A troubling case that my team and I recently resolved involved a product manager who was abruptly cut off long-term disability (LTD) benefits two years after her claim was approved.
The individual, struggling with active tuberculosis (TB) disease, received a denial letter from her insurance company on her “change of definition” date—informing her that she was no longer considered “totally disabled” under their policy.
Shocked by her insurer’s decision, the manager asked her family what she should do. Her husband encouraged her to contact Samfiru Tumarkin LLP for a free LTD consultation.
Confident that she had a strong case, we told her to get the denial letter reviewed by her treatment team.
The manager’s treating doctors couldn’t believe they weren’t consulted before she was cut off LTD. They clearly outlined in writing that her condition prevented her from doing any work—not just her own job.
With full support from the medical professionals involved in her care, the manager contacted us again.
Following conversations with her insurance company, we were able to secure an extremely favourable amount of compensation for our client.
READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer
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TB can have a profound impact on an individual’s ability to perform their job duties—even with appropriate treatment.
For Canadians who can’t work due to this debilitating condition, disability benefits are designed to provide financial peace of mind.
If you’re denied or cut off LTD for any reason, here are three things you need to do.
1. Get your insurer’s reasons for the decision in writing
Instead of delivering the “bad news” in a letter or email, some insurance companies notify individuals over the phone.
By informing claimants verbally, insurers are able to adjust their rationale in the event that the decision is challenged.
If this happens to you, contact your insurance company immediately and request a denial letter. This document will force them to “lock in” their reasons for rejecting your claim or cutting off your access to LTD benefits.
READ MORE: 4 reasons long-term disability claims in Canada are denied
Once you have the denial letter in your possession, connect with an experienced disability lawyer at Samfiru Tumarkin LLP. We can review your situation, assess your legal options and help you secure the compensation you deserve.
Even if your insurer hasn’t provided you with this document yet, it’s still in your best interest to contact my firm. We offer LTD consultations at no cost to you.
2. Discuss the decision with your treatment team
After receiving the denial letter from your insurance company, schedule a meeting with your treating doctor. It’s very important that the document is brought to this appointment.
During the meeting, ask your physician if they agree with the insurer’s decision. If they disagree, have them explain in writing why your condition prevents you from resuming your job duties.
In the event that other medical professionals are involved in your TB care, gather their opinions as well. The more supporting documentation you can provide, the better.
READ MORE: ‘Get full support from your doctor’: Disability lawyer’s guide to making insurance claims
If your access to LTD benefits is cut off on or around your “change of definition” date, like the product manager, remain calm.
In this situation, make sure your treating doctor clearly outlines in writing why your condition prevents you from doing any work—not just your own occupation.
3. Contact us
Being wrongfully denied or cut off LTD can be incredibly distressing. For many of my clients, they weren’t sure how they were going to pay bills or put food on the table without access to disability benefits.
Following an unjust denial, it’s crucial that you get the right legal advice before appealing your insurance company’s decision.
READ MORE: 3 reasons you shouldn’t appeal a denied long-term disability claim
The compassionate team at Samfiru Tumarkin LLP regularly resolves issues involving LTD, short-term disability, life insurance, critical illness and mortgage insurance claims across Canada.
We provide free consultations for these types of matters and don’t get paid unless we get results.
Over the years, my firm has helped thousands of Canadians, including Julie Austin, Sandra Bullock and Mitchell Murphy, secure the compensation they’re legally entitled to.
Denied or cut off long-term disability? Asked if you want to appeal your insurer’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 employment law and long-term disability claims. The firm provides legal insight on Canada’s only Disability Law Show on TV and radio.