Long-term disability denied in P.E.I.: Your rights

Long-term disability (LTD) benefits in Prince Edward Island play a crucial role if you can’t work because of an illness or injury. It’s a type of insurance that provides you with the financial support you need when you’re unable to generate income for you or your family.

However, it can be devastating for claimants when their legitimate LTD claims are denied by insurance companies in the province.

Without access to disability benefits, many are unsure how they are going to pay bills and put food on the table.

If your insurer turns down your legitimate LTD claim, don’t panic.

An experienced disability lawyer at Samfiru Tumarkin LLP can review your legal options and work to get you the money you are owed.

WATCH: Disability lawyer Sivan Tumarkin addresses three common misconceptions about LTD claims on an episode of the Disability Law Show.

Common reasons LTD claims are denied in P.E.I.

Long-term disability insurance companies in P.E.I. are constantly looking for ways to deny LTD claims. By not providing you with benefits, they are able to increase their bottom line.

Some of the most common reasons insurers will use to deny claims include arguing that:

• You filed your LTD claim or appeal late
• You aren’t “totally disabled”
• You didn’t provide enough medical evidence
• You aren’t following an appropriate treatment plan or adhering to treatment recommendations
• You have a pre-existing condition

If your insurance provider identifies one or more reason to turn down your LTD claim, don’t lose hope. You have a right to ask questions and learn more about their decision.

An experienced disability lawyer at Samfiru Tumarkin LLP knows the right questions to ask, and how to determine if the insurance company has made mistakes when denying your claim.

If my insurer denies my claim, should I get the decision in writing?

You should ask for a denial letter from the insurance company. This document will explain why your LTD claim was turned down.

It should also reference:

• How to appeal the insurer’s decision
• The two-year limitation period within which you can file a legal claim for compensation

In some cases, insurance companies will try to explain over the phone why you were denied or cut off disability benefits. Don’t end the call until they confirm that they will also provide you with their decision in writing.

Once you receive the denial letter, gather any other relevant documents (i.e. your policy, application forms, etc.) and contact an experienced P.E.I. disability lawyer at Samfiru Tumarkin LLP.

We can review your situation, identify the mistakes made by the insurer while handling your LTD claim, and secure the compensation you deserve.

LEARN MORE
• Disability Law Show: Mistakes people make when denied LTD
• Invisible illness and long-term disability claims: Your rights
• Disability in the workplace: Rights for employees

Should I get supporting medical information from my doctor before filing my claim?

Yes. In Prince Edward Island, if your doctor says you can’t work because of your illness or injury, you should qualify for long-term disability benefits.

Getting a letter from your doctor that explains why you are unable to work due to your condition is crucial. Follow their advice on what treatment you need and check with them to see how long you need to be off work.

It’s not uncommon for insurance companies to pressure individuals to return to work before their doctor recommends. In some cases, they will use a refusal as a reason to stop paying disability benefits and close the claim prematurely.

You should also ask your doctor to provide you with referrals to as many treatment providers and specialists as possible. The more medical documentation you can provide, the higher the likelihood that your LTD claim will be approved.

SEE ALSO
• Doctor and Treating Health Professional Reports
• Disability Law Show: Common LTD insurance tactics

If my long-term disability claim is denied, should I appeal?

Rather than appeal, you may be better off filing a legal claim instead. In P.E.I., the appeals process is typically handled by the same insurance company that denied you disability benefits in the first place.

Insurers use the appeals process to run out the clock on the two-year window, or limitation period, that you have to take legal action after your LTD claim has been denied.

Once the two years are up, the insurance company doesn’t have to pay your claim and you can’t file a legal claim to get the money you are owed.

SEE ALSO
• Disability Law Show: Why you shouldn’t appeal a denied LTD claim
• Disability lawyer discusses Ontario woman’s life insurance denial
• Sun Life reinstates long-term disability coverage after legal action

I already appealed, what should I do now?

If you appealed the insurance company’s decision to turn down your long-term disability claim, and were unsuccessful, you may still have options.

As long as it hasn’t been two years since your LTD claim was denied, an experienced P.E.I. disability lawyer at Samfiru Tumarkin LLP can review your situation and help you secure the compensation that you are entitled to.

Your top priority should be your health and recovery, not having to deal with an insurance company. Once we are formally hired to represent you, we will communicate with the insurer on your behalf.

How we can help

If your long-term disability claim is denied in P.E.I., or you are cut off from your disability benefits, contact the experienced disability law team at Samfiru Tumarkin LLP.

We know the law and regularly resolve LTD, life insurance, and mortgage insurance claim denials.

Several of our lawyers previously worked for insurers, which means we know how they operate, why they make certain decisions, and how to enforce your rights.

We have helped thousands of clients, including Julie Austin and Sandra Bullock, hold insurance companies accountable after their claims were denied or cut off prematurely.

Our disability lawyers for P.E.I. provide free consultations and we don’t get paid unless we secure the compensation that you are legally entitled to.