ARCHIVED CD 2010-007: Sample Letter B
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SAMPLE LETTER FOR LONG-TERM DISABILITY INSURANCE
Employment Income When Employee is Struck off Strength (SOS) and is Claiming Long-Term Disability Insurance
Group Policy No.: Group Plan G68-1400 Industrial Alliance
Industrial Insurance and Financial Services Inc.
Group Life and Disability Claims Department (PSMIP)
522 University Avenue
Toronto ON M5G 1Y7
Dear insert appropriate name :
SUBJECT: Employment Income when the Employee Is Struck off Strength and Is Claiming Long-Term Disability Insurance (Group Plan G68-1400) Industrial Alliance
The purpose of this letter is to report the amounts paid to the employee when the employee is struck off strength (SOS) and is claiming Long-term Disability Insurance.
|Employee's name||Employee's Certificate Number|| SOS Date
AMOUNTS PAID WHEN THE EMPLOYEE IS SOS
The employee is entitled to a return of contribution (ROC).
The employee is not entitled to a return of contribution (ROC).
If yes, indicate the amount of the ROC :
The employee applied for a medical retirement.
The employee did not apply for a medical retirement.
If yes, indicate if the employee was approved:
Should you require additional information, do not hesitate to contact me at
###-###-#### or by email INSERT E-MAIL ADDRESS.
Compensation and Benefits Advisor
c.c. Employee file
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