Are you someone who needs long term disability insurance? Unfortunately, no one can know whether they need this type of insurance coverage until they experience a debilitating injury, illness or other disability. The following is an overview of Ontario long term disability, including the typical causes of long term disability claims, how to qualify for long term disability Ontario, and what to do if your long term disability benefits are denied.

Ontario Long Term Disability Overview

Ontario long term disability insurance is typically purchased privately or through an employer. This type of coverage is meant to provide income replacement in case the policyholder suffers an injury, illness or other disability that makes them unable to work.

The cost of long term disability insurance can vary depending on whether you are purchasing the plan privately or through your employer, the type of policy you purchase, and other factors. Policyholders must pay a certain amount each month to ensure their policy remains active.

What Are the Typical Causes for Long Term Disability Claims?

Many long term disability claims involve personal injuries following an accident. However, there are several illnesses or other health conditions that are common long term disability claims. These include:

• Arthritis
• Back injuries
• Cancer
• Chronic pain
• Diabetes
• Fibromyalgia
• Heart Disease
• Infection
• Mental health issues
• Nervous system disorders
• Stroke
• Traumatic brain injuries

Receiving a diagnosis for one of these conditions does not guarantee that you will qualify for Ontario long term disability benefits. You must follow your insurance company’s procedure for applying for long term disability. The insurer will review your application and determine whether to approve or deny your long term disability claims.

Qualifying for Long Term Disability

Insurance companies are motivated by their bottom line and will often deny legitimate Ontario long term disability claims. For this reason, it is important to carefully follow your insurer’s procedure for applying for long term disability and collect the proper documentation from your employer and health care providers to prove that your disability prevents you from working.

Some insurance companies create policies with vague language that can be difficult to understand. They often make their policies confusing on purpose so that policyholders may believe they are not entitled to benefits and will be discouraged from appealing the decision. Even the definition of “disability” can be confusing. To confuse matters even more, your insurer may recognize a different definition of “disability” after it has paid your long term disability claims for two years.

Long term disability lawyers Ontario can help you gather the documentation and other evidence to create a strong case, boosting the chances that your long term disability claims will be approved.

Why Was My Long Term Disability Claim Denied?

Denial of long term disability claims in Canada is quite common. The denial letter will explain the reasons why your claim was not approved. Typically, a long term disability denial letter will include pertinent information, such as:

• How “disability” is defined in your policy
• What your long term disability plan covers
• The reasons your long term disability claims were denied
• Information the insurer relied on from your medical records to justify the denial
• The date the letter was written

If you can’t find your denial letter, you can request another copy from your plan administrator or plan advisor.

How Do I File a Long Term Disability Appeal?

There are typically strict deadlines involved in filing an Ontario long term disability appeal. To appeal the denial, you can either file an internal appeal with your insurance company or file an external appeal, which involves a neutral third party. Because internal appeals are handled within the insurance company, the people tasked with reviewing your appeal are not neutral parties and may be motivated to deny your appeal.

An external appeal essentially involves suing your insurance company and having your case heard by a tribunal or court of law. Although suing your insurance company may seem like a drastic step to take, it is actually a quite common method of fighting a denied claim.

It is a good idea to speak with lawyers for Ontario long term disability before you appeal the denial. They can carefully review your policy and the reasons your claim was denied and help you put together a compelling long term disability appeal. They are knowledgeable about the tactics insurance companies use to deny long term disability claims, and can help you fight for the benefits you deserve.