Unlike organizations such as the Canadian Life & Health Insurance Association (CLHIA) that receive funding from Canadian insurance companies, we are an independent private organization that does not receive any funding from public or private organizations. (This is to prevent conflict of interest). Therefore, we rely solely on the fees paid by our clients in order to continue our operations.
Consulting Rate:
$120.00 per hour (fees are billed precisely and accurately to the minute).**
Most claims are usually resolved within 1 or 2 months. Please contact ACG for a FREE no-obligation 20-minute telephone consultation to discuss your unique claim situation.
Please note: A fee of $600 is payable upfront as a retainer. This is our minimum charge for opening the file and will be applied towards services performed. Once the consultant performs five hours of services, the retainer is depleted and no further work will take place until the retainer is replenished.
**Alternate payment structures may be arranged to address any financial constraints of the client.
For your convenience, we accept several methods of payment:
- E-Transfer
- Credit Card
- PayPal
- Cheque (please note, ACG will not be able to start work on your file until the funds are cleared)
What to Expect:
Depending on the nature and complexity of the case, the services performed for each client will differ. For example, a typical claims appeal normally involves the following:
- A full review of case file history or relevant facts of the case.
- A detailed telephone interview with the client.
- Additional information gathering from other pertinent sources, if required (eg. Healthcare providers, case managers, employers, etc).
- Development of a case resolution plan (CRP).
- Contact with the insurer to execute case resolution.
- Follow-up with the insurer for decision.
- Once decision is rendered and if satisfactory outcome (i.e. the claim is approved and re-opened), the consultant will continue to advocate on the client’s behalf to ensure the insurer’s ongoing case management plan is fair and reasonable. If not reasonable, the consultant has the experience and expertise to negotiate an alternate case management plan with the insurer.
- If decision from insurer is not favourable (i.e. the claim remains denied), consultant will discuss next steps with the client and consider other options, including alternate means of recourse. The consultant will remain the client’s advocate throughout this process.