For many people, it’s shocking and confusing when an insurance company denies their long-term disability (LTD) claim. So they’re often hopeful when they receive an opportunity to appeal the decision.
While it might seem like a good idea to accept the offer, you’re better off speaking with a disability lawyer than going through the appeals process.
Here are the top three reasons why you shouldn’t play the insurer’s game if your LTD claim is denied.
1. The appeals process was created to benefit insurance companies
The appeals process is not part of the disability policy. It was created by insurance companies and in my view, after years of experience, it’s intended to distract clients from taking legal action against the insurers for denying LTD claims.
In almost all cases, the appeals process is handled by the same insurance adjuster that denied your LTD claim. Unless the information provided to the insurance company during your appeal is significantly different from what was included in your initial claim, it’s unlikely you’ll get a different outcome.
READ MORE: Reasons LTD claims are rejected and how to fight back
Many claimants are not told why their LTD claim was denied by the insurance company. Without the reason for the denial, it’s extremely difficult to argue why the claim should be approved.
2. Appeals are not sent to a neutral third-party arbitrator
While it might seem like the opportunity to appeal your denied LTD claim is coming from a neutral third party, the process is anything but neutral.
It’s done internally, not by a government body or an organization separate from the insurance company. This means the insurer can reject your LTD claim without any negative consequences.
When you file an LTD claim, make sure you have documentation from your doctor that clearly explains your medical issues. This can increase the chances of your claim being approved.
READ MORE: ‘Get full support from your doctor’: Disability lawyer’s guide to making insurance claims
3. Appeals are rarely successful and waste valuable time
From the moment your LTD claim is denied, you have two years to start a lawsuit. Insurance companies will often use the appeals process to run out the clock on your ability to file a legal claim.
Once the two years are up, the insurance company does not have to pay your LTD claim, and you can’t take legal action.
Insurers know that if your treating doctor agrees you cannot work, a judge is very likely to find that not only are you entitled to benefits, but that you could also receive additional compensation. As a result, most insurance providers choose to settle once a legal claim has been filed.
READ MORE: What to expect when hiring a lawyer to fight your disability claim denial
Skip the appeals and speak with a disability lawyer
Instead of wasting time appealing your denied LTD claim, contact an experienced disability lawyer, like the ones at Samfiru Tumarkin LLP, immediately.
Members of our team previously worked for insurers, which means we know how they operate, why they make certain decisions and how to enforce your rights.
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 to secure assistance from a disability lawyer in Ontario, British Columbia or Alberta. Get the advice you need — and the compensation you deserve.
James Fireman is a disability lawyer at Samfiru Tumarkin LLP, one of Canada’s leading law firms specializing in employment law and disability claims. He provides free advice as a host of Canada’s only Disability Law Show on TV and radio.