Disability law is complex. Policy wording is complicated, and the requirements for accessing the benefits are often lengthy. Sometimes, an application is rejected simply because an insufficient amount of medical information was provided. In other cases, the application form was simply incomplete.
The second event occurs at the so-called ‘change of definition’ date. Many policies have a definition change clause within the terms of the policy, allowing the insurer to end monthly benefit payments to an injured person if they are found to not have a disability severe enough for benefits. Commonly, the definition of benefits changes from an ‘own-occupation’ standard to an ‘any-occupation’ standard. In short, if you can do some job that you would be reasonably able and qualified to do, the insurance company will terminate benefits.
Benefit cut-offs are often unfair. Decisions are generally made by medical consultants working for the insurance company. Appeals are possible, but the review will be done by the insurance company.
Our work begins with an assessment of your medical file. Following a detailed review of your health and the insurance policy, we develop a strategy to demonstrate your level of disability to the insurer. A properly developed claim will result in one of three main possibilities:
Your health has improved such that you are able to work.
Your benefits are reactivated – you return to being “on claim”.
You receive a lump-sum payment to give up your policy.
Enforcing your contractual benefits is often challenging and discouraging. We help take this burden from our clients through our management of your claim. We are committed to fighting for your health and recovery.
We encourage you to speak to us about your disability benefits claim. We will review the policy with you and provide our opinion on your likelihood of success. We look forward to your call.