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Long Term Disability Claim Tricks and Tactics for Claimants (Ontario)

Lots of people call my law firm for legal advice for their long term disability claims. Often for these people, it’s their first time dealing with a large insurance company over a claim of significant value which can impact the course of their financial security for the rest of their lives.

Questions like:

What should I (or shouldn’t) say to the adjuster over the phone?

How do I complete all of these forms?

Who should complete these forms?

When should I apply for long term disability benefits?

How can I apply for long term disability benefits?

What must I do once my long term disability claim gets denied?

Should I appeal the long term disability insurer’s decision; and if so; how do I go about that?

When should I retain a long term disability lawyer?

How much will retaining a long term disability lawyer cost?

How long will my case take to get settled or go to trial?

As you can see, people have a lot of questions regarding their long term disability claims. This is completely understandable. Long Term Disability claims are hard to understand right off the bat! They are contractual disputes. The terms of each contract are different. They all depend on the wording of the policy and each policy of insurance is similar; but it’s NOT the same. This is what makes things a bit confusing.

A car accident is easy to understand. In a car accident case, an at fault driver causes a car accident and is held accountable for the pain, suffering and ensuing economic losses they have created through their own negligence.

A long term disability case is based on the wording contained in the policy of long term disability insurance. These policies are long, verbose and hard to understand. There are multiple clauses, exceptions, time periods etc which makes hard even for an experienced long term disability lawyer to understand.

Here are some basic tips and tactics for those looking to claim long term disability benefits, or for those currently in a dispute with their long term disability insurer.

  1. Don’t wait to apply for Long Term Disability benefits, and don’t wait to lawyer up! Too often we see people delay their decision to either apply for long term disability benefits, or wait to retain a long term disability lawyer. This is a big “no-no”. There are time limits which begin ticking from the date of your onset of disability or last day of work to apply for long term disability benefits. There are also time limits to sue from the date of denial of your long term disability benefits (2 years). Waiting on these time limits will jeopardize your case. Failing to apply in the requisite time frame, and failing to retain a lawyer to commence an action within the requisite time frame will kill your claim before it even gets up off the ground.
  2. Applying for Long Term Disability Benefits means that you’re disabled. Being disabled is binary. There is no in between. Either you are pregnant, or you’re not. There is no being half pregnant. Long Term Disability is the same. Either your are disabled and not working, or you are not. Some policies give credit to disability for part time or reduced hours, but these policies represent the minority of polices we see. Being disabled does not mean that you cannot work your normal 9-5 job, but on the side you work another job. Being disabled does not mean you collect LTD benefits, CPP disability benefits, but you also work at a cash job earning under the table dollars which you are hiding from your long term disability insurer and the Government of Canada. If this is your tactic, insurers are very effective at revealing your truth. This sort of behaviour is dishonest, misleading and will result in significant consequences to you and to your case.linkedin-2-300x300
  3. Assume that the insurance company is spying on you. If you are feeling a bit paranoid after applying for long term disability benefits, your feeling is justified. Insurance companies hire private investigators, and have their own investigations departments to look in to you at very early stages of your claim, even before you have retained a long term disability lawyer and even before you have brought a civil action. These investigators can do background checks on you, search your social media profile online, even camp out outside of your home and follow you around town as you go on your day to day. The reason they do this is to try to catch you doing something or acting in a certain way to discredit your disability claim. IE: If you say you can’t run around or bend and they have surveillance of you playing soccer in your men’s league, that’s not a very good look. If you say you can’t lift, but they have surveillance of you lifting a heavy bag of rice or a case of water, that’s not a very good look either. Finally, if you say you can’t work, but they have surveillance of you armed with cleaning supplies and performing a cleaning/caretaker job, that’s not a good look either. Even if you are completely disabled, this won’t stop an insurer from doing their due diligence in snooping on you. Insurance companies are not in the business of gratuitously paying out money to begin with.
  4. Don’t miss any medical/treatment appointments. Lawyers who act for long term disability insurers LOVE pointing out when disability claimants miss medical appointments, or fail to see their doctors/treating professional on a regular basis. For those defence lawyers, this means that the claimant is failing to mitigate their injuries and they are not getting the treatment they need to get better. In addition, it sends a signal to the insurer that your injury/disability is NOT severe. If it were severe, you WOULD BE GETTING REGULAR treatment and you would NOT miss an appointment. Insurance companies and their lawyers will use the Plaintiff’s failure to attend at regular medical/treatment appointments against them to discredit their case and to argue that they are in breach of the terms of their long term disability policy. Don’t hurt your own case by failing to attend  or by missing an appointment. Your long term disability case is too important.

For more tips, give Goldfinger Injury Lawyers a call at 1-877-730-1777. We serve clients across Ontario with ability to meet with you in person at your home or at one of our meeting offices in Toronto, London, Peterborough, Kitchener and Owen Sound. Get Goldfinger Injury Lawyers working for you.

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