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44% of plan members have had a benefits claim denied: Sanofi

Almost half (44 per cent) of plan members said they’ve had a benefits claim denied, according to the 2019 Sanofi Canada health-care survey. Among this group, 20 per cent have had a dental claim denied, followed by a prescription drug claim (15 per cent) and a claim for a paramedical service (13 per cent). More […]

  • By: Staff
  • June 26, 2019 November 11, 2020
  • 09:03
Is scrutiny on the rise for long-term disability claims?

A recent RBC Insurance Services Inc. study found 45 percent of employees on disability claimed their workplaces pressured them to go back earlier than they felt they were able to do so. This is a significant increase from the 33 per cent of respondents who said the same in the previous year’s survey. Indeed, there’s a […]

Employers, insurers facing challenges as genetic testing grows in popularity

Genetic testing is gradually growing in popularity as some employers adopt a more preventative benefits and wellness strategy. In its annual employee benefits report, the U.S.-based Society of Human Resources Management found 18 per cent of organizations offered genetic testing in 2018, up six per cent from 2016. It also found plan members are increasingly interested in learning […]

Constructive dismissal and the corresponding duty to mitigate damages

In a recent case, the Ontario Superior Court found an employee failed to mitigate damages when he refused a return-to-work offer from his employer, with whom he had a good working relationship. In the case, Gent v. Strone Inc., the plaintiff, David Gent, had been employed for 23 years by Strone Inc., first as a carpenter and then […]

  • June 4, 2019 September 13, 2019
  • 08:30
The legal risks of drug plan design changes

Drug plan design changes are often unavoidable, whether they’re due to a carrier modifying contracts across the board or an employer looking to manage ballooning costs. Generally, “plan sponsors are looking at programs like more managed formularies and, potentially, maximums,” says Suzanne Lepage, a private health plan strategist in Kitchener, Ont. “Changes driven at the […]

Health Canada moving to simplify generic drug approval process

Health Canada has proposed amendments to the Food and Drug Regulations that would make it easier for drug companies to get authorization to produce generic versions of brand name drugs. The amendments would allow Health Canada to more quickly to approve generic drug applications that have the same active ingredients as their brand name equivalent […]

Settlement reached in Ontario age discrimination benefits case

Following the Human Rights Tribunal of Ontario’s decision in a landmark age discrimination case last year, former high school teacher Steve Talos has reached a settlement with the Grand Erie District School Board. Though Ontario abolished mandatory retirement in 2006, it still allowed employers to terminate benefits plans for workers age 65 and over. In […]

The conflation of medical and recreational cannabis can present challenges when it comes to workplace policies, says Gregory Clooney, a lawyer and senior legal consultant at Morneau Shepell Ltd. “This should be avoided as these are two very different concepts to be addressed within their own context,” he says. “Yes, there’s some potential overlap, but this can […]

Ontario court grants appeal for employee in long-term disability case

The Ontario Court of Appeal has ordered a full trial for an employee who sued for $300,000 in long-term disability benefits despite signing a document that released such claims. The decision in Swampillai v. Royal & Sun Alliance Insurance Co. of Canada reverses a lower court decision that summarily found the release to be “unconscionable.” […]

Wabush Mines retirees to regain portion of cut pension benefits

Wabush Mines pensioners in Newfoundland and Quebec will see some reversal of the pension cuts that went into effect when the operations’ parent company filed for creditor protection in 2015. When Cleveland-Cliffs Inc. shuttered Canadian operations, it left the defined benefit pension plan underfunded, subjecting pensioners to a benefits cut of more than 20 per […]