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Normandin Beaudry

Influenza A (H1N1): How does it impact your group benefits plan?


There, in black and white

NB Bulletin Vol. 12 N. 16, December 2009

Short-term disability insurance

Under normal circumstances, insurance companies require a doctor's note for the payment of short-term disability insurance claims. However, all of the insurers surveyed confirmed that they are prepared to show flexibility on this requirement when it comes to the reimbursement of short-term disability benefits for individuals who exhibit flu-like symptoms. This decision was made following recommendations issued by public authorities requesting that individuals exhibiting these symptoms stay home to prevent the potential inundation of medical centres. With these recommendations in mind, and in an effort to simplify claims processing, some insurers teamed up with the Canadian Life and Health Insurance Association to develop a self declaration form to be completed by the employee, whereas others will manage the situation separately for each client based on the region affected and the risks inherent to the group.

The impact of influenza A (H1N1) on claims paid by your plan will depend on the current number of flu cases from your organization and the waiting period before benefits are paid that applies to your plan. Health agencies currently believe that an individual becomes contagious one day before exhibiting any symptoms and remains contagious for approximately 7 more days2. If your short-term disability insurance plan has a waiting period of 7 days or more, it is very likely that your insurer will not pay any claims unless there are complications to the individual's state of health.

Flu onset during travel

All insurers will process cases of influenza A (H1N1) that occur during a trip outside Canada in accordance with the standard terms of the contract in effect. No special processing will be applied to these claims. The costs of your plan could be impacted if your employees frequently travel outside of Canada, particularly given that health care costs are generally higher outside of the country.


No insurer would agree to pay disability insurance benefits if an insured was quarantined because of contact with an infected person or only to limit the likelihood of becoming infected by the virus, and the insured exhibited no flu-like symptoms.

Business continuity plan

All of the insurers have implemented an internal business continuity plan. All of them thus maintain that they will be able to offer the services required in the event of a pandemic or any other catastrophe. Some insurers did specify that insureds could experience a service slowdown.

1Blue Cross, Desjardins Financial Security, Manulife Financial, Sun Life Financial, Great-West Life, Industrial Alliance, La Capitale, SSQ Financial Group, Standard Life.

2Source: Public Health Agency of Canada (


Please feel free to contact us for additional information.

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