|
|
|
|
|
|
Long Term Disability |
|
|
|
|
|
|
|
|
|
|
|
Industrial and Institutional:
Active (Hour Bank) and Disabled/Associate (Class 001)
Honourary or Exempt (Class 002)
Commercial:
Active (Hour Bank) (Class 003)
Active (Monthly) (Class 004)
SUMMARY OF BENEFITS
Class 001
This benefit is equal to 75% of monthly earnings, subject to
the
85% All Source Maximum described under Offsets in the Long
Term
Disability section later in this booklet. The maximum benefit
payable
is $1,700 per month.
The qualifying disability period starts when you first become
totally
disabled and ends after 365 days, provided your disability is
continuous
and you are under age 60. If the disability is not
continuous,
the days you are disabled will be accumulated to satisfy the
qualifying
disability period provided:
- no interruption is longer than 2 weeks;
- the disabilities arise from the same or related disease or
injury.
No-Evidence Limit: $1,700
Coverage terminates on the date you attain age 60 or
retirement,
whichever is earlier.
Class 002
No Long Term Disability coverage for retirees.
Classes 003 & 004
This benefit is equal to 66.67% of monthly earnings, subject
to the
80% All Source Maximum described under Offsets in the Long
Term
Disability section later in this booklet. The maximum benefit
payable
is $2,000 per month.
The qualifying disability period starts when you first become
totally
disabled and ends after 119 days, provided your disability is
continuous
and you are under age 60. If the disability is not
continuous, the days you are disabled will be accumulated to satisfy the
qualifying
disability period provided:
- no interruption is longer than 2 weeks;
- the disabilities arise from the same or related disease or
injury.
No-Evidence Limit: $2,000
Class 003
Coverage terminates on the date you attain age 60 or
retirement,
whichever is earlier.
Class 004
Coverage terminates on the date the Member ceases employment,
retires or attains age 60, whichever is earlier.
EMPLOYEE LONG TERM DISABILITY BENEFITS
In the event you become totally disabled for the required
period
of time known as the Qualifying Disability Period and you are
under
the continual treatment of a legally qualified physician
deemed
appropriate by the Insurer, you will receive a monthly income
benefit.
|
Qualifying Disability Period |
As described in the
Summary of Benefits.
|
|
Monthly Benefit |
As described in the
Summary of Benefits.
|
|
Maximum Disability Period |
to age 60. |
Benefits will not be payable beyond age 60, unless you
satisfy the
Qualifying Disability Period while age 59, in which case
benefits will
be payable for a maximum of 12 months.
Total Disability
You are considered totally disabled, during the first 24
months
(for Class 001) and for the first 12 months (for Classes 003
and
004) in which you receive benefits, if you are unable to
perform any
and every duty of your occupation. After this 24-month
period (for
Class 001) and 12-month period (for Classes 003 and 004) you
are considered totally disabled if you are unable to perform
any and
every duty of any occupation for which you are reasonably
qualified
by training, education or experience.
Recurrent Disability
If a disability recurs and it is due to the same or related
causes, it
will be considered as one continuous disability and will not
be subject
to the Qualifying Disability Period unless you have returned
to
active, full-time employment for a period of 6 consecutive
months
or longer.
If your new disability is due to causes unrelated to your
prior disability
you may be eligible for a new disability period, subject to
the
Qualifying Disability Period, if you have returned to active
work for
at least one full day.
Offsets
The amount payable under this benefit for total disability is
calculated
by deducting from your benefit any other sources of
income. These are specified in the Master Policy and include
the
following:
- wages or retirement benefits payable from your employer or
employer’s pension or retirement plan;
- any payments on account of your disability from any
Workers’
Compensation law or similar law;
- payments received from the Canada or Quebec Pension Plan,
excluding payments made in respect of dependent children;
- any income or benefit payable under any other plan or
program
of any government or of any subdivision or agency of the
government,
including any plan or program established pursuant to
a provincial automobile insurance act.
All Source Maximum:
Your total monthly income while disabled (Long Term
Disability
benefit plus any income listed above and Canada or Quebec
Pension
Plan family benefits) cannot exceed 85% (classes 003 &
004
80%) of your gross monthly earnings as of the date your
disability
commenced. If your total income exceeds 85% (classes 003
& 004
80%), your Long Term Disability benefit will be reduced
accordingly.
|
|
|
|
|
|
EXCLUSIONS AND LIMITATIONS
Benefits are not payable for the following:
- for any portion of a period of disability unless you are
receiving
ongoing supervision/treatment by a physician deemed
appropriate
by the Insurer for the impairment which is causing the
disability. You will not be paid for any portion of a period
of disability
during which you do not participate in the treatment program
recommended by said physician;
- for any portion of a period of disability during which you
are
receiving treatment by a therapist unless such treatment is
recommended
by a physician deemed appropriate by the Insurer;
- for any portion of a period of disability resulting from
substance
abuse, including alcoholism and drug addiction, unless you
are
participating in a recognized substance withdrawal program;
- disabilities resulting from self-inflicted injuries or
attempted suicide;
- disabilities as a result of participation in a war, riot,
insurrection
or criminal act;
- for the portion of a period of disability during which you
are
- imprisoned in a penal institution; or
- confined in a hospital, or similar institution, as a
result of
criminal proceedings;
- any period of disability, or portion thereof, during any
leave of
absence (including maternity leave) as defined in the General
Provisions section of this booklet;
- for a disability which commences on or after the date a
strike
begins, except as outlined in the Master Policy; however, an
employee may commence to fulfill his/her qualifying
disability
period from the date of disability;
- to an insured individual who refuses to participate in a
rehabilitation
program which is deemed appropriate by the Insurer, the
attending physician or on the advice of independent medical
opinion;
- to employees of Classes 003 and 004 unless they have been
actively working for a participating employer for a minimum
of
24 hours per week at the date of disability.
|
|
|
|
|
|
Subrogation
If you are entitled to recover compensation for loss of
income
from a third party as a result of the incident which caused
or contributed
to the disability, for which benefits are paid or payable,
the
Insurer will be subrogated to all your rights of recovery for
loss of
income, to the extent of the sum of benefits paid or payable
by the
Insurer. You shall execute such documents as required by the
Insurer.
In the event you provide proof to the Insurer that you have
not
recovered full compensation for loss of income, the Insurer
shall
determine the proportion of damages actually recovered and
share
pro rata in that amount.
Should you choose to settle the matter prior to judicial
determination,
it is understood that the sum reached in settlement will be
deemed to be full compensation for loss of income, and the
Insurer’s
right of subrogation will apply.
The term compensation shall include any lump sum or periodic
payments which you receive or are entitled to receive on
account of
past, present or future loss of income.
Disability Case Management Program
Manulife Financial has developed a disability case management
program. The purpose of this program is to assist you, in the
event
you become totally disabled and qualify for benefits, to
return to
productive employment. Our disability case management team
includes medical consultants, claim adjudicators and a field
coordinator.
This team will work with you, your employer and your
physician
to assist you to recover and return to the workplace.
Rehabilitative Employment
If you are disabled, the Insurer may recommend that you
undergo
some suitable rehabilitative training program which would
take
into account the nature and limitations of your disability.
Further
details on this aspect will be provided in the event you
become disabled.
Canadian Residency Requirement
No benefits are payable if the Member resides outside Canada
for
any period exceeding 90 consecutive days or a total of 180
days in
any 365-day period, unless:
- the Member has previously notified and received approval
in
writing from the Insurer, and;
- the Member remains under the regular care of a licensed
physician
deemed appropriate by the Insurer, and;
- proof of the ongoing disability can be determined on
evidence
satisfactory to the Insurer in English or French within 30
days of
request.
|
|
|
|
|
|
|
PDF - 180 Kb)