Common misconceptions of beginning an LTD legal claim | Disability Law Show TV – S4 E21

Episode Summary

COMMON MISCONCEPTIONS OF BEGINNING AN LTD LEGAL CLAIM on Season 4 Episode 21 of the Disability Law Show with disability lawyer and national practice leader and Partner James Fireman.

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

Episode Notes

Surveillance worries while on long-term disability

My neighbour has tipped off my insurance company about my daily activities while I am on LTD. I’m worried I’m now going to undergo additional surveillance. Does this mean that my long-term disability benefits will be cut off?

• Surveillance and disability claims: Claimants do not need to worry about surveillance if they have their doctor’s support to remain on LTD and they have been honest with their insurance adjuster regarding their abilities and functions. When a legal claim has begun, a disability lawyer can request a claimant’s entire file including all of the surveillance information. In most cases, surveillance confirms that a claimant is unable to work and is following recommended treatment. In some cases, surveillance can strengthen a claimant’s rights to disability benefits.

Offered a lump sump settlement by the insurance company

I’ve been receiving long-term disability payments for over three years now due to macular degeneration. The insurance company just contacted me to offer a lump sum settlement if I give up my ongoing benefits. Is this something I should consider?

• Ongoing benefits or a settlement: Claimants can consider settlement offers but should try and determine where their best interests lie. Claimants can consider what the insurance company’s total exposure is on a claim; what the total amount of benefits will be up to the age of 65. In many cases, insurance companies are aware that they will have to pay claimants for many years and do not wish to continue doing so. By offering a lump sum settlement insurance companies would potentially be paying fewer benefits to a claimant. For some claimants, there is value in receiving an upfront benefit at one time. There is also value for claimants for tax purposes.

Common misconceptions of beginning an LTD legal claim

• The process for filing disability benefits is long and arduous: Most disability claims are straightforward and simple. Typically claimants will have a few forms to fill out that gives their legal representation all of the necessary information. One of the forms required will typically be filled out by a claimant’s treating doctor.
• Claimants must be incredibly involved in the process: Once a claimant has applied they can and should focus on following recommended treatment from their medical team. Claimants will also have to have an initial in-depth conversation with their insurance company and should be open and honest. After the initial judication and possible approval, there is not a lot of communication between the adjuster and the claimant.
• Insurers are unresponsive and uncommunicative: While on occasion insurance adjusters can be unresponsive, it is considered rare and uncommon. In the majority of cases, claimants do see approval or denial of benefits within 1-2 months of applying for benefits.
  • LEARN MORE
    Dealing with difficult LTD adjusters

• Clients do not have many options or power: It is important for claimants to assert whatever power they have during the claims process. During the application process, claimants should ensure that the insurance company has all of the necessary medical documentation as well as ensure that all communications are recorded accurately. At every instance of communication between the adjuster and claimant, claimants should document in writing the conversation and their version of events.

On LTD as well as maternity leave

I just found out that I am pregnant. I’ve been off on long-term disability for the last few months and likely won’t be returning to work anytime soon. Can the insurance company stop my LTD payments and force me to apply for EI maternity benefits when the baby is born?

• Parental leave and LTD: Claimants should look closely at their disability policies to determine their rights if on maternity or parental leave. If there are no provisions regarding maternity leave specifically stated in the policy, insurance companies cannot decide to stop payments. Claimants are within their rights to ask their claims handlers why the decision has been made to stop benefits.

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Previous Episode: Disability Law Show S4 E20 – 3 Ways to React to an LTD Denial