If you’ve received a medical diagnosis preventing you from performing the duties of your job, you may be eligible to collect long-term disability benefits. However, for a variety of reasons, the majority of claims for long-term disability benefits are denied.
Insurance companies are not required by law to release statistics about the number of long-term disability claims they regularly deny. However, since approximately 60% of claims for the Canada Pension Plan (CPP) disability benefits are denied, it can be assumed that insurance companies deny the same amount of claims filed.
If your claim for long-term disability benefits has been denied, even though you believe your medical condition should make you eligible to receive them, a long-term disability claims lawyer may be able to help you appeal the insurance company’s decision.
What to Do if Your Long-Term Disability Benefits Claim Was Denied
If your claim for long-term disability benefits is denied, your insurance provider will generally notify you in writing. The notification letter will likely contain the following information:
- Details regarding the long-term disability benefits provided by your policy
- The insurance company’s definition of “disability”
- The reason your claim for benefits was denied
If you wish to appeal the company’s decision, you may only have a limited amount of time in which to proceed, beginning from the date your denial notification letter was issued.
Filing an Internal Appeal for Denied Long-Term Disability Benefits Claims
If your claim for long-term disability benefits was denied, you may be able to appeal the insurance company’s decision. The notification letter informing you of your denied application may contain information about how to appeal the insurer’s position. Often, denied claims require applicants to provide additional supporting documents to their insurance company, including:
- Medical documents supporting the severity of your condition
- The results of different medical tests
- Additional information from your employer
The insurance company may then use this additional information to reassess your claim. This process may take a substantial amount of time, and may not lead your insurer to reverse their initial decision.
Denied Claims for Long Term-Disability Benefits and External Appeals
With the assistance of a long-term disability claims lawyer, you may decide to appeal the denial of your benefits claim in court. In these external appeals, your eligibility to collect long-term disability benefits payments would be determined by a third party, not your insurance company.
External appeals, also known as a lawsuit, is where you choose to sue the insurance company in the Ontario Superior Court of Justice. If the case is resolved in your favor, you may be awarded compensation for:
- Benefits denied in the past
- Punitive damages
- Damages for mental stress you experienced
- A portion of your legal fees
Contact Preszler Injury Lawyers to Discuss Your Denied Claim
More than half of all claims for long-term disability benefits are denied. If you’ve been diagnosed with a serious medical condition that prevents you from returning to work, and your claim for benefits was fairly denied, Preszler Injury Lawyers may be able to provide you with assistance. For a free, initial consultation about your denied claim, and legal options that may be available to you, call Preszler Injury Lawyers today at (416) 364-2000.