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Lawyers for Denied Long Term Disability Claims
We can Help If an Insurance Company Has Denied Your Claim for Long Term Disability (LTD) Benefits
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Sun Life Denied Your Long Term Disability Claim? We Can Help.
Receiving a denial letter for your Sun Life Long Term Disability (LTD) claim can feel like a devastating blow, especially when you're facing health challenges and financial uncertainty. It's important to remember that a denial is not the end of the road. At Iacobelli Law, we have extensive experience helping individuals like you navigate the complexities of Sun Life LTD claims and secure the benefits they deserve.
Why Was Your Claim Denied?
Sun Life may deny LTD claims for various reasons, including:
What Can You Do?
Don't Delay: There are strict timelines for appealing a denial and taking legal action. Contact Iacobelli Law today for a free consultation. We'll review your case, explain your options, and help you fight for the benefits you are entitled to.
Why Was Your Claim Denied?
Sun Life may deny LTD claims for various reasons, including:
- Insufficient medical evidence: Sun Life might claim your medical records don't adequately demonstrate the severity of your condition or its impact on your ability to work.
- Failure to meet the definition of "disability": LTD policies have specific definitions of "disability," and Sun Life may argue that your condition doesn't meet their criteria. This often revolves around the "own occupation" and "any occupation" definitions within your policy.
- Pre-existing condition exclusions: Your policy may exclude coverage for pre-existing conditions, and Sun Life might deny your claim based on this clause.
- Lack of ongoing communication: Sun Life requires regular updates and may deny your claim if you fail to provide timely information or attend required medical examinations.
What Can You Do?
- Don't Panic: Take a deep breath and carefully review Sun Life's denial letter. Understand the specific reasons for the denial and gather all relevant documents related to your claim.
- Gather Strong Evidence: Compile comprehensive medical records from all your healthcare providers, including doctors, specialists, and therapists. A strong medical file is crucial to demonstrating the severity and impact of your disability. Consider obtaining a functional capacity evaluation to provide objective evidence of your limitations.
- Consider a Comprehensive Appeal: Sun Life has an internal appeals process. Work with an experienced disability lawyer to prepare a compelling appeal package that includes strong medical evidence, supporting documentation, and a persuasive legal argument challenging the denial.
- Contact Iacobelli Law: Our team specializes in LTD claims and has a deep understanding of Sun Life's policies and procedures. We can:
- Thoroughly review your policy and denial letter.
- Analyze your medical records and identify any gaps in your evidence.
- Help you gather the necessary documentation to strengthen your claim.
- Craft a persuasive appeal that addresses Sun Life's concerns.
- Negotiate with Sun Life on your behalf.
- Represent you in court if necessary.
Don't Delay: There are strict timelines for appealing a denial and taking legal action. Contact Iacobelli Law today for a free consultation. We'll review your case, explain your options, and help you fight for the benefits you are entitled to.
How Disability Lawyers Are Paid - No Upfront Costs
We understand that following a disability that prevents you from earning an income, the last thing that you need is the added expense and stress of having to pay a lawyer by the hour to fight for you. We never ask for any fees upfront. Our disability lawyers work on a contingency fee basis - so you pay no fees unless we are successul in your Disability claim. Request a Free Consultation and our lawyers will explain the process and how we are paid at the conclusion of your case.
Learn About Your Rights and How We Can Help
Disability Claim Denied? You do not have to face the consequences alone. We are a dedicated insurance denial and personal injury law firm that provides compassionate legal counsel. We are experienced and have helped restore LTD benefits to individuals and families throughout Ontario.
Top Reasons Why Disability Claims Get Denied
Navigating the world of disability claims can be challenging and frustrating, especially when your claim gets denied. Let's consider some of the main reasons for Disability claim denials and tips on how to improve your chances of a successful claim.
#1 Understanding Disability Definitions
One of the primary reasons disability claims are denied is due to the claimant not meeting the definition of "disabled" as specified by their insurance policy. Disability insurance policies are contracts written by insurance companies, and they include specific, legally binding definitions of what it means to be disabled. Typically, these contracts require the individual to be totally disabled from engaging in their work.
Change in Definition After Two Years
Many policies include a clause that changes the definition of disability after two years. Initially, you may qualify for benefits if you are unable to perform the duties of your previous job. However, after two years, the criteria often shift to a broader definition, requiring you to be unable to engage in any employment for which you are suited by training, education, or experience. This change gives insurance companies a new opportunity to reassess your claim and potentially deny benefits.
#2 Lack of Medical Documentation
Another common reason for denial is the lack of medical documentation supporting your disability. Insurance companies rely heavily on medical records and the opinions of healthcare providers. Even if you experience symptoms that prevent you from working, the insurance company needs substantial evidence from medical professionals to back up your claim.
It's crucial to have consistent and comprehensive medical documentation. This includes regular visits to your doctor, detailed medical records, and ongoing treatment plans. Without this, the insurance company may argue that there is insufficient evidence to support your claim.
What To Do If Your Disability Claim Is Denied
If your claim is denied due to insufficient medical documentation, there are still options available. Seek ongoing medical attention and work with your healthcare providers to ensure all symptoms and treatments are thoroughly documented. New medical records can help build a stronger case if you decide to appeal the denial.
#3 Inconsistencies in Claims
Inconsistencies in your claim can also lead to denial. This happens when there is a discrepancy between your reported symptoms and your activities. For instance, if you claim to be unable to work due to a disability but are seen engaging in activities that contradict this, the insurance company may deny your claim.
Maintaining consistency in your statements and actions is critical. Ensure that all information provided to your doctor and the insurance company aligns with your reported symptoms and limitations. Inconsistent claims can undermine your credibility and lead to a denial.
#1 Understanding Disability Definitions
One of the primary reasons disability claims are denied is due to the claimant not meeting the definition of "disabled" as specified by their insurance policy. Disability insurance policies are contracts written by insurance companies, and they include specific, legally binding definitions of what it means to be disabled. Typically, these contracts require the individual to be totally disabled from engaging in their work.
Change in Definition After Two Years
Many policies include a clause that changes the definition of disability after two years. Initially, you may qualify for benefits if you are unable to perform the duties of your previous job. However, after two years, the criteria often shift to a broader definition, requiring you to be unable to engage in any employment for which you are suited by training, education, or experience. This change gives insurance companies a new opportunity to reassess your claim and potentially deny benefits.
#2 Lack of Medical Documentation
Another common reason for denial is the lack of medical documentation supporting your disability. Insurance companies rely heavily on medical records and the opinions of healthcare providers. Even if you experience symptoms that prevent you from working, the insurance company needs substantial evidence from medical professionals to back up your claim.
It's crucial to have consistent and comprehensive medical documentation. This includes regular visits to your doctor, detailed medical records, and ongoing treatment plans. Without this, the insurance company may argue that there is insufficient evidence to support your claim.
What To Do If Your Disability Claim Is Denied
If your claim is denied due to insufficient medical documentation, there are still options available. Seek ongoing medical attention and work with your healthcare providers to ensure all symptoms and treatments are thoroughly documented. New medical records can help build a stronger case if you decide to appeal the denial.
#3 Inconsistencies in Claims
Inconsistencies in your claim can also lead to denial. This happens when there is a discrepancy between your reported symptoms and your activities. For instance, if you claim to be unable to work due to a disability but are seen engaging in activities that contradict this, the insurance company may deny your claim.
Maintaining consistency in your statements and actions is critical. Ensure that all information provided to your doctor and the insurance company aligns with your reported symptoms and limitations. Inconsistent claims can undermine your credibility and lead to a denial.
Denied Long Term Disability Claim - Should You Appeal?
If your long term disability claim has been denied, you will probably receive a letter from the insurance company explaining the denial and your right to appeal the denial of your long term disability benefits. In our experience, there is no benefit to filing an appeal. Instead, you should consult with a lawyer to assess the strenght and merits of your claim and then proceed by suing the insurance company. From our experience, this is the better course than utilizing the insurance company appeals process. That process, while it sounds like a good idea, is more often just another opportunity for the insurance company to further delay your claim.
Don't be misled by your insurance company - their interest will not change. Asking the insurance company to reconsider their decision almost never yields any benefit to the disabled party. In some cases, this process can actually result in the time running out to file a lawsuit agains the insurance company,
Don't be misled by your insurance company - their interest will not change. Asking the insurance company to reconsider their decision almost never yields any benefit to the disabled party. In some cases, this process can actually result in the time running out to file a lawsuit agains the insurance company,
How Much Time Do I Have To Sue for Denied Disability?
Once your application for Long Term Disability is denied, you only have 2 years to file a lawsuit. This is a statute of limitations and is the law in Ontario. The time limits are strict. With few exceptions, failure to meet the strict timelines for filing a lawsuit will result in you being barred from bringing a claim, and the Long Term Disability Insurer will not have to pay
Get Help Now with a Free Consultation
If you believe that your Long Term Disability insurance provider has wrongly terminated or denied benefits, you have a limited time to take action. Many LTD policies have time limits for bringing a lawsuit against the insurance company, and there are also statute of limitations for commencing a lawsuit.
For a free consultation with a lawyer, contact Iacobelli Law Firm.
In recognition that serious injuries commonly result in serious financial hardship, we offer contingency fee retainers, so that you pay No Fee unless you win.
For a free consultation with a lawyer, contact Iacobelli Law Firm.
In recognition that serious injuries commonly result in serious financial hardship, we offer contingency fee retainers, so that you pay No Fee unless you win.
Long Term Disability Carriers
We have litigated and won Long Term Disability Benefits that have been denied by the major disability insurance carriers. We know who their adjusters are and which firms they hire to defend their denied claims. Let us put our experience and knowledge to work for you to obtain the denied disability benefits that you deserve.
There are several long-term disability (LTD) insurance providers in Ontario. Some of the most notable include:
There are several long-term disability (LTD) insurance providers in Ontario. Some of the most notable include:
- Manulife: One of the largest insurance companies in Canada, with a wide range of LTD products and a strong reputation for financial stability.
- Sun Life: Another major player in the Canadian insurance market, offering comprehensive LTD coverage and a variety of optional benefits.
- Canada Life: Known for its flexible LTD plans .
- Desjardins Insurance: A large insurer with a particularly strong presence in Quebec and Ontario.
- RBC Insurance: A well-established insurer with a wide network of advisors and a variety of LTD plans.
- Blue Cross Blue Shield: A major player in the Canadian insurance market, especially when it comes to health and disability coverage.
- Empire Life: A mid-sized insurer with a focus on individual LTD plans.
Expertise in Long Term Disability Claims
Our Lawyers are Experienced in Fighting for Denied Long Term Disability Benefits.
Call us for a Free Consultation
Call us for a Free Consultation