The Disability Board of Management is responsible for the overall administrative and financial management of the Disability Insurance Plan, including the review of the contract of insurance, review of any financial or service agreement, the financial status of the Plan, the services of the Insurer, the administrative fees and charges, the adequacy of reserves, the premium levels, the disposition of disputed claims, and other matters referred to it by the National Joint Council on the overall operation of the Plan, and for making appropriate recommendations to the National Joint Council.
Committee Advisor: Laura Mackenzie
Quarterly Report to the National Joint Council (June 2025)
Regular Activities:
- The Board of Management has met three (3) times since the last Council meeting and considered eleven (11) appeals over the reporting period. The Board agreed with Sun Life’s (SL) decision to decline to provide disability benefits for ten (10) appeals and disagreed with SL’s decision for one (1) appeal.
- In the eleven (11) appeal cases reviewed, SL declined to provide disability benefits as it was of the view that the medical information on file does not support a finding of continuous total disability that would prevent the claimant from performing the essential duties of their regular occupation for nine (9) appeals, the information on file does not support a finding of continuous total disability that would prevent the claimant from performing the essential duties of any commensurate occupation for one (1) appeal, and that the medical information on file demonstrated that the claimant had a pre-existing condition for one (1) appeal.
- The Board wishes to note the departure of an Employer Side representative, Nathalie Leblanc, from Agriculture and Agri-Food Canada, and to thank them for their contributions to the Board.
- The Board welcomed a new Employer Side representative, Sharon Bowles, from the Treasury Board Secretariat.
- The Board received a presentation from SL on an overview of claims received in 2024 and discussed ways to improve how the Board reviews appeal files. SL shared that in 2024, over 5,000 claims were received, and 1,284 claims were declined. Of the declined claims, 307 were reviewed by the SL Appeals Committee, where 194 decisions were maintained as declined and 113 were overturned and approved. Of the claims declined in 2024, 20 proceeded to the Board. SL agreed to continue providing these statistics to the Board.
- The Board continues to receive monthly financial updates from SL.
- The Board tabled a memo to the Executive Committee at their March meeting outlining short- and long-term solutions to address the appeals backlog. The Board prepared a response to the Executive Committee's proposed solution to the backlog asking the Executive Committee to reconsider the Board's initially proposed solutions.
- The Board finalized their 2024 Annual Report.
Outstanding Item(s):
- Forty-two (42) appeals. Of these, thirty-two (32) appeals have been received by the NJC Secretariat from SL and are scheduled for review, and ten (10) are still under review with SL.
Next Meetings: September 9, 2025; November 7, 2025