Long-Term Disability Insurance 101

Published 02/09/2018

If you’ve been denied long-term disability benefits, it’s crucial to understand your rights. Learn the common reasons for denials, and explore your options to appeal and regain the benefits you deserve.

Insurance is intended to both manage risk and protect against the loss of property through theft, damage, and destruction. This is generally called property risk.

Insurance also manages risk and protects against lawsuits for negligence, malpractice, or failure in fiduciary duty. This is often called liability risk.

Insurance that manages risk and protects against loss of income or support through disability or death is called personal risk. An example of personal risk insurance is insurance that relates to premature death and poor health and disability.

A personal risk is normally subdivided into three different categories, namely premature death, poor health and disability, and living resources.

Poor health and disability risk is the risk of having to pay someone’s medical expenses or loss of income because of an accident-related injury or psychiatric illness. Our Hamilton lawyers often deal with injured or sick people who desperately need financial reimbursement for health-related expenses and the replacement of lost wages.

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What exactly is the role of long-term disability insurance?

For a lot of working-age people, the chance of getting sick, getting hurt, being unable to work or having to reduce work hours or work duties is substantially greater than the chance of dying.

The role of disability income replacement insurance, or long-term disability benefits, is simply to provide a stream of income payments to you as a disability-insured person to replace income lost due to being unable to work because of an injury or illness.

What types of disability insurance coverage are there?

Disability income insurance provides periodic payment benefits for disability resulting from both accidents and sickness. Basically, there are three types of disability insurance coverage in Ontario:

  • Government Plans: Government plans include the disability provisions of CPP, QPP, EI, and WSIB. These types of plans offer very limited protection as part of Canada’s social security benefits.
  • Disability Group Insurance Coverage: Disability insurance coverage is also offered through group plans, which are available through an employer or association. They generally offer more limited protection but at a lower cost to the insured or workplace.
  • Disability Coverage Through Individual Policies: Individual insurance policies are available directly from an insurance company or broker on a client-to-client basis. These types of long-term disability benefits offer the most extensive protection but at a higher cost to the insured.

Have you been denied long-term disability, or have your benefits been terminated?

If your disability income insurance or long-term disability coverage has been denied, our long-term disability lawyers can help. We are committed to helping injured or disabled persons receive the coverage they have both paid for and deserve.

If you have been denied your long-term disability benefits, you deserve to understand your full rights and options under your policy. Oftentimes, insurance companies will deny long-term disability benefits because of the following factors:

  • Misrepresentation of your health
  • Insufficient medical evidence
  • Failure to meet your policy’s definition of a disability
  • Insurer claims it has evidence contrary to your disability claim
  • Insured missed deadlines or failed to attend appointments

I highly recommend Lalande Personal Injury Lawyers legal team. Matt Lalande and his team are caring, compassionate and patient. From our first appointment to the last, we always knew what to expect and were encouraged to ask as many questions as needed. Matt’s knowledge, experience and professionalism is outstanding. He is also very friendly, kind and relatable. Sarah was a pleasure to work with – always so friendly, helpful and available. Their clear communication, during our difficult situation, made things less stressful. We are thankful to have had them on our side. – Kristy Sarrazin

Connect with our Long Term Disability Lawyers Today

If you have been denied long-term disability benefits, please talk to us. Lalande Personal Injury Lawyers has extensive experience with denied long-term disability carriers, and we can help you get your benefits back on track.

Our disability insurance lawyers assist claimants during all stages of a claim for disability insurance benefits—whether at claim denial or termination. We never charge upfront legal fees. Please arrange a free consultation with one of our lawyers by filling in a contact form below or by calling 905-333-8888 today.

Article FAQs

Why was my long-term disability claim denied?

Claims can be denied due to insufficient medical evidence, missing deadlines, or misrepresentation of health. Insurers may also deny benefits if they believe you don’t meet the policy’s definition of disability.

What types of disability insurance are available in Ontario?

There are three main types of disability insurance: government plans (e.g., CPP, EI), disability group insurance (provided through employers), and individual policies (which offer the most extensive coverage but at a higher cost).

Can I appeal a denied long-term disability claim?

Yes, if your long-term disability claim was denied, you have the right to appeal. Our lawyers can guide you through the appeals process and help you gather the necessary medical evidence to support your claim.

What should I do if my long-term disability benefits were terminated?

If your benefits were terminated, you should contact a long-term disability lawyer immediately. We can help you understand your rights and take the necessary steps to get your benefits reinstated.

How can a long-term disability lawyer help me?

A long-term disability lawyer can help you understand your policy, gather medical evidence, and fight for your rights. We can assist with everything from initial claims to appeals and termination cases, ensuring you get the benefits you deserve.