3 Common “Excuses” Insurers will use to deny your LTD claim | Disability Law Show S3 E1

Episode Summary

3 COMMON “EXCUSES” INSURERS WILL USE TO DENY YOUR LTD CLAIM on the Disability Law Show with disability lawyer James K Fireman.

Watch above to discover your workplace rights and learn everything you need to know about disability law in Ontario and British Columbia on Season 3 Episode 1 of the only disability law show on TV.

Denied an LTD claim after multiple appeals

A client with a back injury appealed his case six times and was denied each time. He’d seen many specialists who agreed he could not stand for longer than 30 minutes at a time. He eventually reached out and the entire process was settled in a little over a year.

Segment begins at 0:55

New case manager

I’ve been on LTD for 3 years now and I work for the provincial government. I’m still ill and cannot go back to work. I’ve gotten a new case manager who has called and asked some new questions. I’m a little worried, is it possible they can cut me off now even though I’m still unable to work and have doctor’s notes?

Segment begins at 5:47

3 Common “excuses” insurers use to deny LTD claims

1️⃣ You are not “totally disabled” under the policy

This is a term that conjures a very extreme image but it is a very specific definition in an insurance policy.
Segment begins at 9:40

2️⃣ You don’t have enough medical support proving your disability

This is a vague answer an insurer will usually give.
Segment begins at 12:45

3️⃣ You filed your long-term disability claim late

There are different deadlines and one is for filing an application.
Segment begins at 15:05

My benefits have been cut off due to missed treatments

My 37-year-old friend has an alcohol problem. He was approved for long term disability, but a few months ago the insurance company cut him off because they say that he missed a few therapy sessions. The problem is that he is an alcoholic, but his doctor says that he’s been doing very well overall. I’m afraid that ending his benefits will now make his situation worse. What should he do?

Segment begins at 20:37

My insurer is offering a buyout

I’ve been receiving long term disability since I was 52 for degenerative disease. I have a hard time moving my hands and I worked as a mechanic for over 30 years. Over the last 3 years, I have been given $3,000 per month. My adjuster called me last week and offered me a “buy out” for $100,000 tax-free. Should I take it? What happens if I don’t?

Segment begins at 25:52

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Next Episode: Disability Law Show S3 E2 – Situational v. generalized conditions in LTD claims

Previous Episode: Disability Law Show S2 E29 – 3 Reasons to Hire Samfiru Tumarkin LLP to Fight for your LTD