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 from Sunlife. 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.
If you’ve been denied long-term disability – call us today. Our Hamilton disability lawyers have been helping claimants who have been denied long-term disability and have recovered millions in compensation since 2003. For a free consultation with an experienced long-term disability lawyer in call Lalande Personal Injury Lawyers at 905–333-8888 or fill out a free Consultation Form today. Alternatively, you can call us toll-free, no matter where in Canada you are located at 1-844-525-2633. Our long-term disability lawyers would be happy to schedule a no-obligation consultation with you and your family, and we would be happy to advise you of all of your legal rights and options.
If Sunlife terminated your disability benefits, it’s important to take specific steps to address the situation effectively. Here’s a general guide on what you should do:
Every case is unique, and the best course of action depends on the specifics of your situation, including the reason for the termination, the terms of your Sunlife insurance policy, and your medical condition. It’s strongly recommended to seek professional legal advice from our disability lawyers to navigate this process effectively.
Long-term disability claims can be denied by Sunlife for several reasons, some of which are as follows:
It’s important for claimants to thoroughly understand their policy, gather comprehensive medical evidence, and adhere to their treatment plans to strengthen their long-term disability claims. Connecting with a Sun Life long-term disability insurance lawyer as soon as possible after your denial is the best thing you can do – do not waste time. The longer you wait, the longer you are delaying the recovery of your claim.
If your long-term disability benefits have been denied – Sunlife will offer you the option of an internal appeal. Do you have to do it? The answer is no – and we recommend you don’t.
Pursuing an internal appeal of denied disability benefits is not always advisable due to inherent biases and the limited scope of review within the insurance company. Here are several compelling reasons why filing a lawsuit might be a better option than an internal appeal:
Bias of the Insurance Company:
Advantages of Filing a Lawsuit:
While a lawsuit can be more time-consuming and potentially more costly upfront, for many, the prospect of an impartial review and the potential for more careful consideration of their claim makes it a more attractive option than an internal appeal. It’s important for individuals to consult with legal professionals to understand their specific situation and receive tailored advice before deciding which route to approach after a Sunlife denial.
When an individual is approved for long-term disability (LTD) benefits through Sunlife, it’s essential to understand that the definition of disability may change after two years. This change in definition is a crucial aspect of the policy and can significantly impact the claimant’s eligibility for continued benefits.
During the first two years of receiving LTD benefits, the policy typically defines disability under the “own occupation” provision. This means that the claimant is considered disabled if they are unable to perform the essential duties of their own specific job due to an illness or injury. The “own occupation” definition is generally more lenient, as it focuses solely on the claimant’s ability to perform their current job.
However, after two years, the definition of disability often shifts to the “any occupation” provision. Under this definition, the claimant is considered disabled only if they are unable to perform the duties of any occupation for which they are reasonably suited by way of education, training, or experience. This change in definition is significant because it broadens the scope of potential jobs the claimant may be expected to perform, making it more challenging to qualify for ongoing benefits.
Insurers pay close attention to this two-year mark because it allows them to reassess the claimant’s eligibility for benefits under the more stringent “any occupation” definition. From the insurer’s perspective, this shift in definition helps to control costs and ensures that only those who are truly unable to work in any capacity continue to receive benefits.
It’s important to note that while the two-year mark is a critical point in the lifecycle of an LTD claim, not all insurance adjusters are acutely aware of the legal nuances surrounding this change in definition. Some adjusters may not fully grasp the implications of the shift from “own occupation” to “any occupation” or may not be well-versed in the relevant case law that has shaped the interpretation of these provisions.
This lack of understanding can lead to mishandled claims, improper denials, or failure to thoroughly investigate the claimant’s ability to work in other occupations. As a result, claimants may find themselves unfairly denied benefits or faced with the daunting task of appealing the insurer’s decision.
To protect their rights and ensure they receive the benefits they are entitled to, claimants should familiarize themselves with the terms of their specific policy and seek the advice of experienced legal advice from Lalande Personal Injury Lawyers, who specialize in disability insurance claims. These experts can help navigate the complexities of the two-year mark, gather the necessary evidence to support the claim, and advocate on behalf of the claimant to secure the benefits they deserve.
In Ontario, Canada, the time frame within which a claimant must file a legal claim following the denial of long-term disability benefits is typically governed by a limitation period – which is two years. This means that a claimant usually has two years from the date they are first informed of the denial to initiate legal proceedings.
However, there are important nuances to consider:
Given the complexity of these matters and the significant impact of missing a limitation deadline, it’s highly advisable to consult with our disability lawyers, who specialize in disability insurance claims, as soon as possible after a Sunlife denial. Our legal professionals can provide advice tailored to your specific situation, including the relevant limitation periods and any actions you need to take.
If Sunlife has denied your long-term disability benefits, it’s crucial to seek the guidance of an experienced long-term disability lawyer to navigate the complexities of your claim and secure the compensation you deserve. At Lalande Personal Injury Lawyers, we understand the profound impact such a denial can have on your life and are committed to advocating for your rights.
Here’s what you can do:
If you’re ready to start, you can also send us a confidential email through our website and we will be happy to get right back to you. We are here to provide you with the personalized and effective representation that you need during this challenging time.
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