Effective April 1, 2019, OHIP+ will no longer provide drug coverage for individuals under the age of 25 who have access to private insurance. Therefore, prescription drug claims for children and youth 24 years of age and younger with private plan coverage will have to be submitted directly to their private plan. Click here for details!

Long Term Disability Insurance & Termination of Coverage

Extended Insurance

If your Long Term Disability insurance terminates during a period of total disability, the Insurer continues to be liable as though the provision remained in force.  If a recurrence of disability occurs within 6 continuous months after termination of this benefit, the Insurer shall continue to pay your benefits but only for the remainder of the original maximum benefit period.  Such disability must have been caused by an accident or sickness that occurred before termination.  The Insurer shall not be liable for benefits after termination of either the contract or Long Term Disability Income benefit once a replacing Insurer is bound contractually or as a matter of law.

Termination of Coverage

Your eligibility for Long Term Disability terminates the earlier of your retirement or attainment of age 65.

Proof of Loss

Written proof stating the occurrence, character and extent of loss must be submitted to the administrator within 6 months after the end of the qualifying period for Long Term Disability Insurance.  The qualifying period is 52 weeks; therefore you must apply within 18 months of leaving work due to disability.

Written proof of the continuance of disability must be furnished to the Insurer at such intervals as it may reasonably require.  As part of the proof, the Insurer shall have the right to require satisfactory evidence that the member has made application for all benefits referred to in the reductions provision and that he has furnished all required proofs for such benefits.  If the member did not make such application, he must provide satisfactory evidence that he was not eligible for such benefits.  The Insurer shall also have the right to require satisfactory evidence of the amount of such benefits payable.

The Insurance Company shall have the right and opportunity to examine any person whose injury or illness is the basis of claim, when and as often as it may reasonably require during the pending and payment period, if any, of such claim.

 

Claim Forms

Brochures:

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Teamster Local Union 230 Members' Benefit Fund c/o Benefit Plan Administrators
90 Burnhamthorpe Road West, Suite 300 Mississauga, Ontario L5B 3C3