Payment of Benefits

You must be under the care of a physician to receive disability benefit payments.

Total Disability Benefit

If you are under age 65, benefits for total disability are paid to age 65 or for two years, whichever is longer. If you are age 65 or older, benefits for any total disability are paid for a maximum of 24 months.

You are considered totally disabled if you sustain irrecoverable loss of speech, hearing in both ears, sight or the entire use of two limbs.

You must have insurance coverage in force in order to be eligible for a claim.

Partial Disability Benefit

Benefits for partial disabilities due to accident or sickness are paid to age 65 or for two years, whichever is longer.
If you are age 65 or older, benefits for any partial disability are paid for a maximum of 24 months.

The partial disability benefit is proportionate to loss of income and is calculated as follows:

Pre-disability
monthly income
  – Monthly income while
partially disabled
  X   Amount of insurance

Pre-disability monthly income

Example
If you have $4,000 Doctors Manitoba coverage and have a drop in income from $8,000 per month to $3,000 per month, your partial disability benefit is:

$8,000 – $3,000 X 4,000 =  $2,500

$8,000

Pre-disability income for a partial disability lasting more than one year is increased by the Consumer Price Index to a maximum of 6% compounded annually.

If partial disability occurs after your 65th birthday, a period of at least 30 consecutive days of total disability must first occur before partial benefits may be paid.

If a partial disability occurs prior to age 65, you are not required to satisfy any period of total disability prior to the commencement of partial disability and benefits will commence on the later of your elimination period or 30 consecutive days of disability.

Recurring Disability

If, after a disability, you return to work and are again disabled from the same or related causes, your disability is treated as a continuation of the previous disability if you returned to work for less than 180 days. If you become disabled after returning to work for 180 days, the disability is considered a new disability.

Organ Donation

If, after your insurance has been in force for at least six months, you donate an organ to another person, any resulting disability is deemed to be caused by sickness and you are entitled to benefits.