3 Common myths about insurance adjusters | Disability Law Show TV – S5 E25

Episode Summary

3 COMMON MYTHS ABOUT INSURANCE ADJUSTERS on Season 5 Episode 25 of the Disability Law Show with disability lawyer and Partner Tamar Agopian.

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

Episode Notes

Baker v Blue Cross insurance

Do disability claims often lead to court and are they often awarded punitive damages?

• Jury trial disability claim: While most disability claims are resolved long before a court appearance, on occasion they do lead to a trial. In the case of Baker v. Blue Cross, a jury awarded the claimant $1.5 million in punitive damages. In some provinces, after a successful trial decision costs are awarded. This case highlights the fact that disability litigation is very difficult and it is vital to hire the right disability lawyer.

Opting out of a return-to-work plan

The insurance company recently referred me to a rehab consultant and put me on a return-to-work plan. This new program has aggravated a lot of my symptoms and my stress levels have increased. Am I allowed to opt out of this plan?

• Returning to work: It is important to look closely at the terms outlined in a disability policy regarding return-to-work and rehabilitation plans. For claimants that do not comply with the terms outlined, the insurance adjuster will cut off benefits. Claimants need to speak to their own treatment providers and determine if their return-to-work plan is advisable. Rehabilitation plans are typically a pressure tactic to force a claimant to return to work.

3 Common Myths about insurance adjusters

• Adjusters are well-versed in every aspect of a claimant’s file: Insurance adjusters are often overwhelmed and have many claimant files. Adjuster roles can have a lot of turnovers and do not have much if any, medical training. Due to the challenging nature of the job, insurance adjusters often miss important details in a claimant’s file.
• Insurers can behave in any manner with claimants: The relationship between a claimant and an insurance adjuster is a contractual relationship. Adjusters are expected to operate in good faith with claimants. A failure to do so, such as abusive or bullying behaviour, can lead to punitive damages. Claimants unsure about dealing with an adjuster should speak to a disability lawyer and their treating doctors.
• A denial of benefits is final: Insurance companies will often deny disability benefits and influence claimants to walk away from their rights. Claimants who have the support of their doctors, do not have to accept a denial of benefits and can file a legal claim.

Unemployed and needing disability benefits

My claim for LTD was approved but I was laid off from my job. I’m now worried the insurance company will cut off my benefits as a result. Do I have to be employed to continue to receive disability benefits?

• Employment issues and LTD: Long-term disability plans are typically group insurance plans accessible through an employer’s coverage. Individuals who have received approval for LTD do not have to be employed to continue to receive benefits. While a denial or cut-off of benefits can occur, claimants should seek legal advice. It is vital to speak to a disability lawyer aware of the potential overlap between employment and disability issues.

PREVIOUS EPISODE: Disability Law Show S5 E24 – Top tips for strengthening an LTD claim