Making A Claim

To make a claim, you would generally contact your advisor for assistance.

A claims examiner confirms that

  • the insurance contract was in force at the time of the claim
  • for life insurance, that the deceased was the life insured
  • the loss is covered by the contract
  • the claimant is the one named in the policy

Death Claims

A death claim requires the following at the claimant's expense

  • claimant's statement
  • Attending Physician's Statement confirming the date and cause of death
  • perhaps copies of the following: death certificate, coroner's report, provincial medical examiner's report
  • return of the policy contract
  • if the beneficiary is the estate of the deceased: a certified copy of the letters probate or letters of administration

Disability Claims

Disability claims can be contentious

  • fraudulent claims
  • the claimant may not meet the definition of disability
Type of Total Disability Benefit Payable When …
any occupation (good) unable to work at any job for which reasonably suited
get either full DI benefit or other income but not both
regular occupation (better) unable to perform essential duties of own regular occupation
benefit adjusted if any other employment income
own occupation (best) unable to perform essential duties of own regular or previous occupation
full benefit even if working at another occupation

Time Limits

From the date that the claim arises, the claimant has

  • 30 days to notify the insurer of the claim
  • 90 days to provide proof of the claim

The claimant's statement contains

  • the date the disability started
  • the cause, nature and treatment of the disability
  • the name of the doctor

The doctor provides an Attending Physician's Statement showing

  • details of the disability
  • estimated duration of the disability

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