3 Things to know about surveillance and LTD claims | Disability Law Show TV – S4 E32

Episode Summary

3 THINGS TO KNOW ABOUT SURVEILLANCE AND LTD CLAIMS on Season 4 Episode 32 of the Disability Law Show with disability lawyer and national co-managing Partner Sivan Tumarkin.

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, excluding Quebec, on the only disability law show on TV and radio in Canada.

Episode Notes

Failed return to work after LTD benefits were cut off

My wife passed away due to COVID-19 which added significant stress to my already fragile mental health. Despite this, my benefits were cut off. I tried to return to work but was not successful. What can I do?

• Returning to work: Many claimants are urged by their insurers to return to work before they are actually ready. It is important for claimants to only return to their workplace if given approval by their treating medical doctors.
• Recurrence clause: In most disability policies, a recurrence clause is included. This clause states that claimants who attempt a return to work but are unsuccessful can resume their disability benefits without an elimination period. In some cases, claimants can be owed additional punitive damages if the conduct of the insurance adjuster has caused additional harm to claimants.

Conflicting medical advice from doctors and insurers recommended professional

Am I obligated to follow advice from the psychiatrist recommended by my insurer if it conflicts with treatment from my own doctor and therapist?

• Following treatment and recommendations: Claimants are not obligated to follow the recommendations of an insurer’s psychiatrist or medical team if it conflicts with the advice given by their own doctor. While most disability policies require claimants to seek out treatment, they should follow the recommendations provided by treatment providers that know them well.

MORE ABOUT INVISIBLE ILLNESS
• Depression and LTD
• Anxiety disorders and long-term disability claims

3 Things to know about surveillance and LTD claims

• Limits to surveillance by the insurance company: Despite the fact that insurance companies are permitted to conduct surveillance on claimants, there are limits to the surveillance that they are able to do. In most cases, private investigators are hired by the insurance company but they are unable to interact with claimants or enter a claimant’s home.
  
• Surveillance does not show what insurers want: Claimants often worry about the extent of surveillance and the communication with adjusters after surveillance has been conducted. Insurers will lead claimants to believe that they have been “caught” doing something illegal or should not be doing. Claimants who are legitimately disabled, should continue to live their lives and follow their doctor’s recommendations.
• Contacting a disability lawyer due to benefits ending: Claimants should not be discouraged from pursuing their disability benefits and rights and contact a disability if their claim has been cut off due to surveillance.

 Can’t afford to hire a disability lawyer after LTD is denied

What options does someone have if their disability claim is denied, but they can’t afford to hire a lawyer?

• Hiring the right disability lawyer: Many claimants who are unable to work and have had their disability benefits claim denied are in a difficult financial position and are unable to pay a lawyer. Most disability lawyers work on a contingency plan so that claimants are not forced to pay any compensation immediately and only if their claim is successful.
• Punitive damages in a disability benefit legal claim: Insurance adjusters are obligated to operate in good faith with claimants. Adjusters who have caused further harm to claimants due to their behaviour could face additional damages. It is important to remember that while very few cases lead to court, insurance companies are held responsible for their actions if a legal claim is filed.

PREVIOUS EPISODE: Disability Law Show S4 E31 – 3 Common Misconceptions about LTD claims