Conduct that constitutes “bad faith” by your LTD insurer | Disability Law Show TV – S3 E17

Episode Summary

CONDUCT THAT CONSTITUTES AS BAD FAITH BY YOUR LTD INSURER on Season 3 Episode 17 on the Disability Law Show with disability lawyer and co-founding partner Sivan Tumarkin.

Watch above to discover the steps you need to take when the insurance company cuts off or denies your long term disability claim in Ontario, British Columbia, or Alberta, on the only disability law show on TV and radio in Canada.

Episode Notes

Denied LTD due to insufficient medical support of disability

I have a mental health illness and in the last 2 years, it has worsened. I had to take a short-term leave and applied for LTD with my psychologist and doctor’s support I was denied on the basis of insufficient medical support.

Appealing a denial claim for LTD benefits usually does not work as the appeal process is internal. Contacting a disability lawyer is important to begin a legal claim.

Segment starts at 2:01

Two-year mark of long-term disability

My wife suffers from a combination of a mood disorder and depression. She’s been on LTD for just over a year and just received a letter from her adjuster saying that at the two-year mark they think that she will be able to go back to a different kind of job. Can we do anything about this if she’s in no state to return?

Many policies for long-term disability typically, the first two-years an individual has to prove they are unable to do their own occupation due to their disability. Beyond the two-year mark, the test changes to determine whether or not an individual can perform at any job.

Segment starts at 8:30

Conduct that constitutes as “Bad Faith” by your LTD insurer

1️⃣ Ignoring pertinent medical evidence that clearly shows that you are disabled.

Many insurance adjusters are motivated to save money for their company. Insurance companies have an obligation to treat their clients in good faith and so are not allowed to ignore pertinent information.

Segment starts at 14:00

2️⃣ Disregarding the financial and emotional hardship you will endure.

Insurance companies can sometimes ignore the reality of many claimants and the situation they are in. If it can be proven that an insurer made the situation worse for claimants, they can be forced to pay damages.

Segment starts at 17:16

3️⃣ Terminating your benefits before receiving an update from their IME doctor.

Insurers are entitled to have claimants see their medical examiners for an assessment. However, insurance companies cannot cut off claimants before they receive the report from the IME.

Segment starts at 18:44

4️⃣ Making low-ball settlement offers and pressuring you to settle without the benefit of obtaining legal advice.

Some insurers are aware that claimants will be owed benefits for a long time, and want to potentially cut off claimants so they will not have to continue to pay out benefits.

Segment starts at 22:32

5️⃣ Denying benefits for an unreasonable amount of time.

Individuals who are approved for LTD benefits should receive their benefits within weeks of approval. If they have not they should contact a disability lawyer.

Segment starts at 24:41

Forced to do treatments by insurer

I’ve been off work on LTD due to a traumatic brain injury. Last month my insurer sent me to get assessed by a physiotherapist and occupational therapist. After the sessions, my symptoms grew worse. I was told that after 8 weeks or so I should be ready to start a gradual return to work. I asked my family doctor and he thought I had to do what my insurer said. Can my insurance force me to go to physio/occupational therapy?

Sivan explains that insurance companies cannot force an individual to to go occupational therapy or any other treatment that is not prescribed by an individual’s own doctor. It is important for claimants to follow their treating doctor’s recommendations for treatment and medication.

Segment starts at 26:38

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Next Episode: Disability Law Show S3 E18 – 3 Things you can do if denied LTD

Previous Episode: Disability Law Show S3 E16 – Ways to deal with aggressive behaviour from an LTD insurer