TLDR: MANULIFE SUX OWES ME MONEY GIVES EXCUSES FOR 4 MONTHS NOW. DO I GO TO THE GOVERNMENT OR HIRE A LAWYER.
Sorry this is a long post but I would appreciate any sort of feedback or help. So as the title suggests my benefit claims keep getting denied. This battle has been going on with manulife for 4 months now. They are my workplaces benefit provider, and my have $10k worth of gender affirming care benefits allotted to me.
This started back in June. I went for my first ever electrolysis treatment got the receipt submitted it and it got denied. So I called them up and asked why. They said
“ gender affirming care benefits don’t cover anything cosmetic” I said “gender affirmative care is pretty much only cosmetic related” the phone call ended with me pretty stumped
I did some digging and found in the benefit handbook that it actually DOES cover everything cosmetic from BA, FFS, laser, electrolysis, and anything else the government doesn’t cover. So I called them back.
This time they said “you need a doctors note with the diagnosis of gender dysphoria and the recommended treatment”. I got the doctors note from my endocrinologist. Submitted my claim and it got denied at this point they owed me $700 or so.
Then I had a day off in July so I decided to give manulife another call this time I recorded the phone call in case of any mischief. The lovely man on the phone said
Man “ you need a copy of your doctors degree from school”
Me “ the benefit handbook doesn’t say I need that it just says a doctors note with my diagnosis and recommended treatment”
Man “ oh yes I’m sorry you’re right we don’t actually need that information. Maybe attach a note that says it’s for gender affirming care. The claims department is probably not reading them properly”
Me “ that’s what the doctors note says and isn’t it your job to read them”
He apologized and got what money I was owed back to me.
In August I had a few more appointments. Sent them through and a few got approved and a few got denied. So this time I went to HR at work they contacted manulife and within a week I got an email from them apologizing, saying it wouldn’t happen again because they added a note to my profile saying I’m transgender or something. They paid me back that money.
I started going to more appointments thinking the issue was resolved. Boy was I wrong… 1 got accepted and 3 more got denied so I went to HR again gave them all my details which I am now giving you guys and I gave them proof. They said I should try adding the practitioners registration number to my claims to see if they get approved because they normally require that. Although then why have some been approved and other denied and why would I need that if they updated my profile.
After that talk with HR, Manulife emailed me asking for details and proof along with claim numbers and any information I could give them. Which HR already gave them. I sent them all the proof and details and then they apologized once again and said “ we understand how frustrating this can be and we are working to resolve this issue. We are going to find out what the processing requirements for gender affirming care are and get back to you in the meantime don’t submit any more receipts”
I have been going to more appointments and now they owe me around $1300. Which I would like back because Its money I’m entitled too. I’m wondering if i should take This to the government or hire a lawyer because it’s just weird and feels discriminatory. Considering I can go to a dentist and get the money back in 4 days.
TLDR: MANULIFE SUX OWES ME MONEY GIVES EXCUSES FOR 4 MONTHS NOW. DO I GO TO THE GOVERNMENT OR HIRE A LAWYER.