Request for review

Note: you have one year from the date of the decision to submit your rquest for review. Additional information on our collaborative review process is available for workers and employers.

1. Contact the person who made the decision

If you do not understand or agree with a decision ask for a full explanation.

  • For claims: contact your adjudicator or case manager
  • For accounts: contact the customer contact representative, auditor, underwriter, etc. You may be asked to provide them additional information that may help them to change the decision.

If you have new information that we may not be aware of, you would provide it in this step. If you still disagree with the decision, please ask to speak to the supervisor.

Would you like to receive assistance from the:

2. Please ensure you have a copy of your file

If you feel you have new information not already on your file, please send this information to your file. Be sure to provide any additional information you feel could impact the decision you disagree with.

3. Request a review

To start your request, complete the online form.

I disagree with the decision of Customer Service concerning this claim/account and request the decision be reviewed.

What is the decision you wish to have reviewed? (be as specific as possible): *