Disability Law Show: Ontario – S4 E47

Episode Summary

What does the two-year mark of long-term disability mean for claimants? Disability lawyer and partner Tamar Agopian at Samfiru Tumarkin LLP answers this question and more on the Disability Law Show on 640 Toronto and Newstalk 580 CFRA.

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, Tamar and her team can get you the advice you need, and the compensation you deserve.

Listen to the Episode

Show Notes

• Two-year mark of long-term disability benefits: Insurance companies often cut off benefits at the two-year mark of long-term disability benefits as the change in the definition period occurs. Claimants after two years on LTD have to be able to prove that they are unable to work in any occupation as opposed to just their own. This period can be very daunting for claimants. Ultimately, if a claimant’s own medical team has stated that they are not ready to return to work, they have a basis to challenge the insurance company.
• Denial of LTD benefits as a result of pre-existing condition: Disability insurance policies will typically have a pre-existing condition clause in order to prevent individuals from “insurance shopping”. This could occur as a result of a claimant with a terminal or severe illness. Disabled individuals in the first year of employment will be analyzed by insurers to ensure the condition occurred before or after the new job began. This provision however can vary and it is important to determine the wording of the specific policy states. Individuals can request a copy of their disability policy to determine the language and decide whether or not the insurance company has acted in bad faith.
• Response to a legal claim by an insurance company: In some cases, a new adjuster takes over from the insurnace company and a disability claim can take many weeks and months to be resolved or approved. Unlike a disability claim, insurance adjusters must respond to a legal claim and in certain jurisdictions, they are required to sit down with a disability lawyer and discuss the next steps and a settlement.
• Claim against an employer for an unsafe work environment or LTD: In some situations, both a disability claim should be filed as well as a complaint against an employer if the workplace was unsafe. Employers are obligated to provide a healthy and safe work environment for all employees. Employees that are injured at work are able to pursue a Worker’s Compensation claim as well as long-term disability benefits.