Dealing with Difficult Adjusters and Long-term Disability FAQ

Finally getting approved for long-term disability (LTD) benefits can be a huge relief. But what if you are perpetually forced to deal with a difficult adjuster who acts and behaves inappropriately? How do you handle the situation?

The disability lawyers for Canada at Samfiru Tumarkin LLP have created the FAQ below to answer commons questions about long-term disability claims and how to deal with difficult adjusters.

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How should LTD adjusters behave towards claimants?

Insurance companies owe a duty of good faith towards their customers. This means that an LTD adjuster who represents an insurer must treat an insured person, or claimant, with civility and respect. There are no exceptions to this. Adjusters are not allowed to bully claimants, to speak down to them, to harass them, curse at them, threaten them, or otherwise act in a manner that is disrespectful and hurtful.

In some cases, however, it is not clear whether an adjuster has acted inappropriately. An adjuster may have simply miscommunicated information or a request, which could be perceived negatively by a claimant. Such miscommunication may cause a disabled individual to feel harassed or attacked, but that was not the intention and may not constitute inappropriate behaviour. It is important to be as objective as possible about your interactions with your adjuster in order to minimize any disruptions to your LTD claim.

Unfortunately, sometimes adjusters act badly. They may yell, use inappropriate language, or act in a way that makes you feel harassed and bullied. This type of behaviour could lead to increased stress, anxiety, depression and other psychological (and physical) symptoms that aggravate your disability and adversely impacts your general health. In such circumstances it is imperative that you do not let such behaviour go unanswered.

What should I do if my adjuster is behaving inappropriately towards me?

There are three things you can and should do if your adjuster is behaving in a manner that causes you harm:

1. Be direct with your adjuster

Advise your adjuster – in writing – that such behaviour is unacceptable. Outline to them in an email exactly what your interactions with them have been like, and state, unequivocally, that you will not tolerate such behaviour. Express to them how their behaviour makes you feel and how it affects your health.

Be as matter of fact as you can be and focus on what happened. Keep a copy of this email. Do not engage in a back-and-forth argument with the adjuster. They key is to record – in writing – your interactions with the adjuster (ideally on the same day of the interaction).

2. Inform your doctors

Let your doctors or other health professionals who are treating you know of your interactions with your adjuster, and the stress and anxiety (as well as other symptoms) that these interactions are causing you.

It is very important that these reactions resulting from your adjuster’s behaviour is recorded by your doctors and other treating health professionals. Their notes and records may be needed to support your potential future claim for extra-contractual damages (punitive damages) against your insurer should we need to pursue legal action down the road.

3. Request a new adjuster

If your adjuster’s behaviour does not improve despite your requests, contact your adjuster’s manager and ask to have another adjuster take over your file. Again, this request should be made in writing. If the manager fails to take steps to change adjusters, this may also be used down the road when we pursue legal action against your insurer.

WATCH: Disability lawyer Sivan Tumarkin explains why you shouldn’t fear your insurance adjuster on a Season 3 episode of the Disability Law Show.

What you should NOT do if your adjuster is behaving inappropriately towards you

Do not stoop down to their level. Do not yell at your adjuster; do not swear; do not use profanities and do not refuse to comply with your obligations under your LTD policy. If you do any of those things, you may jeopardize your LTD claim. Instead, remain as calm as possible and take the steps outlined above. If that does not resolve the issue, contact us immediately and we will discuss with you – at no cost – all of your options.

Questions? Concerns? Contact Us!

If you are experiencing an issue anywhere in Canada (excluding Quebec) with your long-term disability claim, your employer or the insurance company, we’re here to help. Call our team at 1-855-821-5900, email Help@DisabilityRights.ca, or contact us online for a FREE consultation.

You can also post your specific question about your long-term disability claim online for a quick answer by a disability lawyer at Samfiru Tumarkin LLP, at MyDisabilityQuestions.com.

As Canada’s most positively reviewed disability law firm, we have the experience, tenacity and determination required to provide you with the advice you need, and the compensation you deserve.