“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...

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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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What is disability insurance?

Disability insurance is a form of health insurance. It is income paid to you by your insurance company when you can’t work due to sickness or accidental injury. Disability insurance income replaces either a portion of your regular income or is a set dollar amount. Benefit periods and amounts may depend on whether the disability was caused by an accident or illness and whether the disability is “short term” or “long term.” Disability insurance should provide peace of mind in the event that you are disabled and require replacement income. Unfortunately, this does not...

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What is critical illness insurance?

Critical illness insurance is an insurance product where the insurer is contracted to pay money (lump sum or structured) if the policyholder is diagnosed with one of the critical illnesses listed in the insurance policy. These are ‘peace of mind’ contracts. The contract or policy will set out several definitions and terms. Contractual definitions and terms are almost always open to interpretation. Most of these denials involve disputes over definitions of when a diagnosis of a critical illness is considered valid, allegations of misrepresentation, non-payment of premiums, and exclusion...

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