Ottawa Long Term Disability Claim Lawyers
If you are injured or otherwise impaired and can no longer work, there are government funded plans that can help replace your loss of income. However, these public plans may be difficult to qualify for or may only be of short duration. To fill the gap, many employees in Ottawa and across Eastern Ontario have access to short term (STD) and long term disability insurance (LTD) coverage. Sometimes this insurance coverage is provided as a group benefit through employment. Other times, individuals may obtain LTD coverage privately.
If you have your own private LTD plan and you pay the premiums, then when the benefit is paid, it is not considered taxable income. However, if your employer pays the premium, then any STD or short term benefits received will be considered taxable income.
Long Term Disability Benefits Refusals
Often, even though insurance premiums are paid, insurance companies still deny valid claims for long term disability benefits. The insurance company might come up with a variety of reasons for denying or cutting off your benefits. As LTD lawyers assisting clients with claims in cities such as Ottawa in Kingston, some of the reasons we frequently see for a termination or denial of an LTD claim include:
1) You do not meet the qualifying time requirements to claim benefits.
LTD policies usually contain notice provisions. Many times people do not assume they will be impaired over the long run and do not immediately apply for STD or LTD benefits. If you wait too long, the insurer may argue that you are in violation of a notice provision and that they have been prejudiced by the delay.
2) Your impairment does not meet the technical definition of disability, according to the insurance company adjuster.
Although you may not be able to work due to your impairment, the insurer may argue that your impairments are subjective. They may say that an illness such as fibromyalgia or depression cannot be objectively verified and therefore does not meet the disability test.
3) The insurance company “medical partner” has reviewed the file and determined you do not meet the medical test of disability.
Many insurance companies have consultants who are on the insurance company’s payroll or are paid significant sums of money by insurers to provide opinions on claims. It is not unusual to see “experts” like this who do not even practice medicine in terms of actually treating patients; they solely earn income by providing insurers with opinions. Given this lack of independence it is not surprising when these consultants provide an opinion that you do not meet the disability test.
4) The test for impairment has changed after two years and you are no longer eligible for benefits.
Many LTD policies provide that for the first two years after becoming impaired, you are entitled to benefits if you cannot return to the job you held at the time you became disabled. However, at two years, the test changes for most policies. The new test is usually a variation of whether you are impaired from performing the essential tasks of any occupation for which you are reasonably suited based on your training, education and experience. In other words, if the insurance company comes up with some other job they say you can do, then they use this as an excuse to cut off your benefits. An insurer may say something like “Based on our Functionabilty Assessment and Labour Force review, we believe you are qualified to perform any of the following occupations: 1) parking lot attendant, 2) telemarketer or 3) retail sales person. As such, you are no longer considered disabled and your benefit is terminated.”
5) The insurance company says you have not had appropriate treatment.
Most LTD insurance policies contain a requirement that you are continually in treatment or under the ongoing care of a physician. Some policies may even say that you need to be in treatment that the insurance company considers reasonable. Therefore, if your family doctor has prescribed a particular form of therapy and your insurance company adjuster believes another form of treatment would be more reasonable, this can be used as a reason to terminate your benefits.
6) You gave false medical information or made misrepresentations when applying for benefits.
If your long term disability insurance company finds out that you have made misrepresentations regarding your medical health or any other material matter, they can use this as a reason to refuse your claim.
How We Can Help
Don’t give up if the insurance company says you are not entitled to long term disability benefits for any of the reasons listed above or for any other reason.
We are familiar with the insurance industry and insurance company tactics. Our lawyers have previously represented insurance companies and are familiar with insurance company methods. We have handled LTD claims across Ontario in cities such as Ottawa, Kingston, Brockville, Cornwall and Pembroke, to name a few.
We will help you fight for your rights and hold the disability insurance company accountable if it denies your legitimate claim for benefits.
We will help get your benefits re-instated or negotiate a lump sum settlement of past and future benefits. We have specific experience handling claims against insurers such as Sun Life, Manulife, RBC, Desjardins and Great West Life, among others.
Our lawyers offer free no obligation consultation and in most cases there are never any fees charged unless and until you win or settle your claim.
If you or someone you love has been denied their rightful benefits, contact us to discuss how we can help obtain the compensation that is owed by the insurance company.