could be a just another Insurer trap.

I also would think an Insurer who reduces benefits prior to entitlement being decided puts themselves in breach of the contract and may fuel a bad faith claim.


#8

The policy has to say the have “the right to estimate and deduct”. If that wording is not in the actual policy, then they are on shaky ground to do so. If the policy says the words “right to estimate and deduct CPP” then that is all the authority that is required. You don’t have to look for cases or judicial decisions.

Sometimes insurers will get you to sign a form (separate from the policy) that says you agree to give them the right to estimate and deduct. These forms are very dubious in terms of their legal effect, unless, the Policy says you will have to sign such a form (which some policies do say this).


Cpp and Irrev Consent To Deduct and Pay An Insurer a One Time Retroactive CPP Payment to Insurer Form