Common use of Disputed W.S.I.B. Claim Clause in Contracts

Disputed W.S.I.B. Claim. If an employee covered by the Short Term Disability Plan suffers a disability for which payment is in dispute with the W.S.I.B., weekly indemnity payment will be made retroactively if requested by the employee and provided they have been off work for at least one (1) month due to the disability without W.S.I.B. having accepted the claim and providing the employee is subject to the rules and regulations covering the Short Term Disability Plan. If the W.S.I.B. claim is subsequently established, the employee will then repay the weekly indemnity payment(s) received to the appropriate fund or insurance company. b) An employee absent from work and in receipt of an amount of disability benefit under this Plan, shall continue to receive such benefit, even though a work shortage develops which would have resulted in the employee being laid off had they been at work, provided that the employee remains disabled and continues to furnish evidence satisfactory to the Company and/or Insurer, and verifies the continuance of disability. c) An employee shall not be eligible for an amount of disability benefit under this Plan unless they are actively employed by the Company at the date that the employee becomes eligible or until they subsequently return to active employment d) An employee making a claim for an amount of disability benefit after lay-off or termination of employment, for disability established to the satisfaction of the Company and/or Insurer as having occurred prior to their lay-off or termination, shall be eligible for an amount of disability benefit provided such disability was accompanied by a continuance of absence that commenced prior to actual layoff or termination. e) An employee shall be considered as eligible to submit a claim for benefit if the employee is requested to return to work within seven calendar days after the date of layoff and is unable to return to work because of disability. Disability will be considered as starting from the date the employee is required to return to work. f) Successive periods of disability separated by less than four consecutive weeks shall be considered one period of disability, unless the subsequent disability is due to an accident or illness entirely unrelated to the previous disability and commences after return to active employment on full time. g) An amount of disability benefit under this Plan shall not be paid in the event the absence is a result of i) Any injury arising out of or sustained while doing any act or thing pertaining to any occupation or employment for remuneration or profit, or ii) Disability or loss (1) while the protected person is on or could be on Maternity/Parental Leave, or (2) if a protected person fails to qualify for Maternity/Parental Leave because of failure to meet the length of service requirements, during the period of Maternity/Parental Leave that the protected person could be on if she qualified for such leave, in accordance with the Employment Standards Xxx 0000, Ontario or any other relevant provincial statutes, or iii) Any injury or illness entitling the employee to compensation under any Workplace Safety Insurance Board or similar legislation, or iv) Self-destruction or any self-inflicted injury, while sane or insane, or v) Any injury or illness resulting from insurrection or war, whether war be declared or not, or from participation in a riot, or civil commotion, or vi) Disability for which the employee is not under the treatment of a medical practitioner, or vii) For a period of disability in excess of four weeks where treatment is rendered solely by a chiropractor. In the case of chiropractors, certification of disability will only be accepted for payment of benefit for up to a maximum of four weeks per insured person per calendar year, or viii) Alcoholism or Drug Addiction, unless the employee is undergoing a recognized course of treatment by a specialist in care and treatment of alcoholism and/or drug addiction, or unless the employee is undergoing regular rehabilitative treatment approved by the insurer and a physician h) An amount of disability benefit will not be payable for those days for which the employee receives holiday pay, vacation pay, or more than one-half days regular pay, from the Company. i) An amount of disability benefit will not be payable following the normal retirement date of an employee, or other than retirement under the total and permanent disability provision of the Company pension plan. j) An amount of disability benefit will not be payable following the early retirement date of an employee, if early retirement was approved prior to the onset of the disability. k) The amount of disability benefit under this Plan will be reduced by the amount of pension for which the employee is eligible under the total and permanent disability provision for the Company pension plan.

Disputed W.S.I.B. Claim. (a) If an employee covered by the Short Term Disability Weekly Indemnity Plan suffers a disability for which payment is in dispute with the W.S.I.B., weekly indemnity Weekly Indemnity payment will be made retroactively if requested by the employee and provided they have he has been off work for at least one (1) month due to the disability without W.S.I.B. having accepted the claim and providing the employee is subject to the rules and regulations covering the Short Term Disability Weekly Indemnity Plan. If the W.S.I.B. claim is subsequently established, the employee will then repay the weekly indemnity Weekly Indemnity payment(s) received to the appropriate fund or insurance companyCompany. If an employee’s weekly indemnity benefit claim is delayed by more than one (1) month, the company will advance the benefit payments to the employee. (b) An employee absent from work and in receipt of an amount of disability benefit under this Plan, shall continue to receive such benefit, even though a work shortage develops which would have resulted in the employee his being laid off had they he been at work, provided that the employee remains disabled and continues to furnish evidence satisfactory to the Company and/or Insurer, and verifies the continuance of disability. (c) An employee shall not be eligible for an amount of disability benefit under this Plan unless they are he is actively employed by the Company at the date that the employee he becomes eligible or until they he subsequently return returns to active employment. (d) An employee making a claim for an amount of disability benefit after lay-off or termination of employment, for disability established to the satisfaction of the Company and/or Insurer as having occurred prior to their his lay-off or termination, shall be eligible for an amount of disability benefit provided such disability was accompanied by a continuance of absence that commenced prior to actual layoff lay- off or termination. (e) An employee shall be considered as eligible to submit a claim for benefit if the employee he is requested to return to work within seven calendar days after the date of layoff lay-off and is unable to return to work because of the disability. Disability will be considered as starting from the date the employee he is required to return to work. (f) Successive periods of disability separated by less than four consecutive weeks shall be considered one period of disability, unless the subsequent disability is due to an accident or illness entirely unrelated to the previous disability and commences after return to active employment on full time. (g) An amount of disability benefit under this Plan shall not be paid in the event the absence is a result of i) Any injury arising out of or sustained while doing any act or thing pertaining to any occupation or employment for remuneration or profit, or ii) Disability or loss (1) while the protected person is on or could be on Maternity/Parental Leave, or (2) if a protected person fails to qualify for Maternity/Parental Leave because of failure to meet the length of service requirements, during the period of Maternity/Parental Leave that the protected person could be on if she qualified for such leave, in accordance with the Employment Standards Xxx 0000, Ontario or any other relevant provincial statutes, or iii) Any injury or illness entitling the employee to compensation under any Workplace Safety Insurance Board or similar legislation, or iv) Self-destruction or any self-inflicted injury, while sane or insane, or v) Any injury or illness resulting from insurrection or war, whether war be declared or not, or from participation in a riot, or civil commotion, or vi) Disability for which the employee is not under the treatment of a medical practitioner, or vii) For a period of disability in excess of four weeks where treatment is rendered solely by a chiropractor. In the case of chiropractors, certification of disability will only be accepted for payment of benefit for up to a maximum of four weeks per insured person per calendar year, or viii) Alcoholism or Drug Addiction, unless the employee is undergoing a recognized course of treatment by a specialist in care and treatment of alcoholism and/or drug addiction, or unless the employee is undergoing regular rehabilitative treatment approved by the insurer and a physician h) An amount of disability benefit will not be payable for those days for which the employee receives holiday pay, vacation pay, or more than one-half days regular pay, from the Company. i) An amount of disability benefit will not be payable following the normal retirement date of an employee, or other than retirement under the total and permanent disability provision of the Company pension plan. j) An amount of disability benefit will not be payable following the early retirement date of an employee, if early retirement was approved prior to the onset of the disability. k) The amount of disability benefit under this Plan will be reduced by the amount of pension for which the employee is eligible under the total and permanent disability provision for the Company pension plan.

Disputed W.S.I.B. Claim. If an employee covered by the Short Term Disability Plan suffers a disability for which payment is in dispute with the W.S.I.B., weekly indemnity payment will be made retroactively if requested by the employee and provided they have been off work for at least one (1) month due to the disability without W.S.I.B. having accepted the claim and providing the employee is subject to the rules and regulations covering the Short Term Disability Plan. If the W.S.I.B. claim is subsequently established, the employee will then repay the weekly indemnity payment(s) received to the appropriate fund or insurance company. b) An employee absent from work and in receipt of an amount of disability benefit under this Plan, shall continue to receive such benefit, even though a work shortage develops which would have resulted in the employee being laid off had they been at work, provided that the employee remains disabled and continues to furnish evidence satisfactory to the Company and/or Insurer, and verifies the continuance of disability. c) An employee shall not be eligible for an amount of disability benefit under this Plan unless they are actively employed by the Company at the date that the employee becomes eligible or until they subsequently return to active employment d) An employee making a claim for an amount of disability benefit after lay-off or termination of employment, for disability established to the satisfaction of the Company and/or Insurer as having occurred prior to their lay-off or termination, shall be eligible for an amount of disability benefit provided such disability was accompanied by a continuance of absence that commenced prior to actual layoff or termination. e) An employee shall be considered as eligible to submit a claim for benefit if the employee is requested to return to work within seven calendar days after the date of layoff and is unable to return to work because of disability. Disability will be considered as starting from the date the employee is required to return to work. f) Successive periods of disability separated by less than four consecutive weeks shall be considered one period of disability, unless the subsequent disability is due to an accident or illness entirely unrelated to the previous disability and commences after return to active employment on full time. g) An amount of disability benefit under this Plan shall not be paid in the event the absence is a result of i) Any injury arising out of or sustained while doing any act or thing pertaining to any occupation or employment for remuneration or profit, or ii) Disability or loss (1) while the protected person is on or could be on Maternity/Parental Leave, or (2) if a protected person fails to qualify for Maternity/Parental Leave because of failure to meet the length of service requirements, during the period of Maternity/Parental Leave that the protected person could be on if she qualified for such leave, in accordance with the Employment Standards Xxx 0000Act 1974, Ontario or any other relevant provincial statutes, or iii) Any injury or illness entitling the employee to compensation under any Workplace Safety Insurance Board or similar legislation, or iv) Self-destruction or any self-inflicted injury, while sane or insane, or v) Any injury or illness resulting from insurrection or war, whether war be declared or not, or from participation in a riot, or civil commotion, or vi) Disability for which the employee is not under the treatment of a medical practitioner, or vii) For a period of disability in excess of four weeks where treatment is rendered solely by a chiropractor. In the case of chiropractors, certification of disability will only be accepted for payment of benefit for up to a maximum of four weeks per insured person per calendar year, or viii) Alcoholism or Drug Addiction, unless the employee is undergoing a recognized course of treatment by a specialist in care and treatment of alcoholism and/or drug addiction, or unless the employee is undergoing regular rehabilitative treatment approved by the insurer and a physician h) An amount of disability benefit will not be payable for those days for which the employee receives holiday pay, vacation pay, or more than one-half days regular pay, from the Company. i) An amount of disability benefit will not be payable following the normal retirement date of an employee, or other than retirement under the total and permanent disability provision of the Company pension plan. j) An amount of disability benefit will not be payable following the early retirement date of an employee, if early retirement was approved prior to the onset of the disability. k) The amount of disability benefit under this Plan will be reduced by the amount of pension for which the employee is eligible under the total and permanent disability provision for the Company pension plan.