Mental health claims have been on the rise in recent years, and the COVID-19 pandemic has exacerbated this trend.
According to an October 2021 report by the Canadian Life and Health Insurance Association (CLHIA), mental health claims in Canada have been increasing steadily over the past several years.
The impact of this increase in mental health claims on insurance providers and their disability case managers can be significant. They will find that the number of new claims being opened outpaces the number of claims being resolved. This will result in more open, unresolved mental health claims for the insurance provider. This is particularly significant when the claimant has exhausted all avenues of rehabilitation, cannot go back to work on a consistent basis, and must then apply for Canada Pension Plan Disability (CPPD) benefits.
The process of applying for CPPD benefits is harrowing.
This is especially true for someone suffering with mental health issues, as it involves the claimant filling out Service Canada’s application form for CPPD benefits. The form in itself is daunting and extremely difficult for the disabled person to understand and complete. A Medical Report must also be completed by the claimant’s medical practitioner; the claimant must also ensure that the medical practitioner completes the Medical Report in a timely manner. Upon completion of the application and Medical Report, the documents must be submitted to Service Canada for review and to determine if they meet the government’s disability legislation. Due to the overwhelming amount of CPPD applications that Service Canada receives, it takes at least 4-6 months to receive a decision. Unfortunately, the denial rate for the Canada Pension Plan disability benefit (CPPD) is high for several reasons, including lack of understanding of the application process.
Once there is a change in definition from own occupation to any occupation, and claimants must apply for CPPD benefits, some insurance providers may consider increasing their number of case managers to help manage the new case load. Others may invest in specialized CPPD case management services. The benefit of investing in such a service, aside from the obvious financial impact, would be the practice of putting the disabled claimants at ease while going through the process, producing positive results as well as a positive experience, and promoting Social Responsibility.