DISABILITY: INFORMATION
AND CLAIMS PROCESS

1. First, submit your claim online by filling in all the required information, taking into account the waiting period applicable to you.
2. We will perform an initial analysis of your claim and then contact you about the forms and documents we will need based on your situation (e.g., a statement from your attending physician). If your claim is not eligible due to a specific provision of your coverage, we will notify you.
3. We will start the full analysis of your claim once we have received all the required documents.
4. It is sometimes necessary to request documents from external organizations such as hospitals or medical archives.
5. We’ll stay in touch with you throughout your claim.

Your request will be processed on a priority basis according to the date we receive the documents. Processing times are sometimes beyond our control and vary depending on how quickly documents are received from external agencies.

1. All required forms must be fully completed.
2. You must have been unable to work for at least the entire waiting period.
3. You must have a recognized medical diagnosis that results in functional limitations and restrictions that prevent you from performing your work or daily activities, as defined in your coverage.
4. You must be under the care of a doctor.

The online application allows us to open a claim file. We ask a few questions to determine whether the minimum eligibility requirements have been met.

• If these requirements are met, we then need a more detailed statement, completed by you, in order to continue our analysis of the file.
• If the eligibility requirements are not met, we will unfortunately be unable to continue the process. In this case, you would be saved the trouble and expense of obtaining medical forms.

There may be several reasons, such as:

• Your disability is due to an illness, but your insurance only covers accidents.
• Your condition is related to a specific exclusion or limitation in your contract.
• You returned to work before the end of your waiting period.
• Your health condition is not covered by your contract.
• Your contract was no longer in force at the time of your disability.

Yes, but only attending physician’s statements and employer forms are accepted. The insured’s statement and iA Financial Group authorization forms must always be completed by the insured.

We would need to know your medical history in the following two situations:

Policies issued in the last two years

We check medical histories, even if they are not related to the disability, to ensure that the information provided at the time you enrolled in the policy is accurate and complete. This procedure is standard for all insurers.

Complex medical conditions

The company must obtain additional medical information to assess and determine eligibility for benefits, in accordance with the terms and conditions of the policy.

In such cases, if the request is made by us, we will bear the costs of obtaining this information.

The duration of this period can vary from one to several months. It is therefore essential for us to check whether your health condition has changed and whether it still corresponds to the definition of disability set out in your policy. To do this, we need up-to-date medical information to support your file and keep track of your health condition. This also enables us to determine whether we can provide additional assistance, such as a medical expertise or rehabilitation, to help you resume your activities and plan for a return to work, in accordance with the provisions of your insurance policy.

In most cases, copies of original documents are acceptable. However, some healthcare facilities require an original authorization. We will be sure to indicate this clearly.

The letter we send you will include all the information you need to return the documents to us.

You will receive payment by direct deposit or cheque, whichever you prefer.

In the case of income replacement insurance, the benefit amount has been calculated on the basis of your employment income at the time your policy was taken out. In order to confirm this amount, we will ask you to provide us with proof of your employment income prior to the start of your disability period. We will contact you to let you know which documents are required.

In the case of loan insurance, we will ask you to provide supporting documentation for your loans at the time of the disability up to the amount specified in your policy. Please note that loans already covered by another insurance policy are not included in your coverage.

In the case of overhead expense insurance, we will ask you to provide supporting documentation for your overhead expenses up to the amount specified in your policy.

The length of your disability must first exceed the elimination period.

If you return to work, you will receive a benefit for the entire eligible period of your disability.

If your disability continues after this period, an initial payment will be made, followed by monthly payments towards the end of each month, by direct deposit or cheque.

You have 60 days after receiving our denial letter to send us additional information, if applicable.

Let us know and we’ll see what we can do until your next appointment.

If you pay your own insurance premiums, your disability benefits are not taxable.

If an employer is paying the premiums for an employee, i.e., the insured person, then the benefits are taxable. The insured person is responsible for declaring the total amount received, as iA Financial Group will not issue any tax information slips.

Talk to your accountant or a tax specialist for a full understanding of your situation.