For many individuals in Kingston, being denied or cut off long-term disability (LTD) benefits is an incredibly overwhelming experience.
Instead of seeking legal advice and challenging their insurance company’s decision, claimants often “accept their fate”—confident that any effort to change the outcome would be futile.
READ MORE: 4 major reasons long-term disability claims are denied in Canada
If you’ve been denied or cut off LTD, all hope isn’t lost. A Kingston disability lawyer can make the difference.
Before scheduling a consultation with a legal professional, here are three things you need to know.
1. A denial letter is a crucial document for your legal team
Denial letters force insurance companies to “lock in” their rationale for preventing an individual from accessing LTD benefits or suddenly cutting a claimant off.
If your insurer terminated your claim without a legitimate reason, this document will make it very difficult for them to pivot to a different explanation at a later date.
However, it’s not uncommon for insurance companies to give themselves some wiggle room by delivering a “verbal breakdown” of the decision over the phone. If this happened to you, contact your insurer immediately and request a denial letter.
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READ MORE: Denied or cut off LTD? 4 reasons to get your insurer’s decision in writing
2. Full support from your treatment team strengthens your legal claim
Another important step after you’ve been prevented from accessing LTD benefits is to bring the denial letter to the doctor providing primary care for your disability.
Schedule a meeting with them at their earliest convenience. During the appointment, ask your doctor if they agree with the insurance company’s decision. In the event that they disagree, have them explain in writing why your condition prevents you from resuming your job duties.
If other medical professionals are involved in your 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
In some cases, insurers cut individuals in Kingston off LTD on or around their “change of definition” date. This usually occurs two years after a claim was approved.
If this situation applies to you, make sure your treatment team clearly outlines in writing why your condition prevents you from doing any work—not just your own occupation.
3. Internal appeals rarely work—you’re better off filing a legal claim
Far too many of my clients, including individuals in Kingston, finally seek legal advice after multiple internal appeals—losing precious time that could’ve been used to obtain a real resolution immediately after their LTD denial.
Contrary to popular belief, this process doesn’t involve a “third party” that’s capable of overturning your insurance company’s decision. Internal appeals are handled by your insurer, which makes it very unlikely that a review of their own ruling will yield a different outcome.
That’s why you’re better off contacting Samfiru Tumarkin LLP. We can move your file out of the “internal appeal loop” and into a formal legal process.
My firm offers free consultations for issues involving LTD, short-term disability, life insurance, critical illness and mortgage insurance claims across Ontario. In most cases, we’re able to reach a settlement without getting the courts involved.
Over the years, we’ve helped thousands of Ontarians, including Julie Austin and Sandra Bullock, secure the compensation they’re legally entitled to.
READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer
A troubling case that my team and I will never forget involved a bank clerk in Kingston who was cut off LTD on her change of definition date.
The individual, struggling with chronic back pain, received a denial letter from her insurance company—informing her that she no longer met the definition of “totally disabled” under their policy.
Devastated by the update, the bank clerk asked her husband what she should do. She was encouraged to contact Samfiru Tumarkin LLP for a free LTD consultation.
Confident that she had a strong case, we told the bank clerk to get the denial letter reviewed by her treatment team. Horrified by the insurer’s decision, her treating doctors clearly outlined in writing why her condition prevented her from doing any work—even on an hourly basis.
With full support from the medical professionals involved in her care, the bank clerk contacted us again.
In the end, all it took was a brief phone call with her insurance company—not a legal battle—to secure a life-changing settlement for our client.
READ MORE: Fired in Kingston? 3 ‘major mistakes’ to avoid before contacting an employment lawyer
Denied or cut off long-term disability in Kingston? Asked if you want to appeal your insurer’s decision?
Contact Samfiru Tumarkin LLP 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. The firm provides legal insight on Canada’s only Disability Law Show on TV and radio.
