Trying to get Denial of benefits letter for almost 4 weeks


#1

August 2nd I was informed I was being cut off LTD after calling to tell them I had not received payment. I learned at that point I don’t have an “own occupation” clause. They’ve concluded I am not able to do my own job.
A few days later I called to ask if a Denial of benefits letter was forthcoming.They said sure. I didn’t receive anything so called back. The two people I talked to said they couldn’t do it, the team leader had to. She was away for another week, said she was sick. Aug. 21 I was contacted by team leader, who said she was going to talk to the “marketing department”, to see what was going on with my case and would have a letter for me by the 25th. I didn’t receive anything and she didn’t call. I was able to contact her on wed the 30th, and she said she couldn’t send me anything because she had yet to talk to my HR dept., with which she was contacting within the hour and she would get back to me by friday (yesterday). She never did.

My next thought was to get written confirmation from her that I had sought a denial letter throughout this time-frame. She knows I want this letter so I know what I’m supposed to appeal. She said there won’t be a deadline since I haven’t received it and it could be extended anyway. But this persons actions are so screwy and bizarre I can’t trust her.
At this point I’d be happy to lawyer up but am part of a large union, and at this point have not yet been able to get hold of the higher up union guy that deals with this stuff. I’m not sure if I can sue or only arbitration. Also not sure about asking the union about that.
I appreciate any comments.
Thanks.


#2

If you don’t have an “own occupation” clause then I think you need to prove that you can’t work for this or any other employer doing any sort of work.
If you have medical support that you can’t do any work then get a hold of your union guy.


#3

I would personally send a formal letter by mail, fax and email (all three) to the Insurer, HR and the Union.

If it doesn’t work then you have a written proof that they don’t respond to your requests. After all that you can proceed with a complaint against them.


#4

Do you have a copy of your collective agreement? Who pays the disability premium-you or your employer?

Some collective agreements mandate the LTD process fr appeals and you can only arbitrate.

There is also a failure to represent that you can file against the Union. Not usually successful but can cost them money and grab their attention.