Disability Claims: Privately Purchased

If your insurance company is not fulfilling their promise and providing you with the financial support set out in the policy you have purchased, you need to speak to our disability lawyers to see how this can be rectified. We will look into taking legal action against them to pursue the benefits you are entitled to. We will handle your insurance company and let you focus on your health.

Privately purchased disability insurance policies are sold as providing long term disability benefits if you are unable to work in your own profession and that benefits will continue even if you are able to work in another occupation. The fine print in these policies may show that your coverage is not as clear-cut as you may have originally thought. We can answer your questions with legal expertise and give you the peace of mind you need.

If you have questions about the policy you have purchased, submitting a claim, or about your current or future dealings with your insurance company and case manager, we can support you. Get in contact with our office to arrange a consultation with one of our disability claim lawyers. We can answer your questions with legal expertise and give you the peace of mind you need.

The application process is complex and our years of experience in dealing with disability claims will enhance your chances of having your initial claim approved. Always bear in mind that the application form is drafted by the insurance company with vague questions which can easily be misunderstood or misinterpreted.

Once your claim is approved, the insurance company will continually adjudicate your entitlement to ongoing benefits, which means that benefits can be stopped at any time. You may be required to provide regular updates (sometimes monthly) and to have your doctor(s) complete further forms. We can handle the ongoing claim, where any request and communication is routed through our office.

If you are able to work in a reduced capacity but have a loss of income exceeding 15-20% of your pre-disability earnings, you may be eligible for residual or partial disability benefits. Residual disability benefits include a specific percentage of earnings, while partial benefits are based on a percentage of the loss of your income.

In the situation that there may be offsets as part of your claim, there are scenarios that need to be reviewed. Does the insurance company have the right to deduct benefits from CPP or an existing severance? If you are able to earn income in another capacity, this could potentially limit the amount that the insurance company will want to pay you on a monthly benefit. We can answer your questions with legal expertise and give you the peace of mind you need.

Once long term disability payments are being made, the insurance company is losing money on your policy, and in some circumstances may be interested in “buying out” your policy for a one-time lump sum payment. There are numerous factors that go into putting a value on your policy including your life expectancy, likelihood of remaining totally or residually disabled, how much your insurance company has reserved for your policy and the present value of future monthly long term disability benefits.