APPEAL PROCESS (Plan member's role)
If Manulife declines or terminates your claim for disability, that decision cannot be challenged in a court of law. It may only be appealed through the appeal process in accordance with the Plan's Appeal Guidelines.
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If you wish to appeal, you must inform Manulife of your intent within 30 days of Manulife's decision.
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Ways to appeal (within 6 months of Manulife’s original decision)
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You can present new information (such as medical reports, job information, etc.) to support your claim.
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If Manulife maintains their position after this new submission, you can submit new information a second time.
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If Manulife still maintains their position after this second new submission, you can request an appeal hearing.
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You also have the option of going straight to an appeal hearing without submitting any new information.
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Important note
No new information can be submitted after you request an appeal hearing. The Appeal Board will only consider the information on file at the time the hearing is requested.
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Who attends the hearing:
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the chair of the Appeal Board (a qualified doctor chosen by the Board of Trustees)
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a representative from the Plan
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a representative from Manulife
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yourself
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a friend or family member for support (this is optional)
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your representative (lawyer, union representative, also optional)
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The hearing format
The appeal hearing is informal.
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First, Manulife will give a summary of the case and their reason for denying or terminating the claim.
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Next, you and/or your representative will present your case.
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The parties involved can present their cases in writing, either before or during the hearing.
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If the Appeal Board has any questions, they will ask after both sides have presented their cases.
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Any written submission for the appeal hearing must:
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not contain new information or evidence
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be written in lay terms if it includes references to case law. The Appeal Board are medical doctors and if they require legal assistance to interpret the case law presented, they will postpone making a decision and consult with the Plan's legal counsel.
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The Appeal Board decision
Once the Appeal Board has considered the case at the hearing and made a decision, that decision is final and binding.
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Questions?
Refer to the Plan's Appeal Guidelines or contact:
Theresa Williams, Director Claims Management
902-461-0421 Ext. 223
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