Feelings of defeat notwithstanding, a denied claim is not the end of the road.
Insurance companies routinely deny benefits for valid claims to minimize costs. They know that the majority of Canadians are not well-versed in the complexities of disability law and may give up when they are given a denial. Insurance companies also give the option of appealing a denied claim. This is a way of fighting back that works for them, as appeals are often reviewed by the same people who denied the claim to begin with.
There are some legitimate reasons to appeal a denied disability claim.
Reasons to Appeal Your Disability Claim Denial |
Opportunity to Provide Additional Evidence | Appealing your denial allows you to submit new evidence or clarify existing information. This step is important if your application needs more detailed documentation or your condition has worsened since the original submission. |
Correcting Mistakes | The application process can be complex, especially for those who are inexperienced in disability insurance (most people). These complexities often lead to misunderstandings, inaccurate information, and clerical errors.
An appeal allows you to address these issues directly, present your case more clearly, and ensure all relevant information is considered. |
The Appeals Process
The appeals process differs depending on your insurance provider and the specifics outlined in your disability insurance policy. Generally, there are three stages.
1. Internal Review
The first stage of the appeals process involves an internal review by your insurance company. It usually does not involve any new people. The same claims person will review the information again. During this stage, you should submit additional evidence or clarify existing information.
However, the majority of appeals are unsuccessful, particularly when there is a lack of significant new medical information. Typically, you submit your appeal letter, wait for over a month, and then receive a response from the insurer upholding their original decision. They might extend an offer to make another appeal. Some appeal up to three times, only to find themselves months later in the same position as they started.
Insurance companies generally aim to avoid litigation and don’t want you to hire a disability lawyer. As long as you are appealing, you are not initiating legal action.
2. Independent Medical Examination
Insurance companies often request an Independent Medical Examination (IME) during appeals. Conducted by a doctor on behalf of the insurance company, the IME aims to provide an unbiased assessment of your condition. This is not the case. The IME aligns more with the insurance company's goal of minimizing costs than assisting you.
3. Legal Action
If your insurance company does not approve your disability insurance claim, you can take legal action against them. This step involves legal procedures that force the insurance company to the negotiating table, and requires the assistance of a lawyer who specializes in disability law.
The Importance of Hiring a Disability Lawyer
When you hire a disability lawyer like Share Lawyers, your claim is reviewed by a different part of the insurance company, signaling that the denial is being taken very seriously. This alone can tip the scales in your favour before any legal action is taken.
If your disability claim has been denied, let us get involved immediately.
Disability Insurance Claim Denied? Share Lawyers Secures Your Benefits
Now that we’ve answered the question “Should I appeal my disability claim?”, you’re likely pondering your next steps. Don’t take no for an answer. At Share Lawyers, we empathize with your situation and want to help you get your life back on track.
When you work with us, we become your advocate and handle fighting back against your insurance company so you can focus on what matters most: your health. For over 35 years, we’ve helped thousands of Canadians successfully overturn denials and obtain their rightful benefits.
Our track record speaks for itself, with most cases settled before reaching court. We’re so confident in our ability to win that we work on a contingency-fee basis—you don’t pay until we succeed.
It all starts with a free conversation with one of our experienced disability lawyers.
Still asking yourself, “Should I appeal my disability claim? A quick conversation with one of our lawyers will help.
Contact Share Lawyers today and let our 35+ years of experience work for you. We can help you win your case againstCanada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. Our legal team offers a free consultation and works on a contingency basis. There are no fees unless you win your case.
