This article provides an overview of Blue Cross long-term disability plans. We cover how to apply for benefits, appeal a denial, and more.
Blue Cross is a non-profit insurance company that operates across Canada. The Canadian Association of Blue Cross Plans is made up of several shareholders in regions across the country.
About Blue Cross
The Blue Cross Life Insurance Company of Canada (Blue Cross Life) is a federal company that operates in all provinces and territories. It is owned by six shareholders, which includes Medavie Blue Cross, Manitoba Blue Cross, Saskatchewan Blue Cross, Alberta Blue Cross, Pacific Blue Cross, and Blue Cross Canassurance. These shareholder companies are part of the Canadian Association of Blue Cross Plan, which is a not-for-profit organization.
Blue Cross covers the following provinces and territories:
- Alberta Blue Cross (Alberta and NWT)
- Manitoba Blue Cross (Manitoba and Nunavut)
- Pacific Blue Cross (BC and Yukon)
- Saskatchewan Blue Cross
- Medavie Blue Cross (Ontario, Quebec, New Brunswick, Nova Scotia, PEI, and Newfoundland and Labrador)
The insurance company provides short and long-term disability benefits for its shareholder organizations. While it is a not-for-profit company, Blue Cross acts like a for-profit insurance company when administering claims for disability benefits.
Resolute Legal disability lawyers have represented many people involved in appeals or lawsuits with Blue Cross Life insurance. We have represented people in both short- and long-term disability appeals. The following article gives an overview of Blue Cross and includes links to more detailed articles.
Blue Cross Long-Term Disability
Blue Cross provides long-term disability benefits through group and individual insurance policies. Group policies are common with small to mid-sized businesses. While individual policies, are typically used by those who are under-insured or self-employed. Blue Cross also acts as an administrator for some government-sponsored long-term disability plans. For example, they control the Province of New Brunswick’s long-term disability plan.
How much does Blue Cross long-term disability pay?
Unfortunately, we can’t provide you with the exact amount because it will depend on your specific policy and pre-disability earnings. However, Blue Cross benefits are based on a percentage of your monthly income at the time you become disabled. Most insurance companies will cover anywhere from 50 to 85% of your salary. So, your policy’s coverage amount will likely fall in that range.
If approved, benefits are paid once a month via direct deposit. You will receive benefits for as long as your plan allows. This will either be until a certain age or until you no longer meet the definition of disability. To determine if you have long-term disability benefits through Blue Cross, log in to your account and check your policy to see if you have coverage.
For more information on long-term disability insurance in Canada, check out our Ultimate Guide to Long-Term Disability.
Short-term disability
Blue Cross Life Insurance provides short-term disability benefits through group insurance policies. Blue Cross also manages short-term disability benefits for some government-sponsored plans. Look for a document called the group benefits booklet to see if you have short-term disability coverage.
Applying for Long-term Disability
In general, Blue Cross’ application process for long-term disability is similar to most insurance companies.
Usually, you will have to complete an Employee’s Statement. Then, you will have to ask your doctor to fill out an Attending Physician’s Statement. Your employer is also responsible for completing the Employer’s Statement. With some policies, you may need to submit a Job Description form as well.
With that said, there are no general disability claim forms for Blue Cross. While many of the forms are similar, each plan or policy has its own unique forms. So, it’s important that you use the forms for your specific plan. Do not just search for forms online.
The region you live in will also determine which forms you fill out. It will also dictate where you send your completed forms.
Checking your claim status with Blue Cross Life
The best way to check the status of your disability claim is to contact your Blue Cross representative. Try to work with them first. If they fail to respond to your inquiries, you can refer to Blue Cross’ complaint process. However, use it as a last resort.
Appealing a Denial
If Blue Cross denies your application, then you will get the chance to appeal. They will provide you with the reason for denial and allow you to dispute it.
Once you receive your denial letter, you must notify Blue Cross in writing about your intention to appeal before the end of the appeal deadline.
The deadlines to appeal will depend on your region and specific policy. In Manitoba, for example, you must inform Blue Cross about your intent to appeal within 30 days of receiving a denial letter or within 30 days of the date of claim closure — whichever is later.
You can appeal a denial either internally with Blue Cross or externally through a legal appeal.
However, at this point, you might want to get in touch with a disability lawyer. They have experience and will be able to help determine your next steps.
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