Employer Claims Forms Mississauga, ON

Claims Initiation for an Employer

Short Term Disability Claims

•  Complete and forward the Claimant's Statement to Fenchurch General Insurance Company as soon as practicable.
•  Complete and forward the Employer Statement to Fenchurch General Insurance Company as soon as practicable
•  Ensure employee has a blank Claimants Statement and Attending Physicians Report.

Long Term Disability Claims

• Complete and forward the Employer Statement to Fenchurch General Insurance Company no later than 3 months after the first day of absence
• Ensure employee has a blank Claimants Statement and Attending Physicians Report.

Forms

•  Early Intervention
•  Employer Statement
•  Claimants Statement
•  Attending Physicians Report
•  Direct Deposit Authorization
•  Authorization for Release of Information

Claims Guide

The document included in this section is a more detailed guide to the claims adjudication and management procedures for both Short Term and Long Term Disability plans insured by Fenchurch.

• Employer Application Guide

Frequently Asked Questions

Who will be reviewing the member's application for disability benefits?

A member of Fenchurch General Insurance Company Disability Management will be allocated to handle each application and he/she will remain the prime contact throughout the duration of the claim.

How long will it take for me to receive a decision on an application?

Once a complete file is received, our goal is to adjudicate and inform the claimant of our decision within 5 working days for a Short Term Disability claim and 10 working days for a Long Term Disability claim.

What happens if the claim file is incomplete?

We will endeavour to collect any missing information as quickly as possible. During this process your claim will be designated as pending.

What is the most common cause of a delay in adjudication?

The most common cause for delay is the time it takes for the attending physician to return his report. Often such reports are vague, have information missing or are illegible. This can cause considerable delay.

What happens if my application is declined?

The applicant has the opportunity to appeal our decision and can supply additional information to support that appeal. Such additional information is not confined to medical information; any background to the circumstances can be provided.

Are we permitted to know the medical condition from which a claimant is suffering so that we can plan for a return to work or replacement?

No, we are only allowed to provide a note of the results of our adjudication and other information which is not considered to be personal under the privacy laws. The exchange of personal information would need to be by agreement between the claimant and the company.

Employer Claim