In law, the LTD or STD insurance policy is a contract between the insured and the benefit provider. Under the contract, the insurance provider has an obligation to provide benefits to workers who are prevented from working as a result of injury or illness. The policy also imposes obligations on a benefit claimant, which may be to provide medical evidence, participate in independent medical examinations and/or apply for Canadian Pension Plan disability benefits, and so on.
In order to effectively initiate and manage a claim for benefits, you must be both persistent and diligent. It is essential to keep excellent records at every stage of the process. You should maintain a dedicated file containing a copy of all medical reports, benefit application forms, correspondence, and any other documents you have generated in relation to your benefit claim.
Further, you must be diligent in obtaining up-to-date medical reports and should not hesitate to advocate for yourself at your doctor’s office. It is important to explain to your doctor the purpose of the medical report sought and the insurance provider’s requirements.
Many plaintiffs in disability insurance litigation have argued that insurance providers employ a claims management system intended to wear down and frustrate the benefit recipient. If you believe the insurer is making excessive demands or not getting back to you, do not give up and simply go away. Keep in mind that it is not uncommon for benefit claims to be initially refused or terminated, and later reinstated.
Consult a lawyer if you are considering making a claim for disability benefits and/or if your claim for benefits has been terminated or refused. You should feel entitled to access a policy that you have purchased and likely paid into for a number of years. Stay tuned for our next blog post about bringing your insurance provider to court.