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Appeal Process

Members are encouraged to appeal to the Disability Advisory Council (the Council) if they wish to have their claim reviewed further. The Council is independent from Canada Life and reviews appeals fairly and objectively.  

Plannera’s Disability team can provide clarity on process, answer procedural questions, and guide members on their submissions.  

1. Intent to Appeal  

Members must provide written intent to appeal within 60 days from the date they received the decision letter from the insurer.  

Verbal notice is not acceptable.

Written intent can be submitted to:  

Example of intent to appeal:

A written email or statement such as: 

  • “To the DIP Council, I intend to appeal the decline/termination of my disability benefits.”
  • The statement should include the member’s full name.  

Sending this written noticed within 60 days secures your right to appeal while you gather supporting documents.  

2. Submitting Appeal Information

Once intent to appeal has been submitted:  

The member may provide any written submissions or supporting documentation to the Council for consideration, including but not limited to:  

  • Letters or statements from treating providers
  • Medical documentation (tests, assessments, chart notes, functional evaluation, subjective reporting)
  • Photographs documenting injury
  • Additional investigative information
  • A personal testimony letter from the member

All documents may be submitted electronically to their assigned Canada Life Case Manager or regina.dmso@canadalife.com.  

3. Appeal Review Process

Appeals are reviewed through up to three levels at Canada Life. The Council will review each appeal that is submitted, if the decision is to maintain the decline/termination by Canada Life.  

 First Appeal Level
  • The member appeals the decline/termination and provides further supporting documentation.  
  • The original case manager at Canada Life reviews any new documentation submitted.
  • If the claim now warrants approval, Canada Life will proceed with approval, and the claim will go into active management, and the appeal process is completed.  
  • If the decision to decline is upheld, Canada Life will notify Plannera and send a letter to the member communicating the decline.
  • The letter will state that the appeal will be reviewed at the next DIP Council meeting, where the Council will review the appeal and communicate their decision.  
Second Appeal Level  
  • If the Council declines the members first appeal, the member may choose to appeal the decision providing new supporting documentation.  
  • A Canada Life Team Manager conducts an independent review on the file with the new documentation submitted.
  • If the claim now warrants approval, Canada Life will proceed with approval, and the claim will go into active management, and the appeal process is completed.
  • If the decision to decline is upheld, Canada Life will notify Plannera and send a letter to the member communicating the decline.
  • The letter will state that the appeal will be reviewed at the next DIP Council meeting, where the Council will review the appeal and communicate their decision.
  • The letter will state that the appeal will be reviewed at the next DIP Council meeting, where the Council will review the appeal and communicate their decision.
Third Appeal Level  
  • If the Council declines the members second appeal, the member may choose to appeal the decision providing new supporting documentation.  
  • Once new documentation is submitted, the appeal is reviewed by Canada Life Head Office.
  • If the claim now warrants approval, Canada Life will proceed with approval, and the claim will go into active management, and the appeal process is completed.
  • If the decline is upheld, Canada Life will notify Plannera and send a letter to the member communicating the decline.
  • The letter will state that the appeal will be reviewed at the next DIP Council meeting, where the Council will issue the final decision.

4. DIP Council Review

A Participating Employee appealing to the DIP Council may provide any written submissions or evidence they believe is relevant. 

The DIP Council will review:

  • The member’s written appeal statement
  • Existing file Information in relation to the diagnosis

The DIP Council may:

  • Accept any evidence it deems appropriate
  • Establish its own procedures for review

Note: The DIP Council’s decision is final, but members may continue to submit additional information to support their appeal up to their limitation of action date (provided in the Canada Life’s decision letter).

5. Timelines and Evidence Submission

  • Members have 60 days to submit their intent to appeal.
  • Members must submit all new medical documentation or additional information by the limitation of action date identified in their decision letter from Canada Life.  
  • If unsure of the dates or process, members may contact disability@plannera.ca or their case manager at Canada Life.  
  • Decisions from the DIP Council are communicated in writing within 24 hours to the member.  

6. Additional Information  

  • The Council acts independently from the insurer (Canada Life) when reviewing appeals. This ensures that decisions are made fairly and in the best interest of the members.
  • The Council evaluates the appeal based on the information submitted, medical evidence, and any additional documentation provided by the member.  
  • The Council’s procedures are designed to consider the member’s appeal thoroughly and independent of prior insurer decisions.
  • The Council meets once per month, except July and August.
  • The Council is comprised of an equal number of union and employer representatives.
  • Plannera’s role is to guide members on the appeal process, clarify submission requirements and answer procedural questions.  

Contact Information