If you have suffered an injury or illness that prevents you from working, you are most likely entitled to access compensation from your insurance company. Unfortunately, many people in Hamilton, Ontario have had their long-term disability claims unfairly denied, or have seen their benefits cut off prematurely.
Sadly, many people with legitimate claims face a variety of hurdles and difficulties when dealing with their insurance provider. Because they have their bottom line in mind, insurance providers sometimes deny disability insurance claims for purely bureaucratic reasons. In some situations, an insurance company will go so far as to accuse people of filing a spurious long-term disability claim.
At Wynperle Law, our long-term disability lawyers understand the subtleties of both short and long-term disability insurance, and we work tirelessly to make sure that you receive the insurance benefits you are entitled to.
If your disability insurance benefits have been denied, prematurely ended or delayed by your insurance company, the long-term disability lawyers at Wynperle Law can help.
Contact us for a free consultation
What Conditions Qualify for Long-Term Disability Benefits?
In principle, any injury, illness or condition that prevents someone from working should be covered by long-term disability insurance. In practice, there are certain exclusions, as defined in particular disability insurance policies, but there are a number of physical, mental and emotional health issues that do make someone eligible for long-term disability insurance benefits.
If you have contracted an illness, been involved in an accident or are suffering from a condition that prevents you from working, you should contact a long-term disability lawyer to discuss your situation. You could be eligible for disability claims.
Lawyers from Wynperle Law have extensive experience in dealing with insurance companies. They will make sure that your rights are respected throughout the claim filing process, and that insurers live up to their disability insurance contracts.
Do I Need a Lawyer for Long-Term Disability Claims?
At some point in most people’s lives, they need an ally to fight in their corner. Hiring a long-term disability lawyer is the best way to make sure that your long-term disability claim is not unfairly denied.
Although legal representation is not required, experienced disability lawyers can help make sure that your application is completed properly, and they will be able to provide you with legal options if your claim is denied.
Disability Insurance Coverage
If you become sick, injured or unable to work for any medical reason, disability insurance protects your income by providing benefits equivalent to a large proportion of your lost income.
Under group policies, disability benefits are often payable for two years if the claimant cannot perform the duties of their own occupation, and after two years if they cannot perform the duties of any occupation that is reasonably suitable.
Private disability policies may follow this common arrangement, but they can also be quite different. Whether it is a group disability policy or a private disability policy, it is always important to check the policy itself for the specific terms and conditions—as they can vary considerably from this format.
Short and Long-term Disability Benefits
When you are unable to work due to a disability, you deserve timely and full payment of the compensation you are entitled to.
Insurance plans typically include short-term disability and long-term disability benefits. Short-term benefits are available to individuals who sustain an injury or illness that prevents them from returning to work.
Note: the injury or illness doesn’t need to have occurred while at work or as a result of the work.
Benefit entitlements, as well as their duration and payable amounts, are outlined in individual policies. For all policies, your inability to work must be supported by your doctor.
If your application for benefits gets denied, you may have the right to sue. If you have been receiving disability benefits and your insurer terminates your benefits, you may also have the right to sue.
2-Year Limitation Period for Denied Disability Claims
If your claim has been denied, and you want to start legal proceedings, there is a two-year time limit to start a lawsuit against your insurance company. Few people realize this deadline exists, which can lead to the denial of many legitimate claims.
Contact a Wynperle disability lawyer to evaluate your options if your benefits have been denied or terminated.
Long-Term Disability Insurance Claims
In order to file a long-term disability claim, you will need to provide your insurance company with the following information.
These records will confirm the diagnosis, course of treatment and prognosis provided by your doctor.
Your employment history will be reviewed in order to establish your previous income levels and future earning capacity.
Current Employment Information
Itemizing your regular tasks will help insurance examiners understand why your condition prevents you from working.
Why You Need a Lawyer
Incomplete or missing information could result in the denial of your claim. Having a disability lawyer review your claim will help make sure it contains all the required information and reduce your risk of denial. If your claim has been denied, your lawyer will be able to review all the pertinent information and increase your chances of approval upon appeal.
Have You Been Unfairly Denied Long-Term Disability Benefits?
If your claim has been denied, it does not mean that you do not have a legitimate claim. Some long-term disability claims are unfairly denied, for a variety of reasons. Ultimately, insurers are looking to make profits, and denying benefits keeps money in the company coffers.
If you believe that your claim was denied without a valid reason, contact a long-term disability lawyer to get the benefits you deserve.
Common Reasons Used by Insurance Companies to Deny a Disability Claim
Insufficient Medical Documentation
A common tactic used by insurance companies is to say that your medical documents don’t properly support your claim without providing a specific explanation.
You Are Not “Totally Disabled”
Insurance companies often use this kind of misleading language to deny claims. Some people believe this term means that you need to be completely paralyzed or in a coma in order to qualify. But that is not true. If your condition prevents you from performing your job, you should qualify for disability benefits.
“You Can Do Similar Work”
Insurance companies will sometimes take away someone’s disability benefits because they claim that the person can move into a similar occupation. If your insurance company adopts this approach, and it runs contrary to your doctor’s advice, contact your disability lawyer.
“We Have Surveillance On You”
Unfortunately, this intimidation tactic is quite common. Insurance companies claim that they catch people performing tasks or activities that purport to prove that the person is not actually disabled. If your insurance company claims ends your benefits or denies your claim as a result of surveillance they collected, contact your long-term disability lawyer as soon as possible.
Hamilton Long-Term Disability Lawyer
At Wynperle Law, our team of long-term disability lawyers has successfully helped many clients achieve a fair resolution to a variety of issues related to their dealings with their insurance company.
If you are having an issue with your disability coverage, the Wynperle Law team will defend your interests if you have experienced any of the following situations:
- Unreasonable demands from your insurance provider in order to receive or maintain benefits
- Wrongful denial of disability claims
- Wrongful termination of disability benefits
- Improper calculation of disability benefits
- Violations of privacy rights