Disability Denials in Atlantic Canada, the Guide

Disability denials follow a pattern. The insurer approves nothing, or pays for a while and then stops, and the letter gives reasons that sound medical but come from the policy wording. The pattern is the same across long-term disability claims in Atlantic Canada, from the definition in the policy to the lawsuit that answers a denial.

Who This Guide Is For

Anyone whose LTD claim has been denied or cut off, and anyone still being paid who wants to understand what the insurer’s file is building toward. Group policies through work and individual policies bought privately are both covered. For how we help, see our long-term disability lawyer.

How Disability Denials Actually Work

A denial is rarely a finding that you are well. It is a finding that the written file does not meet the definition of disability in the policy, on the insurer’s own reading. The reasons insurers put in the letter are catalogued in why insurers deny. The letter also starts clocks. The offer of an internal appeal does not stop them, which is the trap described in the internal appeal, and the court deadline itself is set out in the deadline to sue.

Disability Denials Turn on the Policy, the Denial Letter, the Evidence and the CPP Offset

A denial turns first on the policy: the own occupation and any occupation definitions, and the elimination period before payments start. Next come the denial letter and the deadlines it starts. The fight then moves to the medical records and surveillance, with the change of definition that drives cut-offs at the two-year mark. Last come the CPP disability offset, what a lawsuit claims and what we do on a denial file. A denial file begins when you send us the details on our contact page with a copy of the denial letter. The statutes and decided cases are free to read on CanLII.