District 140 Bulletin #5 -ClaimSecure Issues

TO ALL IAMAW MEMBERS
AIR CANADA – TMOS, FINANCE AND CLERICAL

 CLAIMSECURE ISSUES

Dear Brothers and Sisters:

On January 12, 2012, an arbitration hearing was held in Toronto to deal with some of the basic problems that we have been experiencing with ClaimSecure. The hearing focused on two items, physiotherapy and orthotics, and was based on the premise that once we had an arbitration ruling on some of the anomalies, the company would be able to answer most of the over 100 outstanding issues.

Physiotherapy Coverage

The Union advised the Arbitrator that our members requiring long-term physiotherapy treatment are only getting short-term approvals. The fact is that the ClaimSecure physiotherapist is making unilateral decisions to change our members’ treatment plan.

The restriction ClaimSecure has put on members is that they must use the physiotherapist they have been assigned to for all appointments. If that physiotherapist is not available and the member is treated by another physiotherapist within the same clinic, the claim will be denied.

The requirement for additional information such as results from X-rays and MRIs, as well as clinical notes, are invasive and intrusive to our members. These are just some of the issues that we brought to the Arbitrator’s attention.

Orthotics Coverage

We discussed the number of approved vendors that the Company has elected to use, the amount of money they have allotted for the various orthotic purchases and the definition of “reasonable and customary”.
Thanks to the issues the Union brought to this hearing, the Company is now reviewing the claims and will notify us of which ones they will approve.

Another hearing is scheduled in the very near future dealing with the following legal issues:

  • Who pays for assessment form fees?
  • Does “reasonable and customary” deal with the cost of an item or with its quantity?
  • Is the preferred provider list something that the Company can create and, if so, is this list large enough to cover an entire city and its surrounding area?
  • Has the company changed the process since they changed service providers and, if so, do they have a right to unilaterally do this?

We will keep you informed on these issues as we work through the process. If you have any issues with ClaimSecure, please see the company for resolution. Failing this, please contact your Shop Committee.

In solidarity,

Tony Didoshak
General Chairperson

BULLETIN NO. 005 – ISSUED JANUARY 16, 2012
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