Being diagnosed with cancer can change an individual’s life forever. For Canadians who can’t work due to this grave illness, long-term disability (LTD) benefits can provide a crucial financial lifeline.
Unfortunately, the path to securing these benefits is rarely smooth. In many cases, insurance companies deny legitimate LTD claims for cancer.
One excuse frequently used by insurers to prevent claimants from accessing disability benefits is that they don’t meet the definition of “totally disabled” under their policy.
READ MORE: 4 reasons why long-term disability claims are rejected
If your insurance company rejects your LTD claim for cancer, don’t lose hope. Here are three things you should do.
1. Get your insurer’s reasons for the denial in writing
In our experience, it’s not uncommon for insurance companies to tell individuals over the phone that their LTD claim has been turned down.
If you are informed of the decision verbally, ask your insurer to provide you with their rationale in writing. This is known as a denial letter.
READ MORE: Denied long-term disability? 4 reasons to get your insurer’s decision in writing
Denial letters force insurance companies to “lock in” their reasons for rejecting an individual’s LTD claim – making it difficult for them to pivot to a different explanation at a later date.
If you received a denial letter from your insurer, contact an experienced disability lawyer at Samfiru Tumarkin LLP to discuss your case for free. We can review your situation, assess your legal options and help you secure the compensation you deserve.
Even if you don’t have a denial letter, you should still reach out to my firm. We can answer any LTD questions that you have during a free consultation.
2. Speak with your doctor
Once you have your insurance company’s reasons for turning down your LTD claim in writing, bring the denial letter to your treating doctor. Ask them if they agree with the insurer’s decision.
If you are receiving treatment from several medical professionals, this information should be given to the doctor providing primary care for your cancer.
In the event that your physician disagrees with the insurance company’s decision, have them explain in writing why your condition prevents you from resuming your job duties.
READ MORE: ‘Get full support from your doctor’: Disability lawyer’s guide to making insurance claims
If you are already receiving LTD benefits, it’s possible that your insurer could cut off your access at or around the “change of definition” date. This usually occurs two years after your claim was approved, but insurance companies often let people know that their benefits will end before the two-year mark.
If that happens, contact my firm immediately so we can advise you of your legal options. You should also ask the medical professional providing primary care for your cancer to clearly outline in writing why it prevents you from doing any work.
In the event that your insurer sends you a list of potential roles that you are qualified for, have your treating doctor to review it. Make sure that their report explains why you wouldn’t be able to fulfill the needs of each position, or would be limited in doing so, due to your condition.
3. Contact us
For many of my clients, having their legitimate LTD claim turned down created a substantial amount of mental and financial distress. They weren’t sure how they were going to support themselves or loved ones without access to disability benefits.
If you are denied or cut off LTD for any reason, contact an experienced disability lawyer at Samfiru Tumarkin LLP. It’s very important that you get the right legal advice before appealing your insurance company’s decision.
Our compassionate team regularly resolves issues involving LTD, short-term disability (STD), life insurance, critical illness and mortgage insurance claims across Canada.
We provide consultations at no cost to you and don’t get paid unless we get results. Over the years, we have helped thousands of Canadians, including Sandra Bullock and Julie Austin, secure the compensation that they are legally entitled to.
READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer
A heartbreaking case that my firm recently handled involved an accountant with lung cancer who was trying to transition from STD to LTD. Due to the side effects of his treatment, which included chemotherapy, he wasn’t able to work.
Three weeks after applying for LTD benefits, he got a phone call from his insurer – informing him that his claim had been rejected.
Trying his best to fight back tears, he asked his insurance company why his application had been turned down. He was told that he didn’t meet the definition of “totally disabled” under their policy.
Devastated by the update, the employee requested a denial letter before ending the call.
While he waited for the document to arrive, he contacted Samfiru Tumarkin LLP for a free LTD consultation. We explained his rights and potential options, which helped him feel more confident about his case.
As soon as he received the denial letter from his insurer, he reached out to us again. After reviewing the document and the reports from the worker’s treating doctor, it was clear that the insurance company didn’t do a comprehensive review of his file.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
The employee’s physician specifically noted in multiple reports that the side effects of his cancer treatment, which included fatigue and nausea, prevented him from doing any work – even on a part-time basis.
After bringing our findings to the accountant’s insurer, we were able to secure an extremely favourable amount of compensation for the worker.
Long-term disability claim denied? Asked if you want to appeal the insurance company’s decision?
Contact the firm or call 1-855-821-5900 for a free consultation with a disability lawyer. We help Canadians across all provinces (excluding Quebec). Get the advice you need and the compensation you deserve.
Sivan Tumarkin is a disability lawyer and co-founding partner at Samfiru Tumarkin LLP, Canada’s most positively reviewed law firm specializing in long-term disability claims and employment law. He provides legal insight on Canada’s only Disability Law Show on TV and radio.