What is disability insurance?
During our working life, we have financial responsibilities. If an injury or illness leads to disability or disabling symptoms, our income is at risk. Disability insurance is marketed as a means of managing that risk. It is designed to offer a safety net and provide a source of income in the event you cannot work. Many employers offer short term disability insurance and long term disability insurance as part of a benefits package. LTD insurance is designed to pay a portion of your income. Your level of coverage depends on your income and on what insurance is provided by your employer. There are many different types of policies available through many different insurance companies, but all fall under two categories: employee disability insurance and privately purchased disability insurance (purchased by those who are self-employed).
How does disability coverage work?
Within an insurance company there are several departments, including underwriting and claims.
An underwriter decides whether applications for insurance coverage (risks) should be accepted and on what terms. In the disability insurance market, an underwriter assesses risk according to the likelihood of an employee becoming disabled and assigns a dollar value to that risk in the form of an insurance premium. That premium is calculated by weighing a number of factors and asking for detailed information from prospective clients (employers). An insurance company operates under the assumption that premium dollars paid by its insured, or “policyholders,” and the return on its investments from those premium dollars will be greater than claims incurred (money paid out) and expenses.
If you have filed a disability claim, you will most likely be familiar with your claims adjuster, sometimes referred to as a claims analyst. A claims adjuster generally determines the extent and validity of claims. He or she assesses liability and negotiates any payments paid out by the insurance company. Claims adjusters are responsible for managing and controlling claims costs.
They manage the process of dealing with a claim when it is first made and follow it through. Thus, the claims adjuster is normally the representative at the insurance company with whom the individual filing a disability claim is most familiar.
It’s important to remember that claims adjusters are not on your side. Their main objective is to make sure they pay you as little as possible for your claim or find an excuse to deny it outright. A long term disability lawyer with experience working with insurance companies can assess what you are entitled to and work directly with the insurance company to secure those long term disability benefits for you.
In this video, Lawyer Kirk Sloane explains more about why insurance companies deny so many long term disability claims.
If you are considering stopping work to apply for employee or privately purchased disability benefits, but you’re not ready to talk to anyone yet, you can read through the Stopping Work page on our website.
If you have had your claim for long term disability denied, contact the long term disability insurance lawyers at Share Lawyers. Our 35+ years of experience in long term disability (LTD) law can help you win your case against Canada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. We offer free consultations and there are no fees unless you win your case. Join us on Facebook and become a Top Fan for a chance to win each month.