The Assessment of Your Claim

Once your D&R application is received by HEB Manitoba and reviewed to ensure that all original documentation has been returned and completed, your claim will be assigned to a Claims Specialist. The Claims Specialist will review your application and thoroughly assess your claim to determine if you are eligible to receive D&R Benefits based on the terms of the D&R Plan.

During the assessment and management of your claim, HEB Manitoba may request additional information from your Physician(s). In addition, we will advise you if it is necessary to arrange for a medical examination by an independent Physician or have your file reviewed by our independent Medical Review Committee.

Once the assessment of your claim is complete, HEB Manitoba will notify you in writing of the status of your claim.

If additional information is required, relevant forms may be sent to you for completion. Once received, fill them in and promptly return them to HEB Manitoba.

Note: D&R premiums must be paid to HEB Manitoba up to the date you are eligible to receive D&R Benefits (throughout the 119-day Elimination Period). If premiums are not paid, your coverage will terminate and you will not be entitled to D&R Benefits. There are situations where a D&R claim decision may not be made until after the 119-day Elimination Period. If a decision regarding your claim has not been made prior to the end of the 119-day Elimination Period, D&R premiums must be paid beyond the 119-day Elimination Period to maintain D&R coverage. If you have paid D&R premiums beyond the 119-day Elimination Period and your claim is accepted retroactively, applicable post-dated cheques will be returned or a D&R premium refund can be arranged by contacting your Claims Specialist.

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Disclaimer - This website provides a basic overview of the Healthcare Employees' Pension Plan (HEPP) and the Healthcare Employees' Benefits Plan (HEBP) (collectively the HEB Manitoba Pension and Benefit Plans). Not all employers participate in all Plans. Please check your eligibility for benefits with your employer.

HEB Manitoba is a name notation registered by the Healthcare Employees’ Pension Plan – Manitoba and the Healthcare Employees’ Benefits Plan – Manitoba and under which each of their respective undertakings is carried out.

The information on this website is for convenience of reference only and has no official sanction. View our full disclaimer here.