3 Next Steps If Your Disability Insurance Claim Was Denied

Was your disability insurance claim denied? It’s not over yet. Here are three steps you can take to get the benefits you deserve.

1. Appeal

You need to move quickly if you want to appeal. The standard limitation period in Ontario to appeal this decision is two years, and it starts on the date of the initial decision denying your claim. This might seem long, but time moves fast, and life gets in the way. Two years could pass before you realize it, at which point you’ll be statute-barred from commencing an action. Regardless of the paperwork and evidence you have, this is a legal authority that caps the time limit on when you can bring this appeal.

Appealing the insurance company’s decision is standard practice. The insurance company will send you written reasons for the denial, which you’ll need to understand in order to how to strengthen your claim and determine what other information you can add. You may have new information to provide that appeared after you filed, and you may have other documents to add that weren’t previously part of your claim.

During the appeal, you’re still following the same principles as when you first applied. Keep in mind that vague and inconclusive notes have a low success rate. Don’t exaggerate, remain honest, and attach additional medical proof as required. If you obtained new documents or received additional expenses, be sure to include them.

Even with new information, appealing isn’t always the best option. The insurance company already said no once. At the end of the day, insurance providers don’t want to pay out.

2. Contact an Employment Lawyer

If the appeal didn’t work or you’re simply confused about whether to apply for a long-term or short-term disability benefit, and you’re unsure if have any other options at all, see an employment lawyer who specializes in this area. You may have legal grounds to challenge the disability insurance provider. This is an opportunity you don’t want to miss out on.

If you’re worried about costs relating to this, don’t get ahead of yourself yet. Some firms offer no-charge consultation fees, so it makes sense to see whether you’re entitled to anything at all. An employment lawyer has the knowledge and expertise to determine the next logical step, they’ll protect your rights, and they’ll provide guidance to lead you in the right direction, which could mean pursuing legal action to receive the amount you’re owed.

3. File a Lawsuit

If your claim was denied and your appeal was subsequently denied, you may choose to proceed by commencing a lawsuit. Suing an insurance company is their own kind of wake-up call. It shows that you’re serious about receiving your benefits. The company will begin reviewing your claim again and bringing it to higher authorities within the organization. Superior agents and in-house counsel will have to take another look at your claim to see what went wrong.

The purpose of filing the lawsuit is to receive the disability benefits you’re entitled to. In addition, you may be able to claim additional aspects, such as mental stress, if this was a particularly hardening experience. When you’re unable to work and without the benefits you need, this is an option. But you don’t have to take this step alone, which is where the second step is particularly important. Speaking with an employment lawyer is necessary to discover your options and the best course of action.

Regardless of whether you applied for a short-term or long-term disability claim or you believe appealing isn’t the right option for you, meet with an experienced lawyer to understand your rights and what you can do next.