Why an insurer may ignore a treating doctor’s opinion.
Many people, as well as their doctors, believe that when they file a claim for disability benefits their disability insurance company has to accept the medical professional’s opinion that they are disabled. Common sense suggests this is a reasonable assumption – but it couldn’t be further from the truth. Why? Because many insurers simply do not want to pay disability claims and, when armed with discretionary language in the policy, the insurer has the final say as to who is “disabled”, not the treating doctor. Making matters worse is the fact that the insurance company is...
read moreReducing work hours may imperil disability coverage.
Many people who are struggling to work due to an acute unexpected medical condition do not have the opportunity to prepare or plan for filing a short and or long term disability claim. My experience is that most people who eventually file disability claims have chronic medical conditions which have been ongoing for months and even years. During this difficult period disabled people often find themselves engaged in an heroic effort to continue working. People engage in this long battle for many reasons, one is often financial, and the other is simply their own credibility – they like...
read moreUse social media at your peril.
On June 7, 2016, a judge of the BC Supreme Court rejected claimed damages in a personal injury lawsuit due, in part, to concerns about the plaintiff’s credibility arising out of Facebook photos entered as evidence at trial. In Brennan v. Colinders, 2016 BCSC 1026, the plaintiff was involved in a 2012 motor vehicle accident for which the defendants admitted fault. The plaintiff claimed that the accident caused chronic problems which continued up to the time of trial. The judge rejected this claim, finding that the collision-related injuries had resolved. In awarding $20,000 in non-pecuniary...
read moreShort 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...
read moreCourt punishes defendants for not making admissions.
On May 25, 2016, the BC Supreme Court found the defendants at fault for a motor vehicle accident, and ordered that the defendants pay double costs for an “unreasonable” refusal to make admissions of facts sought in a notice to admit. In Ceperkovic v. MacDonald, 2016 BCSC 939, the defendants were sued for damages arising out of an accident involving three motor vehicles. Prior to trial the defendants were served with a Notice to Admit seeking admission of various facts. The defendants did not admit all of these facts requiring ultimate proof at trial. In finding the refusal to...
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