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Preszler Injury Lawyers

When I Sue the Insurance Company for Disability Benefits What Do I Actually Sue For?


You may file a lawsuit against your insurance company if they wrongfully denied your long-term benefits from your disability insurance, wrongfully terminated you, or reduced your monthly insurance payout. In some long-term disability cases, the policyholder sues the insurance company for refusing to pay their disability benefits—even though the latter received approval to purchase a plan and has paid off premiums for a significant period. Depending on the details of your case, it may be necessary to also sue the following groups of people:

  • Your employer
  • The insurance broker
  • The board of trustees that regulate your long-term disability plan

What Do I Sue For?

There is one reason for all long-term disability lawsuits: To receive the disability benefits legally owed to you. In addition and while every case is different, you may be able to also sue for:

  • Bad faith: If the insurance company’s actions were malicious or fell below the standard of care of good faith dealings, you may be entitled to punitive damages. For bad faith claims, your lawyer would have to prove that the insurance company did not treat you as an equal partner and acted exclusively in their own interest. Situations that may give rise to bad faith claims include the insurance company terminating your benefits without an explanation, terminating benefits when their own medical doctors state that you are disabled, or having their in-house doctor or adjuster ignore medical reports in your favour.
  • Mental distress: If the entire ordeal with your insurance company resulted in tremendous stress, you may sue to receive monetary compensation for your troubles. Depending on the details of your case, you may claim a before and after judgment interest on your compensation and even ask the defendants to cover your legal fees.

Taking Legal Action

Suing your insurance company involves taking specific steps. They include:

  • Hiring a personal injury lawyer: It is advisable to seek legal representation before taking any legal action. When you consult with a lawyer, they may assess your case to see if you have grounds to move forward with the lawsuit. Once the lawyer accepts your case, they may alert the parties involved with a statement of claim. They can also tell you when you sue the insurance company for disability benefits what you actually sue for.
  • Discovery process: Here your lawyer would investigate the case extensively and review your medical records and other relevant documents. They may also send out demand letters, exchange documents with the defence, conduct depositions, and enter witness statements, if necessary. The discovery process also involves awaiting feedback from the insurance company, who would have probably filed a defence against your lawsuit by now.
  • Mediation and negotiation: There is a likelihood that you would undergo additional medical examination with your doctor and the insurance company’s doctor. Per the outcome, both legal parties would move to resolve your case in a settlement. If the insurance company fails to agree on an equitable compensation, your lawyer would proceed to take the case to trial after suing the insurance company for disability benefits.
  • At the trial: Once in court, it is up to the judge and jury to reinstate your long-term disability benefits and award you with damages for past benefits owed. If the case makes it this far, you may be required to appear in court. However, some long-term liability cases lead to mediation or settlement.

Types of Settlements

When you win your case by suing the insurance company for benefits related to your long-term disability insurance, you are likely to receive two types of settlement. They are as follows:

  • Reinstatement payment: This payment is when the insurance company agrees to pay the long-term disability benefits they denied you. Known as arrears, this payment typically covers the benefits from the date they denied you to the date of the judgment. You may receive interest atop your compensation and some contribution toward your legal fees. After the settlement date, they may continue paying your long-term disability benefits, known as futures, or terminate your plan completely.
  • Lump-sum settlement: This settlement is a one-time, full, and final settlement for your claims. Typically, it covers your long-term disability arrears, long-term disability futures, legal costs, interests, and other related claims.

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If you have any questions and would like to schedule a call with our legal team for a FREE no-obligation consultation, contact us now. During this call you can ask any questions as it relates to your accident and/or claim and we'll discuss your options and possible outcomes.

Regardless of where you're located in Ontario – we may be able to help you. Don't delay - call us. Our lines are open 24/7.

When you hire Preszler Injury Lawyers, we may be able to protect your legal interests and help you choose the settlement that makes sense for your lifestyle and medical needs. In our counseling session, we consider several factors, including the nature of your disability; past, current, and future medical bills; and the sufficiency of the compensation. We also support you with a free initial consultation and contingency fees, which allows you to focus on your health without stressing about legal fees. To learn more about what we may be able to do for you, call us today at 1-800-JUSTICE.

 
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