How Do I Appeal a Disability Insurance Denial?

The Disability Insurance company has denied your claim, and they have told you that you can appeal the decision: What do You Do Now?  Unfortunately, the so-called "Appeal" is with the same disability insurance company that has already denied your claim on the first go.  This really is not much of an appeal process, as you will not have an independent adjudicator reviewing the file and determining whether the Disability Insurance company acted appropriately or not.  In our experience, when a person is denied disability benefits, the decision is rarely overturned where the person attempts an appeal on their own.  Disability insurance companies are experienced in reviewing claims and determining those circumstances where a claim may be denied.  The denial of claims saves thousands of dollars for the Disability insurance company.  Those applying for disability benefits may feel that their claim has merit, and they are genuinely disabled and unable to continue working.  Unfortunately, this is not always enough to be successful in a disability claim.  That is why an appeal of the denial, without more, is rarely successful.  

At its core, the disability claim is seeking to enforce a contract.  In exchange for premiums paid on the policy, the Disability Insurance company has promised to pay benefits where specific conditions are met.  It is all in the details of the policy.  In order to be successful, you must be familiar with the terms of the policy and the conditions upon which the insurer is responsible to pay. That is why a disability insurance claims lawyer can be so helpful in the process.  We can review the circumstances of your disability, and look carefully at the terms of your contract to assess the strength of your claim.  With the right guidance and information, our experience has been that claimants are ultimately paid for their disability claim.  Of course, every case and circumstance is different and that is why it is important to have a lawyer look at the particular details of your claim.  

To learn more about your rights following a denied Long Term Disability claim, or for a FREE CONSULTATION with a disability claims lawyer call us at 416-900-1070.  We help with disability claims throughout Ontario.  

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