HOW TO CLAIM BENEFITS
Claim forms are available from the Welfare Plan Office and can be mailed upon request.
The member is required to contact the Welfare Plan Office within thirty (30) days of commencement of a disability and then needs to have the form completed and returned to the administrator within thirty (30) days.
Benefits are payable on the fourth day of sickness and the first day of a non-occupational accident. Benefits will not be paid prior to the first day you are seen by a doctor. A claimant must be unable to perform any of their normal (or any) occupation and the disability requires the full time attendance of a physician and/or surgeon who is a member of a recognized college of physicians and surgeons (licensed medical doctor or chiropractor).
The Wage Indemnity benefit is $560.00 per week for a maximum period of 52 weeks, including any E.I. Sick benefit entitlement. This benefit will change with the E.I. maximum.
If you do not qualify for E.I. sick benefits, our plan will pay $560.00 per week while you are disabled, for a total period of up to one (1) year.
When applying for E.I. sick benefits a member should not quit their job, nor should they accept vacation pay from their employer. The separation certificate required by the E.I. is only a Record of Employment (R.O.E.) indicating insurable hours and that a member is not working due to illness or injury.
Any employment earnings will be deducted from benefits in the week they are earned.
THERE ARE TWO EXCEPTIONS TO THE ABOVE:
1. Permit workers are only allowed to collect wage indemnity for six months from date of claim.
2. Members over age 65 and members who have retired and are collecting pension and subsequently return to work may collect Wage Indemnity for their banked hours only. No contributions will be made by the plan to maintain the hour bank in such case.
In the case of non-occupational accident resulting in bodily injury, the disability must take place within thirty (30) days of the accident, otherwise the disability will be considered due to an illness.
To satisfy the Financial Institutions Commission it is necessary to advise members that under the circumstances of national disaster or widespread and continued sickness of epidemic proportion it could possibly result in the Plan being unable to guarantee payment of all claims.
Benefits will be paid for disabilities due to an accident in which a third party is or may be liable only when the member signs subrogation and assignment forms obtainable from the Welfare Office.
This money is to be fully repaid to the plan when the claim is settled. No lawyers fees will be paid out of the plans portion.
The plan requires a similar reimbursement for all accidents where there is a financial settlement favorable to the member.
Current bank interest rates will be applied to any debt 30 days after the settlement date.
All applications must be approved by the Trustees.
No benefits will be paid for periods of disability arising from:
- Occupational accidents or illness
- Self inflicted injuries or diseases
- Injuries or diseases resulting from war, or participation in a riot, or arising while serving as a member of any armed forces
- Medical conditions existing prior to commencement of coverage
- Disability must occur within a 90 day period immediately following the last day of work with a contributing employer
- No benefits are payable for injuries or illness as a result of an automobile incident for which ICBC or other automobile insurance applies
- No benefits will be paid for any period for which the person has, or will, receive vacation pay for an annual vacation or V.O. time (V.O. time may be collected for the three day waiting period)
- No benefits are payable for E.I. overpayments, violations or other penalties imposed under the Employment Insurance Act