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What obligation does an insurer (Sunlife) have to pay for recommended treatments suggested by qualified professionals? In my case- Sunlife does not want to pay for vision therapy that is recommended by a qualified professional. Therapy over 36 weeks is estimated at $7500 plus special lenses approximately 2K. They cited that sufficient progress has not been made as of yet to put me back to work in the near future. This treatment is meant to help and is similar to vestibular therapy which they previously wanted however focused on the one aspect of vision therapy. I am currently on LTD and they have sent the letter of notice that next summer - we must determine if disability will extend pass my own occupation. Can they deny therapy and coverage of treatments?
Thanks for your message. Unfortunately, generally insurers do not have the obligation to pay for treatment, unless it's stated in the LTD policy. If they refuse outright, you may be able to ask if they'd pay partially to try and get you back to work, but it's often not a requirement. If they try to send you back to work before you and your doctors think you're ready, however, please contact us ASAP and we will help.