Long-term disability (LTD) benefits play a crucial role in providing Ontarians suffering from an illness or permanent injury with the financial support they need when they can’t work.
A disability can affect all aspects of your life. In addition to not being able to perform your job, you may find yourself incapable of spending quality time with friends and family.
For many of my clients, having their legitimate LTD claim denied by their insurance company was an overwhelming experience. They were shocked, confused and afraid as they tried to figure out how they were going to support themselves and their loved ones without access to disability benefits.
If your claim is turned down, it’s important to understand that you may still have options. While the insurance company’s denial might seem formal and final, it can often be overturned with a little pushback.
Here are the three things you need to do if your LTD claim is denied in Ontario.
1. Get the insurance company’s denial in writing
Insurers, in my experience, are hoping that you will throw in the towel after they deny your LTD claim. Unfortunately, many people do give up because they don’t know how to fight back.
Insurance companies typically make money by collecting more premiums than the claims that they pay out. Denying your benefits allows them to increase their bottom line, a duty which benefits their shareholders, but not you.
If your insurance provider turns down your LTD claim, make sure you get their decision in writing.
Once you receive the denial letter, have it reviewed by an experienced disability lawyer, like the ones at Samfiru Tumarkin LLP. We can help you better understand your legal options.
2. Ensure that you have supporting medical information from your doctor
If your doctor says you can’t work because of your illness or injury, you should qualify for LTD benefits.
Even with strong medical documentation, many of my clients have had their legitimate claims rejected by insurance companies. Two common excuses used by insurers are that the claimant didn’t fill out their application properly or they missed a filing deadline.
When applying for LTD benefits, your insurer will require your doctor to fill out a physician statement. It’s a good idea to double-check that they properly completed the form.
You should also speak to your doctor about getting referrals to as many treatment providers and specialists as possible. They can help champion your case.
The more medical documentation you are able to provide, the higher the likelihood that your LTD claim will be approved.
3. Instead of appealing a denied LTD claim, file a legal claim
After your LTD claim is denied, you will likely receive an invitation to appeal the insurance company’s decision. While appealing can work in some cases, you are better off filing a legal claim instead.
The appeals process is typically handled by the same insurer who turned down your LTD claim in the first place. In my experience, it’s used by insurance companies to stall out the two-year window you have to take legal action after you have been denied disability benefits.
Once you file a legal claim, the insurer has two options: provide you with benefits or spend top dollar fighting it.
Since defence lawyers aren’t cheap, insurance companies often choose to pay the LTD claim instead.
Let a disability lawyer fight for you
If you are denied LTD benefits, or you notice any red flags in the way that your insurer is conducting itself, contact a disability lawyer immediately.
At Samfiru Tumarkin LLP, we regularly resolve LTD, life insurance and mortgage insurance claim denials in Ontario, and across Canada.
Our firm provides free consultations and we don’t get paid unless we secure the compensation from your insurer that you are legally entitled to.
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.
Albert Klein is a disability lawyer and partner at Samfiru Tumarkin LLP, Canada’s most positively reviewed law firm specializing in long-term disability claims and employment law. The firm provides free advice as a host of Canada’s only Disability Law Show on TV and radio.