Long-Term Disability Denials

It’s beneficial to consult a long term disability lawyer early in your claim, especially if your benefits are denied or terminated. A long term disability lawyer can help you understand your rights, gather necessary medical evidence, and navigate the insurance company's procedures to ensure you receive the compensation you're entitled to.

LTD claims may be denied or benefits may be terminated if the insurance company believes there is insufficient evidence supporting your disability, particularly for conditions that are hard to prove with medical tests, such as chronic pain or mental health issues.

An experienced long term disability lawyer can assist in gathering comprehensive medical evidence and, if necessary, refer you to specialists for an independent medical examination to strengthen your claim.

If your LTD benefits are denied or terminated, you can appeal the decision or file a lawsuit for breach of contract. Each option has its own timeline: the internal appeal process typically has deadlines specified in your denial letter, while a lawsuit must generally be filed within two years, depending on your province's laws.

LTD policies often define coverage in two stages. For the first two years, you may be eligible for benefits if you can’t perform the duties of your own job (this is known as "own occupation" coverage). After this period, many policies require you to prove you can't work in any occupation you're reasonably suited for by education, training, or experience ("any occupation").

If your benefits are stopped because the insurer believes you can work in a different job, you may have legal options to contest their decision.

In some cases, a lump sum settlement is possible. This one-time payment covers past and future benefits but also releases the insurer from any future obligations under the policy. You would need to negotiate for any additional damages you're entitled to, such as mental distress.

Lump-sum settlements offer closure and certainty, as they eliminate the possibility of future benefit terminations. They can also provide tax benefits, as only the arrears portion is taxable, and allow you the flexibility to return to work without dealing with an insurance company. Additionally, a lump sum can offer financial security for your family if you're concerned about your long-term health.

Yes, if an insurance company acts in bad faith, such as denying a legitimate claim without reasonable grounds or mishandling your claim, a long-term disability lawyer can claim punitive damages.

A notable example is the case of Baker v. Blue Cross, where the Ontario Court of held a $1.5 million punitive damages award against Blue Cross. This case underscores the importance of legal representation in pursuing such claims.

While it might seem cost-effective to represent yourself, insurance companies often offer lower settlements to unrepresented individuals. They may exploit your lack of legal knowledge to undervalue your claim. A long term disability lawyer knows how to gather evidence, negotiate effectively, and, if necessary, take the case to court to secure the compensation you deserve. In almost all cases, the additional compensation obtained with legal representation outweighs the legal fees, and you will never go out of pocket.

Our team handles every aspect of your claim, ensuring you receive the compensation you deserve.

Mike has trained his team to always prioritize prompt communication. In most cases, we respond to clients the same day, whether by phone or email, so you’re never left wondering about the status of your case.

Here’s what we’ll do for you:

1. Build a Strong Case Against the Insurance Company
   Your long term disability lawyer will go beyond the basics to prepare a comprehensive case for your compensation. This includes gathering evidence, working with top-tier medical professionals, and documenting every detail of your losses.

2. Leverage Decades of Expertise
   With Mike’s 40+ years of legal experience, we have built relationships with some of the best experts in the industry. Whether it’s independent medical evaluations, or financial analysis, your long term disability lawyer will know who to call to strengthen your case.

3. Prepare for Trial, Not Just Settlement
   While many cases settle out of court, we prepare every case as if it’s going to trial. This preparation ensures we are always in a position to negotiate from strength, giving you the best chance at securing a fair outcome.

4. Provide Peace of Mind
   From managing paperwork to handling negotiations with insurance adjusters, we take on the stress so you can focus on recovering. Our team is here to guide you every step of the way, answering your questions and keeping you informed.

When you hire us, you’re not just hiring a long term disability lawyer—you’re gaining a team of professionals dedicated to your success. We’re committed to fighting for you and ensuring your rights are protected every step of the way.