Appeal a Claim
We understand that sometimes you may want to appeal a claim decision. Our goal is to make the process clear and straightforward for you.
When to Appeal a Claim
If a claim is declined or covered for a lower amount than you expected, you may have questions or disagree with the decision. That’s why we have a clear appeal process in place.
Steps to Appeal a Claim:
1
Review the Explanation Of Benefits Statement
After Canada Life processes your claim, they’ll issue an Explanation Of Benefits statement. Review this statement first to understand how they reviewed your claim, and contact Canada Life to ask questions.
2
Gather Your Information
If you want to appeal Canada Life’s decision, collect any documents or information that support your appeal, such as medical records or letters from your healthcare provider.
3
Submit Your Appeal
Follow the steps outlined in the Claims Review and Appeals Policy. This policy provides a clear guide on how to submit your appeal and what information to include.
In providing a way to appeal claims decisions, our goal is to make sure every member has fair and consistent access to the benefits covered by the CUPE EWBT plan.
Need Help Appealing a Claim?
If you have questions about the appeal process – we’re here to help.