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Long term disability claims require consideration of numerous legal issues. These include interpretation of the policy terms and conditions, circumstances in which a claim can be legitimately denied, and legal remedies when claims are improperly denied.
Often individuals who are applying for benefits, are on claim, or have had their claim denied are not familiar with their legal rights. Michael Jordan is a long term disability lawyer who provides fast, free, legal advice, including in the following circumstances:
1) When the claim is denied:
Many claims are denied at the initial application stage. Other times the insurance company will pay for a while, before finding a reason to stop paying. It is common for insurance companies to deny for reasons that are not legally correct . Regardless of the reason, if your claim has been denied, you should seek legal advice as soon as possible, and before you appeal. Learn more about long term disability appeals.
2) When you suspect your claim might be denied:
Sometimes it is obvious when an insurance company is laying the groundwork for a denial. For example, if you become aware of surveillance or other investigations into your day-to-day activities. If you suspect the insurance company is setting you up for failure, contact an LTD lawyer.
3) Change of definition is approaching:
Most group policies, and some individual policies, contain a change of definition after two years, although it could be longer or shorter. Generally, the test of disability changes from “own occupation” to “any occupation”. Many insurance companies fail to consider that “any occupation” does not mean any job in the literal sense, but rather it must be an alternative occupation having regard to your ongoing restrictions and limitations, and must also take into account your training, education, and experience.
4) Work hardening programs:
If the insurance company requires you to participate in a work hardening program, but your doctor is against it, you should seek legal advice. If you do not participate, that could lead to a denial of the claim. You must be very careful in these circumstances to avoid your claim being denied.
5) Independent medical exams:
The policy will almost certainly contain a provision that allows the insurer to send you to an independent medical examination, or IME. But if you suspect the IME is not fair in the circumstances, or have other concerns, seek legal advice from an LTD lawyer.
6) Before attempting a return to work:
Most people with a long term disability claim want to get back to work. After all, LTD only pays a percentage of your pre-disability earnings, so there is a financial incentive do so. But the insurance company may misinterpret your willingness to try with you no longer being disabled. Consider seeking legal advice before attempting to return to work.
There are, of course, other times when you should consult a long term disability lawyer. Whatever your concern, Michael Jordan would be pleased to provide you with fast, free, no obligation legal advice.
About The Author
Michael Jordan is a long term disability lawyer with more than 17 years experience litigating all types of insurance claims. He is a founding partner of the Bay Street firm Jordan Honickman Barristers. Michael represents clients across all of Ontario, with satellite offices in Ottawa and London.
Direct Cell: 416-460-6823