All long-term disability claims are not created equal. Within this one area of law, the best approach to challenging a denial or termination of a claim can vary greatly depending on the provider, the type of policy and the disability involved. The methodology with respect to how a claim is processed and appealed is unique to each provider and the contents of their various policies contain subtle differences that require an astute understanding of disability insurance law and litigation strategy to effectively challenge. It is extremely important that your legal representative has a thorough understanding of the subtle differences between providers, as well as the intricacies of their policies and practices in order to provide clients with their best chance for success.
At MK Disability Lawyers, our clients come to us with claims against a variety of Canadian insurance providers, and with respect to various policy types. Our considerable experience representing both insured individuals and insurance companies means that we have a unique understanding of how each provider operates, and how best to challenge their reasoning behind a claim denial or termination.
We have represented clients throughout Ontario against all of the major insurance providers in Canada as well as U.S. insurers, including:
- Sun Life;
- Great-West Life;
- Industrial Alliance;
- The Cooperators;
- Equitable Life;
- Canada Life;
- Blue Cross;
- Empire Life;
- London Life; and
Group Insurance Plans vs. Individual (Private) Plans
Group policies are offered through an employer, union, guild or professional association and may be provided automatically as part of a person’s employment, or they may need to be opted into. Check with your employer if you are unsure as to whether you are covered or not. Group policies will generally provide what is referred to as “own occupation” coverage for a specified period of time, after which coverage will switch to “any occupation”. The difference between the two is how the policy defines “total disability”, which can determine whether a claim is approved or continued.
“Own occupation” coverage refers to a person’s ability to fulfill the tasks associated with their specific job or role. Generally, under a group plan, this coverage will extend for a specified time period before switching to “any occupation”, which refers to a person’s ability to fulfill the function of any role for which they are deemed qualified given their education, training or experience.
Individual or private policies are designed for those who do not have coverage through their employer due to the nature of their occupation. Many professionals or high income-earners opt to purchase a private disability plan on its own because they are self-employed, or to supplement their group coverage in order to secure any income that may exceed the amount payable under the group policy. Individual policy coverage can be customized based on the purchaser’s preferences, allowing the insured to opt for “own occupation”, “any occupation”, or a combination of the two.
Long-Term Disability Lawyers in Toronto & Markham Representing Clients in a Variety of Claims
At MK Disability Lawyers, we have the skills and the depth of understanding necessary to set our clients up for success in one of the most challenging situations a person can face. We represent clients facing all of Canada’s major providers, with respect to any type of LTD policy claim. We bring knowledge from both sides of these disputes that enables us to anticipate the challenges the providers will use to deny or terminate a claim and prepare accordingly. To arrange a complimentary consultation with one of our experienced disability lawyers, please complete the online form, or call us at 844-697-4600.