
Success Story: Mohammed Ibrahim
Mohammed Ibrahim was the owner of a small drywall company. He started the business before either of his sons was born and took great pride in its success and the success of his family. So, when his eldest son became a father, Mohammed was delighted to say the least. He even smoked a cigar to celebrate the arrival of his first grandchild. Little did anybody know that this gesture would come back to haunt him.
Insured With Good Intentions
Because his family was so important to him, Mr. Ibrahim had purchased a $250,000 life insurance policy to provide for them in the event of his death. While at work on one of the hottest days of the year, at age 53, he died from a heart attack. When his wife and sons claimed the benefit, the claim was denied.
Non-Smoker’s Policy
Mr. Ibrahim had purchased the policy at age 50. His application disclosed no prior medical problems, except elevated blood pressure. Of particular note, the policy was issued with a non-smoker provision. He clearly stated on his insurance application that he did not smoke.
Denial Based On Misrepresentation
After his wife and sons submitted a claim for the benefi t, the insurance company ook six months to investigate. It then wrote a letter denying the claim based on misrepresentation. Because more than two years had passed since the policy was issued, the insurance company would have to prove that the misrepresentation was fraudulent to void the policy and deny the claim.
History As A Smoker
Through its investigation, the insurer discovered a photo on one of Mr. Ibrahim’s sons’ MySpace pages showing Mr. Ibrahim smoking a cigar at a party celebrating the birth of his grandchild. The investigators also secured medical records indicating that he had a history of cigarette smoking. The medical information was inconclusive about whether he was still a regular smoker, or had smoked at all since getting insured – other than the cigar at the party.
Got Counsel On Referral
The Ibrahim family heard about the law firm of Share Lawyers through friends who had got help with a disability insurance claim. They engaged the Share Lawyers legal team to pursue the claim. Share Lawyers felt that the matter could be pursued to success.
Trial Would Result In All Or Nothing
A case like this requires a thorough review of medical records and any evidence that could determine whether the case could be settled or would have to proceed to trial. It was understood that, at trial, the outcome would be “all or nothing”. That is, the beneficiaries would either recover the entire life insurance benefit, or the case would be dismissed.
Total Certainty Elusive
After reviewing the evidence and the litigation process, Share Lawyers recommended that they try to settle the case through mediation. The case had strengths, especially that proving fraud is difficult. The case also had weaknesses. Fairly certain that Mr. Ibrahim had quit smoking years earlier, the family were not sure whether he might have snuck a smoke here and there. The insurance
company also could not be certain.
One Cigar Not Proof Of Fraud
Nevertheless, the one instance of celebratory cigar-smoking would not be enough to satisfy the court that Mr. Ibrahim was a smoker,
much less that he intentionally committed fraud in purchasing a non-smoker’s life insurance policy.
Settled For 75%
At mediation, a settlement was achieved. The family received 75% of the life insurance proceeds, plus interest and a contribution
toward their legal costs. The Ibrahims found this outcome acceptable and were pleased that the money would enable them to move
forward with their lives – including care for Mohammed’s grandchild.
*Names have been fictionalized to protect the privacy of our clients.
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A note from our long term disability lawyers
Taking a medical leave from work is not an easy decision to make. Concerns about providing for yourself and your family and keeping your job may cause you to want to push through your pain, but this won’t make your problems go away. Stopping work is often the smartest decision for your long term health and well-being, and your disability benefits are there to provide you with financial support until you can return to work.
If you have made the tough decision to stop working and apply for your short term disability or long term disability benefits, you may feel overwhelmed by the process and have questions that your employer and your insurance company are not able or willing to answer. Share is There to see you through and answer your questions.
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We understand that things have not been easy for you over the last little while. Your health has been suffering, you are unable to work, and now your insurance company, who was supposed to be there in your time of need, has decided they will not pay your disability benefits or respect your disability claim. These benefits exist to provide you with the financial support you need so that you can focus on your health and rebuilding your life. It is unfortunate that your insurance company has not lived up to its promise. If your disability claim has been denied, we will fight to get you the benefits you are entitled to. Our disability lawyers have helped thousands of Canadians get their long term disability benefits over the past 35 years, and we can help you too.
Our experienced disability lawyers can fight back on your behalf
Share Lawyers believes that every client who is dealing with a disability claim deserves superior personal service. To achieve that goal, we have developed our team of experienced, compassionate, and caring long term disability lawyers, law clerks, and administrative staff to meet all of your needs. Our team of experienced long term disability, life insurance, employment, and critical illness insurance lawyers have made successful claims against many insurance companies, third-party administrators and employers.
If you are unable to work, your disability benefits should be there to provide you with the financial support you need. While your insurance company may be focused on finding ways to avoid paying your claim, our focus is on what is in your best interest. When Share Lawyers gets involved, you have an entire team of lawyers that are there to support you and to fight for what is yours.
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In this video, we explain the role of a long term disability lawyer and how we can support you when you have been denied your long term disability benefits.