Important facts you need to know if cut off of LTD | Disability Law Show TV – S4 E04

Episode Summary

IMPORTANT FACTS YOU NEED TO KNOW IF CUT OFF OF LTD on Season 4 Episode 04 of the Disability Law Show with disability lawyer and co-founding 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 Ontario, British Columbia, or Alberta, on the only disability law show on TV and radio in Canada.

Episode Notes

Lump sump long-term disability benefits vs monthly payments

I’m on LTD currently and am wondering if I can approach my insurance company for a lump sum payment instead of monthly payments. I’m 57 years old and my policy covers me until I am 65. What approach should I take to receive maximum benefits?

• Lump sum disability settlements: Sivan explains that some claimants are aware they will never be able to return to work and have their doctor’s support. While it can seem preferable to receive a lump sum payment, once requested, the insurance adjusters will likely reassess the disability benefits claim and approval. Approaching the insurance adjuster must be done carefully and all necessary details must be provided to the insurance adjuster.

Hired a disability lawyer and the claim is taking over a year to be settled

I’ve been going back and forth with my current lawyer about my LTD claim after my benefits were cut off over a year ago. I was told that he could negotiate a settlement with the insurance company, but nothing has been done. I don’t think he’s even started a legal claim! Is it supposed to take this long?

• The legal process after a claim has been filed: Claimants should carefully consider and research the legal team they are willing to hire before filing a legal claim. Insurance companies are aware of the reputations of certain disability lawyers and firms and behave in accordance with the legal team they deal with. Some lawyers are not well-versed in the details of disability law. Most legal claims take a matter of months to be resolved.

Important Facts You Need to Know if Cut Off of LTD

• You do not have to accept a denial of benefits: Sivan explains that claimants are unaware of their rights and their ability to pursue a legal claim once their benefits are denied. Insurance companies and claimants are in a contractual relationship and both parties must abide by the disability policy in place.
• Claimants are often cut off at the 2-year mark: Sivan explains that the vast majority of long-term disability policies contain their own occupation test. Claimants have to prove before two years that they are unable to do their own occupation in order to qualify for long-term disability benefits. After two years, the test changes and claimants have to prove they are unable to work in any occupation due to their condition.
• Told in advance that your benefits will be cut off: Claimants should be proactive and speak to their treating medical team and specialists to determine whether or not they are ready to return to work. If a claimant is still unable to work and has been told the benefits will end, should immediately contact a disability lawyer. The appeals process is ineffective and waiting until benefits end can cause further financial difficulties.
• Receiving LTD benefits if their doctor says they’re unable to work: It is important to remember that only a claimant’s treating doctor and specialists can determine when they are ready to return to work and what accommodations are necessary. While insurance adjusters often send claimants to be assessed by their own doctors, treating doctors’ opinions carry more weight.

Increasing the change of approval for the LTD claim

How can I increase the chances of the insurance company approving my claim for long-term disability benefits?

• Approval for an LTD claim: Sivan explains that it is important to understand that insurance companies decide on claims based on all documentation sent in by the claimant’s medical team. Claimants should make sure that their doctors agree they are unable to work and send in all appropriate medical reports to the insurance adjuster. Claimants should be honest and try not to exaggerate or undervalue their symptoms.

Refused a copy of the disability policy by the insurer

I’ve been on LTD for a year and a half, and the insurer has initiated the change of definition evaluation. I requested a copy of the disability contract so that I could see all the requirements I need to meet to maintain my status, but my insurance adjuster has refused to provide me with a copy. Is there something more I can do?

• Terms in a disability policy: Sivan explains that claimants have every right to view their disability policies and should be given their copies by an insurance adjuster if requested. Claimants are entitled to a copy of the contract. A change in the definition of evaluation is typically undergone at the two-year mark, not before. Contacting a disability lawyer can put further pressure on an adjuster to provide claimants with their policy and all necessary information.
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Previous Episode: Disability Law Show S4 E03 – Top 5 Insurance Company Flaws