Life and disability claims
appeals process
Preparing your appeal
To begin the appeal process, you must inform us in writing of your intent to appeal within 30 days from the date of claim closure or our written claim decision, whichever is later. The Notice of Appeal form is sufficient written notice of your intent to appeal.
Submitting your appeal
Submit your notice of appeal and supporting information to:
- Mailing address:
Manitoba Blue Cross
Case Management Services
599 Empress Street
PO Box 1046 Stn Main
Winnipeg MB R3C 2X7
- Email: LDinfo@mb.bluecross.ca*
- Fax: 204.788.5591
This email and fax number are for life and disability claims ONLY.
Samples of information for the appeal panel's consideration:
- A written statement of your circumstances including why you feel the wrong decision was made
- Medical information supporting your claim, such as (but not limited to):
- ~consultation reports from any specialist(s) you have seen
- ~medical chart copies
- ~lab results, investigative results
If your claim was denied because you did not meet the definition of disability defined by your policy, you should also provide:
- a written statement of your functional abilities (i.e. what you can and cannot do as a result of your medical condition)
- a letter from your physician(s) and other treatment provider(s) supporting your:
- ~diagnosis
- ~impairment arising from this diagnosis, including severity and duration
- ~level of function
- ~restrictions and limitations that have been placed on your level of activity
- ~prognosis
Appeal process
Reconsideration
Your case manager will first review the information provided on appeal and reconsider the initial decision. If the information does not clearly support a change to the initial decision, your case manager will forward your claim to the first level of appeal panel.
First level of appeal
A panel consisting of a designated consultant, a case manager and the supervisor of case management services (or designate) will review your claim and render a decision.
Second level of appeal
Should the first level of appeal panel uphold the initial claim decision, you can request a final review by submitting your intent to appeal at the second level. The appeal process is the same at both levels (see preparing your appeal). Please note that the second level of appeal will only proceed with the receipt of additional new supporting information. A panel consisting of a designated consultant and at least two Manitoba Blue Cross managers (or designates) will review your claim and render a decision.
If you have any questions, please contact your case manager directly.
Appeal decision
Upon receipt of all appeal documentation or by the time limit noted above, whichever is earlier, your claim will be reviewed and a written decision will be provided to you within 30 days. In some rare instances additional information is required by the appeal panel, which may cause delay in the appeal decision. You will be notified in writing of any delay.
*By submitting information via email, you acknowledge and confirm that you are aware that email is not a secure method where privacy can be ensured, and that complete security and confidentiality is not possible at this time. Your confidential use of email cannot be guaranteed, and you acknowledge that information transmitted via email may be subject to access by, or disclosure to, other persons. Without limiting any other disclaimer herein, Manitoba Blue Cross shall not be responsible or liable for any harm that you or any other person may suffer in connection with any such breach of confidentiality or security.