LTD Claims and Appeals

Michael Jordan LTD Lawyer

A long term disability (LTD) claim is a request to receive benefits from an insurance policy that provides financial support for individuals unable to work due to physical, mental, or combined disabilities.

Many LTD claims are approved. When a long term disability claim is denied, the insurer typically offers an appeal process, but this is rarely your best option. LTD appeals have a low success rate and the insurer controls the entire process. Many appeals are unsuccessful due to stringent criteria and the insurer’s tendency to uphold initial decisions. After all, there is no neutral decision maker on appeal.

A different approach involves hiring a skilled long term disability lawyer to pursue legal action against the insurer. Lawsuits, unlike appeals, have a very high success rate. This is because they allow for a more thorough examination of the case in a legal setting, where evidence can be presented comprehensively. In addition, insurers know that a judge is much more likely to side with an individual than an insurance company that is supposed to be in the business of collecting premiums and paying claims. Almost no cases actually go to trial. When an insurer is faced with legal action, it suddenly wants to settle.

Michael Jordan is a long term disability lawyer who understands the complexities of LTD claims and appeals. Michael often sees appeals denied, but remarkable success through strategic litigation. If you don’t have to appeal first, skip that process and retain a long term disability lawyer to take legal action.

For those facing denial of long term disability benefits in Ontario, Michael Jordan offers compassionate and effective legal representation.

LTD Claim

Step 1: LTD Claim Denial

Long term disability Toronto

Denial of long term disability claims, unfortunately, occurs more often than you might think, leaving many individuals who are unable to work due to disabling conditions without the benefits they deserve.

Even with substantial medical evidence and clear documentation, insurance companies may refuse to pay, citing various reasons outlined in their written notifications.

As an experienced LTD lawyer, Michael understands the frustration and hardship this can cause. Such claims are typically rejected at the outset, or after a period of benefit payments. Insurers often deny claims after two years, when most policies include a change of definition of disability from “own occupation” to “any occupation”.

Other common reasons for denial include claims of inadequate objective medical evidence, no substantial proof of ongoing impairment, issues related to pre-existing conditions, non-compliance with recommended medical treatments, or recovery timelines that exceed expectations.

However, being denied does not mean you are not entitled to benefits. With the help of an experienced long term disability lawyer, you can challenge the denial through a well prepared case.

Disability insurance lawyers, specializing in denied long term disability claims, are equipped to navigate these complex processes. They can offer comprehensive support to overturn decisions where disability has been wrongly denied, ensuring that your case is presented with fulsome evidence while taking advantage of the legal system.

Lawsuit

Step 2: Appeal or Lawsuit

APPEAL

Appealing a denied LTD claim is rarely successful, as the decision remains in the hands of the insurance company that initially denied it. Unless new, compelling evidence is presented, the chances of reversal are slim.

It is essential to consult with an experienced LTD lawyer, such as Michael Jordan, before proceeding with an appeal. Michael offers his appeal expertise at no cost, guiding you through the complexities and helping strengthen your appeal with the right evidence.

LAWSUIT

Unlike appeals, lawsuits have a much higher success rate, more than 97% when handled by a highly skilled long term disability lawyer.

Upon initiating a lawsuit, all communication with the insurer is managed by your LTD lawyer, so you can focus on your health. Your lawyer will request a complete copy of the file, prepare court documents, gather evidence, and negotiate a settlement on your behalf.

Choosing the Best Path

Deciding between an appeal and a lawsuit is an important decision. Lawsuits provide several advantages over appeals, including:

  • There is increased pressure on the insurer to provide a fair settlement
  • Your personal involvement is less, allowing your long term disability lawyer to manage the complexities
  • Lawsuits are a more assertive approach to reclaiming denied benefits

Time Limits

With strict time limits for filing claims, appeals, and lawsuits, prompt action is essential. Engaging an LTD lawyer immediately after denial can prevent the expiration of critical deadlines and maximize the potential for recovering your benefits.

Michael Jordan’s extensive experience and proven success rate make him an ideal advocate for those whose long term disability claims have been denied.

Settlement

Step 3: Settlement

There are two types of LTD settlements that a long term disability lawyer can help you navigate:

Reinstatement

Reinstatement involves the insurer paying past benefits owed and resuming monthly payments. If your appeal is successful, and you’re reinstated, you are back “on claim.” However, this means the insurer will continue to closely monitor your condition and activity level.

The insurer will request ongoing medical records, may require you to attend assessments or participate in prescribed treatments and rehabilitation programs. In some cases the insurer will conduct surveillance. Notably, being back on claim does not prevent future denials, as the insurance company always retains the right to reevaluate and potentially deny again.

Full and Final Settlement

The more common resolution is a “full and final” lump-sum settlement. This is a payment that covers both past benefits owing and future benefits.

The amount of a lump-sum settlement is determined by several factors, including your age, the monthly benefit amount, case strengths and weaknesses, and the skills of your long term disability lawyer.

Lump-sum settlements are usually tax-free, or mostly tax-free, depending on your policy. Accepting a settlement concludes your dealings with the insurer, though you can generally maintain medical and other insured benefits.

Considerations

When considering these settlement options, it’s essential to weigh their advantages and disadvantages:

  • Reinstatement keeps ongoing benefits, but requires continued compliance with insurer demands and carries the risk of future claim denials
  • Full and final settlements provide immediate financial relief and finality

A knowledgeable long term disability lawyer can help you make informed decisions tailored to your circumstances, ensuring the best possible outcome for your claim.

Was Your Long Term Disability Claim Denied? Call the Expert

If your long term disability claim has been denied, don’t lose hope. Michael Jordan is a highly rated long term disability lawyer in Ontario. With 20 years of experience, Michael has successfully resolved countless cases, with a success rate of over 97%.

For immediate and help with your LTD claim, or just to understand more about your options, contact Michael Jordan here or call him directly at 833-554-1238 for fast, free legal advice.

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No Fee Guarantee - Michael Jordan

NO FEE GUARANTEE

Michael Jordan provides free legal advice to everyone who contacts him.  If you decide to formally retain Michael to be your long term disability lawyer, you are entitled to a “No Fee Guarantee”. 

This means you pay absolutely no fees or other expenses unless successful, and the legal fees you do pay are a fixed percentage of your recovery.

There are several advantages of Contingency Fee Retainer Agreements: 

 
  • You do not pay anything unless successful, not even the taxes or disbursements
  • The percentage you do pay is fixed in advance
  • Your lawyer is motivated to move the LTD claim forward quickly and to obtain the highest possible settlement
  • Contingency Fee Retainer Agreements are regulated by the Law Society of Ontario
  • You maintain full control of your claim
Free Consultations

Call or complete the contact form to arrange a free consultation.

All calls and form submissions go directly to Michael Jordan, Long Term Disability Lawyer, not a receptionist or legal assistant. Michael will provide immediate free legal advice, and answer all of your LTD questions. If you would like to meet in person, Michael has offices in Toronto, London, and Ottawa, plus he will come to your location almost anywhere in Ontario.

Michael Jordan
Jordan Honickman Barristers

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