Long-term Disability Claims for Executives and Professionals

Many professionals, executives, directors, and business owners have gone to great lengths to secure their future by purchasing insurance coverage that is set up to provide for the individual and their families in the event of a serious injury or disability.  This often goes beyond a standard long-term disability policy and can include critical illness insurance, life insurance, as well as optional additional coverages (called “riders”) for their long-term disability (LTD) insurance policy.

How much does long-term disability pay in Canada?

LTD benefits are based on a percentage of income, so high-income earners are always going to have valuable LTD policies. However, policies for professionals and executives often pay at a higher percentage than standard policies, making them even more valuable.  The value of these policies is greater still when a rider has been purchased on the LTD policy. There are riders available that can ensure that the “own occupation” test remains in place throughout the life of the policy, even after the first two years. This makes it much more difficult for an insurance company to cut off benefits down the road. There are also riders available that can extend the duration of the policy beyond age 65, sometimes to age 70 or beyond.

Moreover, since most people that fall into this category are working in non-physical jobs, when a disability arises, it is most frequently cognitive or psychological in nature, often with an unclear prognosis. The combination of very high monthly benefits with an uncertain recovery makes disability claims for these individuals very valuable, even if no additional coverage has been purchased.

Why are long-term disability claims denied?

The potential value of disability claims for high-income earners is so great, that it creates a compelling incentive for insurance companies to become creative in the ways they adjudicate claims for these individuals. It is common to see such claims be very aggressively defended by the insurance company from the outset. Often, insurers will spend money on medical assessments and other programs very early in the adjudication process. These tactics are designed to either undermine the basis of the claim or to provide superficial treatment that will be relied on by the insurer to take the position that the individual has sufficiently recovered to return to work, even when their treating doctors all continue to disagree.

Moreover, most LTD policies contain deduction and offset provisions that entitle insurers to reduce LTD payments by various types of “income”, which is a term that is often broadly defined. Such provisions can become a major issue for professionals and executives when they are entitled to, and receive, profit sharing, dividends, bonuses, and other types of compensation while they are on disability leave.

Get Help Early

Anyone who is unable to work and has been denied LTD benefits should contact us immediately for free consultation and advice. For high-income earners, getting advice during the application and adjudication process – even before your claim has been denied – is critical.  Knowing how to respond to the demands of an insurer that is intent on saving money is often the difference between disappointment and getting the benefits you are entitled to.

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We Produce Results

At Samfiru Tumarkin LLP, our experienced team of disability lawyers represents individuals throughout Ontario, British Columbia, and Alberta. We do not act for any insurers, however our team is comprised of legal experts who once worked for insurance companies, giving us a unique understanding of how they operate, and what their weaknesses are.

We have successfully represented professionals, such as doctors, lawyers and engineers, as well as senior management and directors, business owners, and many other high-income individuals in assertively pursuing and fighting insurance companies for unjust denials of benefits in complex long-term disability claims.

Samfiru Tumarkin LLP provides free advice on Canada’s only Disability Law Show on TV and radio.