By Matt Lalande in Long-Term Disability on December 22, 2021
A disabling injury or illness can put your entire life on hold, from the personal to the professional, preventing you from enjoying your life as you had and leaving you unable to work and support your household as you had before the disability.
One relief is that a mental or physical disability that prevents you from working entitles you to long-term disability benefits to cover your lost earnings due to your condition. However, many people face an uphill battle when it comes time to seek disability benefits. When you receive a claim denial, it can put a halt on your ability to recover benefits and your ability to support your household.
Disability insurance should protect your ability to support yourself and your loved ones if you experience a health condition that makes you unable to work. When you are injured, you might think that it is automatic that your disability payments will kick in. While this is ideal, it is, unfortunately, not the case for everyone, and many Sun Life policyholders have found that collecting their disability benefits is not as simple as they had hoped.
Disability insurance is supposed to provide you with a safety net in your time of need, but when your claim receives a wrongful denial, your situation might be made significantly worse in the short term, with long-term financial implications.
A disability insurance lawyer can help you through the application process, and if you have already applied for benefits and received a denial, Lalande Personal Injury Lawyers are here to answer any questions you might have, and if we take your case, to advocate for the best possible settlement for your injuries from the insurance company.
We practice disability insurance law and focus on disability insurance denials when it comes to workplace injuries. We have the experience your claim needs to reach the maximum amount possible, and we work to get it into your hands sooner than later.
If you have a disability claim and received a denial in the Hamilton area and Ontario, reach out to Lalande Personal Injury Lawyers today.
Disability insurance functions like other forms of insurance in that it protects the cash or economic value of what the policy insures. For example, if your car has insurance coverage, the insurer should pay up to the value of the vehicle or what it will cost to replace it.
Insurance covers or minimizes your out-of-pocket expenses associated with a disability, whether that includes repairs to your vehicle or repairs to your body in the form of medical treatment.
The purpose of disability insurance is to ensure the economic value of your earning ability, which is what you can generate through working to support your household. Much like your car insurance protects you in the event of a crash, you and your family will rely on your disability insurance to cover the costs of a mental or physical disability.
Policyholders pay premiums on their disability insurance policies, and in exchange for this payment, the insurance companies are supposed to pay out benefits when you experience physical or mental disability as the policyholder. This is not always the case, as the process of being approved for your benefits can be complex and at times convoluted, and when you aren’t familiar with the process or are preoccupied with recovering from your medical condition, you might not receive a fair assessment or full payout of benefits.
Your employer chooses which insurance company to go with, and if you have gone through a claim or are in the process with Sun Life, a company that offers both life insurance and disability insurance, we are here to help. Sun life is an organization that works not for you but for profit. In fact, the company’s insurance sales in quarter three of 2021 were $628 million, with the overall Canadian insurance market growing in quarter three of 2021 by 24 percent over the prior year’s third quarter.
Insurance in Canada is big business, and when you don’t have a long-term disability lawyer fighting for your damages, you’re going against the profit machine of the insurance company, and it is growing. Having a long-term disability denial lawyer on your side as soon as possible following your diagnosis will support a complete payout on your benefits so that you can get on with your life without significant concerns over your inability to work due to your disability.
When you file a claim with the insurance company, it will not look for a minimum number of qualifications before fast-tracking your benefits. Instead, insurance companies will carefully scrutinize every detail of your application to find a mistake or discrepancy that allows them to deny your claim.
To be accepted, it must meet specific parameters and standards that the full-time insurance analysts require for approval, and even if your claim is approved, they will then try to make the amount paid out as low as possible.
Profit is the money that remains after costs come out from earnings/revenues. The way that insurance companies generate a profit is by maximizing their revenues through collecting premiums, making the most of their income, while minimizing their costs by denying as many claims as possible, and by paying as little as they can get away with on those claims which are accepted. They can try to pay you less by making a quick offer of a settlement soon after your disability.
At this point, you might think that the settlement offer is generous, and taking it can help you in the short term. However, it is important to remember that a quick settlement offer from the insurance company will often fail to account for the long-term costs and earnings implications of your injuries.
To be approved, your claim must include the specific information that the insurance company’s analysts and lawyers require. Even if your disability entitles you to benefits, if you do not fill out the application correctly or do not include sufficient evidence to convince the insurance company of your condition, your claim may initially result in a denial. A denial of your initial claim can put a grinding halt on the payout of your benefits and can lead to lasting delays in your benefits that can hurt your family’s financial stability.
Connecting with a disability claims lawyer with experience managing the proper payout of benefits by the insurance company by representing long-term disability denial clients will support the best possible outcome in your case.
The fact that you have a legitimate disability that results in medical expenses and keeps you from working does not mean that you will automatically collect benefits, as mentioned above. Even when you submit an accurate and complete application that has sufficient evidence for the insurance company to approve your claim, you might still receive a denial. The insurance companies sometimes deny a claim initially to get you to settle for a lesser amount before bringing a lawsuit to make them pay you the full amount that you are entitled to.
Your long-term disability claim might receive a denial for many reasons by the insurance company, whether the company has valid grounds to issue a denial or not. The insurance company will carefully scrutinize your application and look for mistakes and discrepancies that will allow them to deny it on procedural grounds.
Disability insurance applications can be complicated, and while it might not seem fair that the insurance companies expect you to fill everything out accurately after having gone through the traumatic experience of a disability, they do so. Further, they are ready to hold any type of mistake against you. When you are trying to cope with physical injuries and the mental health impact that accompanies a disability, it can be difficult to fully and accurately process your application.
Connecting with a Sun Life long-term disability insurance lawyer as soon as possible after your disability diagnosis can ensure that you have the support you need to move through every step of the process as well as possible, to the best of your advantage. If your claim has already been filed and you have received a denial, the long-term disability denial lawyers from Lalande Personal Injury Lawyers are here to negotiate the best outcome for you with the insurance companies so you can focus on your recovery.
While the website and branding might seem to indicate that the customer is important to Sun Life, this is simply not the case, and like any other for-profit insurance company, Sun Life does not always accept and pay on proper long-term disability insurance claims.
Sun Life and other insurance companies commonly deny claims for material misrepresentations in applications or their materials. A material misrepresentation happens when the insurance company thinks that you have violated your duty to honestly disclose all information in your application that is material to the risk that the insurance company takes. This can be difficult to understand as the reason itself is not entirely clear, but rather a claim that something you provided was not clear enough.
When Sun Life questions the validity of your materials and application by claiming a material misrepresentation, they will deny your claim or significantly reduce the amount that it pays on an approved claim. Challenging the amount of the payout of your benefits is a negotiation tactic on behalf of the insurance company and one that can make you wonder whether the policy will cover your damages and costs.
Having a long-term disability lawyer on your side to negotiate on your behalf can remove this stressful posturing by the insurance company from your everyday life. The value of your lawyer is their experience and advocacy, as they step into your shoes and take over the day-to-day negotiations and paperwork requirements so you can focus on recovering.
When you have a disability and are going up against the insurance company and their lawyers, our long-term disability lawyers can support you by:
Long-term disability insurance companies may deny claims based on the high burden of evidence that you must provide alongside your claim to ensure its approval. The insurance company may claim that your disability is not as serious as your evidence states it is and require that you undergo an assessment from its own doctor a doctor who might have a far more friendly assessment for the insurance company.
Sometimes, the insurer will claim that your condition was pre-existing and demand proof otherwise. The insurance is only allowed to ask what the process and rules allow, and having a long-term disability denial lawyer on your side will ensure that you provide no less and no more evidence than you need to maximize our benefits.
Receiving your benefits as soon as possible following your disability is important, and when your claim receives a denial, your Sun Life long-term disability denial lawyer from Lalande Personal Injury Lawyers will have your back and collect maximum benefits for you. Call us today, no matter where you are in Ontario at 1-844-LALANDE or local in the Hamilton / Niagara / Burlington areas at 905-333-8888 tell to discuss your claim today.