Disability Insurance
There are many individuals in Ontario who have a short-term disability insurance or long-term disability insurance policy through their employer or privately purchased such an insurance policy for a “peace of mind” to safeguard them in the event that they injury themselves or suffer from a medical condition that prevents them from working.
If you suffer an injury or an illness that prevents you from working, you likely assumed that the insurance policy will provide you with an income replacement. However, it is our experience that insurance companies frequently deny meritorious insurance claims or improperly terminate insurance claims.
Application for Benefits
The most important step in a claim for disability benefits is the information contained in the application submitted to the insurance company. It is our experience that insurance companies often scrutinize and investigate claims diligently at the outset to look for ways to deny legitimate claims for benefits. We have extensive experience counseling and guiding clients through the process of completing an application for disability benefits.
It is important to express to your physician the importance that his or her involvement is in assisting you to obtain disability benefits. Your physician will be asked to complete an Attending Physicians Statements, which must state whether or not you can perform either the duties of your occupation or the duties of any occupation.
The test that you will have to meet in order to obtain benefits varies from insurance policy to insurance. Therefore, it is important to obtain advice from a lawyer prior to completing the application to ensure that you are providing the insurance company with the requisite information in order to prove that you meet the test for disability under the insurance policy. Once we are retained, we will consult with your physicians to ensure that they are drafting a report in accordance with the information required by the insurance company.
In addition to your physician, the application will also require the involvement of your employer since most tests for disability benefits are dependent on your ability to perform certain tasks in your occupation or any occupation. The application will request information about your duties in your occupation and the manner in which the information is provided can make a difference in whether your claim is accepted or denied.
If you are considering applying for benefits or are waiting for a decision, we encourage you to contact our law firm for a free evaluation of your disability insurance claim.
In the Event that the Benefits are Denied or Terminated
In the event that the insurance company denies your claim for disability benefits or wrongfully terminate your disability benefits, our law firm will review and assess your claim and then provide you with options that could be available to you to claim your benefits.
In the majority of cases where disability benefits were denied or terminated, a court action does not have to be commenced against an insurance company. In many cases, our law firm will review the claim, advise you about any additional medical evidence that will be needed and communicate with the insurance company to have them reevaluate the claim. In addition, we will issue a detailed demand letter which will canvass the medical and legal issues in your case and request that the insurance company reinstate your benefits before we issue a law suit.
The final option is to file a court action against the insurance company to reinstate your benefits retroactively to the date of denial or termination. Our law firm has significant knowledge and experience litigating disability benefits court cases. We encourage you to contact our firm if your disability benefits have been denied or terminated. We will provide you with a free initial consultation and evaluation of your claim.
