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Wage Indemnity |
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For Employees Only
A benefit of $435* per week or the maximum weekly payment
provided under EI Sick benefits* whichever is greater, is
payable if the Employee becomes unable to work while covered for
this benefit, due to an accident, sickness or pregnancy,
provided he/she is under the regular care of a doctor.
*The amount of benefit paid may not exceed 85% of the Employee’s
pre-disability earnings.
Accident
If the Employee becomes disabled due to an accident, benefits
are payable from the 1st day of disability, provided he/she is
under the regular care of a doctor.
Illness or Pregnancy
If the Employee becomes disabled due to illness or pregnancy,
benefits are payable from the 4th day of disability provided
he/she is under the regular care of a doctor. Payments will
continue as long as the Employee remains Totally Disabled, is
under the regular care of a doctor, and is unable to perform any
and every duty of his/her occupation, up to a maximum of 52
weeks from the date the benefits begin.
However, no benefits will be paid during any of the following
periods:
- for any period while on a pregnancy leave of
absence;
- for any period while on a parental leave of
absence;
- for any period while engaged in any business or
occupation for wages or profit;
- for any period while eligible for receipt of E.I. maternity benefits; or
- for any period while eligible for receipt of benefits under WCB or other occupational
disease law.
If the same disability recurs, it must be separated from the
original disability by more than two weeks of continuous active
employment for it to be considered a new period of disability.
If a disability arises from a different and unrelated cause it
will be considered a new disability, provided it commences
following the Employee's return to full-time work.
Limitations
No weekly benefit will be payable for any disability that
resulted either directly or indirectly from, or was in any
manner or degree associated with or occasioned by:
- intentionally self-inflicted injury while sane or
insane;
- any cause which entitles you to apply for and receive
indemnity or compensation under any Workers’ Compensation Act;
- insurrection or war, declared or undeclared, whether or not
there is actual participation therein;
- participation in any riot
or civil commotion;
- committing or attempting to commit a
criminal offense or provoking an assault excluding offenses
related to the operation of a motor vehicle with blood alcohol
content in excess of the legal limit in the province of
residence of the covered Employee.
How to File a Claim
SEND CLAIM TO THE ADMINISTRATOR, DO NOT SEND CLAIM TO
THE INSURANCE COMPANY.
To claim for Wage Indemnity benefits, a
special claim form is required.
This form consists of the
following sections:
(a) Attending Physician’s Statement
(b)
Employer’s Statement
(c) Employee’s Statement
The Physician
should complete the “Attending Physician’s Statement”
portion of the form. He or she must clearly indicate his or her
diagnosis, date(s) of service and type(s) of service rendered.
The “Employer’s Statement” should be completed by the
employer. The date the Employee last worked must be shown on
this form.
Remember! The claimant must be under the
continuous personal care of a medical doctor to qualify for Wage
Indemnity benefits.
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