Short term disability approved, but long term disability denied.

One issue I see all too frequently in my practice is the situation where an insurance company approves a short term disability claim for a period of time (perhaps the maximum time frame, usually no more than 180 days) but then turns around and denies the long term disability claim. Most individuals do not understand how the same insurance company, reviewing essentially the same evidence, and using what is frequently the same definition of disability, can make such contradictory findings. After reviewing hundred of disputed disability claims my experience is that most insureds are simply not...

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Why you should ALWAYS apply for CPP disability benefits.

If you have been receiving long-term disability (“LTD”) benefits for over a year your insurance company will likely require you to apply for Canada Pension Plan (“CPP”) disability benefits. This seems like a no-brainer at first, until you realize that if you win CPP disability your insurance company basically gets to keep all the money. You will have to give the insurance company the retroactive payment you get from the CPP, your overall monthly income may go down slightly. and, you might get an unexpected tax bill for the retroactive payment, even though you paid...

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Why “internal appeals” are WORSE than a waste of time.

If an insurance company denies a claim for long-term disability benefits, the insured should not get side-tracked with the internal appeals process. If the goal is to have the insurer reverse their decision, or to reach a  settlement with the insured, then the fastest way to do this is by litigation. Let me tell you why. Let’s begin with a bit of background about internal appeals and litigation. If one disagrees with the insurance company’s decision about a claim (that is, to deny the application for long-term disability benefits, or to stop payment of benefits), then the insured basically...

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Long Term Disability Insurance – common questions.

Q.What is long-term disability insurance? A. Long-term disability (LTD) insurance is designed to provide replacement income should you become disabled from work. Often, LTD coverage is bundled together with short-term disability coverage (which may cover, for example, only the first six months of disability) under a group insurance plan provided through your employer. If you have a private life or accident and sickness policy, you may have LTD coverage as well. Q. What types of disability are covered? A. Coverage varies from policy to policy, but generally speaking, LTD policies cover any...

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What to do if you have a disability claim.

Disability insurance policies are ‘peace of mind’ contracts that pay you a portion of your lost income if you become “disabled” from working as a result of illness or injury. These can be individual/private plans or policies (paid for privately by the person wishing to be insured) or group plans or policies (paid as part of your employment package). The contract or policy will set out the definition of disability. Contractual definitions are always open to interpretation. Generally you will qualify for benefits if you are not able to do all, or substantially all, of the duties of your...

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Should I retain a long-term disability lawyer?

If you’ve been injured or become ill and can’t work, and your long-term disability (LTD) insurance company denies you benefits, it’s in your best interests to get a lawyer. Unlike a disability claim with the Canadian government (CPP disability), long-term disability insurance companies are not impartial. Long-term disability insurers have a vested interest in the outcome of LTD claims, because the more disability claims they approve and pay out, the less financially healthy their bottom line is. And the fewer long-term disability cases they approve, the greater their profit...

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