Disability Law Show: Ontario – S4 E38

Episode Summary

Who is ultimately responsible for providing all updated medical records? Disability lawyer and partner James K. Fireman and Tamar Agopian at Samfiru Tumarkin LLP answer these questions and more on the Disability Law Show on Newstalk 1010 in Toronto.

Listen below to discover important information about your rights and a guide through the proper steps to take when your insurance provider cuts off your long-term disability or denies your insurance claim.

When you need a disability lawyer in Ontario, James and Tamar can get you the advice you need, and the compensation you deserve.

Listen to the Episode

Show Notes

• The insurance company denies the claim as records of treatment were not found: Many claimants face their benefits being cut off around the 2-year mark as the change in definition occurs at this time from a total disability in an individual’s own occupation, as opposed to any occupation. It is essential for all medical records and documentation to be given to the insurance company. Claimants must undertake a demonstration of appropriate treatment in order to qualify for LTD.
• Denial of benefits based not on updated client information: Most disability policies state that claimants are required to provide additional medical information and claimants are obligated to pay for the information to give to their adjusters. Claimants who have been denied on this basis to speak to their adjuster and if necessary, request a copy of the policy to determine the exact terminology.
  
• A pre-existing condition leads to denial of LTD: A pre-existing condition clause is typically difficult to challenge with the insurance adjuster. This clause essentially states that if a claimant is disabled in the first year of coverage and stems from a condition before a claimant was insured, disability benefits can be denied. If an employer changes carriers, there should be continuity of coverage.