Brampton Disability Lawyers
It is surprisingly frequent for claimants to be initially denied disability benefits by their insurer. More surprisingly: insurance companies may not give you a full picture of why they denied your claim.
A disability claim may be denied because the insurer feels you have not proved the severity of your injury. Or it may simply be denied because of small errors in your application. It is crucial that you have a long term disability lawyer to ensure your claim is comprehensive and makes use of all legally relevant details.
You may be surprised when your insurer denies your disability claim or cancels your benefits. However, this is sadly all-too-common. Your insurer has a vested interest in denying disability claims, and this does affect their decision-making, which can be a shock to the clients who put their faith and trust in their insurer. As a result, some disability sufferers simply take their insurer at their word and give up after being denied disability benefits.
But it’s important to remember that you have other options.
No one understands your body and health better than you do. If you feel that you are physically or mentally unable to return to work, that is enough to signal that you shouldn’t accept your insurer’s decision.
Please take the help of a Brampton long term disability lawyer from Kotak Law. Our firm has a wealth of experience fighting for Brampton clients. Whether you are dealing with an unfair claim denial, or an insurer that appears to be delaying your deserved payments, we are on your side and know how to deal with insurance companies.
We understand the financial and emotional burden of a disability claim denial, which is why we operate with a simple credo: you don’t pay until you win. Our initial consultation is free, and we will serve you without payment until your case is finally concluded.
“Am I eligible for long term disability payments?”
The time frame: there is no specific time frame for how long you have to be out of work to qualify for long term disability, but generally long term disability benefits begin when short term disability benefits run out.
What illnesses can cause long term disability?
Any ailment – mental or physical – that prevents you from fulfilling the fundamental requirements of your line of work, can make for a valid disability claim.
Often those that suffer from difficult-to-measure maladies (such as depression, chronic pain, or fibromyalgia) are less likely to pursue long term disability benefits. This type of injury can be an equally valid reason for a disability claim. However, insurers are often less willing to pay disability claims based on this type of injury, and these claims often require litigation.
Proving my disability
We advise our Brampton clients to be dogged in regularly seeing their doctor and following their exact medical recommendations. This is an important part of your disability claim. It demonstrates that you have made a clear effort to seek treatment, and that your condition has been a consistent problem over the relevant period of time. This also helps create a strong body of medical evidence of your disability.
Your work record is also an important part of verifying your disability. It is important to document instances where your disability prevented you from working. If no more-official documents are created, simply recording this in a journal will benefit your disability claim.
KOTAK PERSONAL INJURY LAW/DISABILITY LAWYERS CAN HELP YOU
We understand that being denied disability benefits can be frustrating and devastating. Your time to fight your disability insurance company is limited. Please do not delay in calling long term disability lawyer. We have successfully sued numerous disability insurance companies including: Manulife, Sunlife, Desjardins, Great West Life, Blue Cross, AIG, SSQ, RBC, Industrial Alliance and more.
Call your trusted long term disability lawyers at 1-888-GOKOTAK or (416) 816-1500. Our consultation is free and we don’t get paid until you do. We can meet you at our offices, at a coffee shop, your home or a local court house. We represent disabled people throughout Ontario including Toronto, Mississauga, Brampton, Milton, Georgetown, Orangeville, Oakville, Burlington, Hamilton, St.Catharine’s, Niagara Falls, Stoney Creek, Kitchener/Waterloo, Cambridge, London, Windsor. Markham, Pickering, Oshawa, Peterborough, Keswick, Kingston Ottawa and other locations.
Disclaimer: This article is intended to supply general information to the public. We make every effort to ensure the accuracy of this information. However, as laws change quickly, the reader should always ensure the accuracy and applicability of such information with respect to their particular case. The information contained in this article cannot replace a thorough and complete review of the reader’s situation by competent legal counsel who has had an opportunity to review all of the facts.
Brampton Disability Cases in the News
CLAIMANT AWARDED AGGRAVATED DAMAGES AFTER LONG-TERM DISABILITY DISPUTE
Long-term disability coverage exists to provide Brampton individuals with an income when they become disabled due to an injury or illness and are therefore unable to earn an income and pay their expenses. Unfortunately, people of any age can develop a disability and disabilities often last many months or years. In fact, the Canadian Life and Health Insurance Association tells us that, on average, one in three people suffer a disability of greater than 3 months, before the age of 65.
The following are not uncommon circumstances that result in disability for many Brampton individuals.
- A severe injury resulting from a motor vehicle accident requires months of recovery
- Cancer patient recovers from chemotherapy and radiation treatments
- Back or wrist injury suffered in a fall prevents accident victim from working for months
- A worker employed in a physically demanding job requires months to rest after heart surgery
- Cycling accident results in broken shoulder preventing the victim from driving and working
Long-term disability plans typically replace 60-85 per cent of a person’s income. Many employers offer long-term disability coverage, but if unavailable through work, Canadians can also get coverage through an individual plan, an association or government plans.
After paying for a long-term disability insurance plan, we assume that we will be covered in the event of a circumstance that prevents us from working. That’s the way it should work, however, unfortunately it is not always the case. Sometimes, the insurance provider for a long-term disability plan disputes a legitimate claim for coverage, which can have a devastating impact on the life of a person who is already struggling physically, emotionally and financially as a result of their disability. These were the circumstances that led a woman to seek aggravated and punitive damages against her disability insurance provider, in Cross v. Canada Life Assurance Co. Ltd., after she was denied deserved benefits for some time.
The Cross case concerns a 57-year-old Vaughan woman who began to experience considerable pain while employed at Canadian Tire, which prevented her from continuing to work. In May 2000, she completed a “Claim for Managed Disability Form” and submitted it to her employer, who requested advice from Canada Life, their group insurance provider. At that time, the plaintiff was diagnosed by two separate doctors; one of whom diagnosed neck and shoulder pain, and arthritis; and the other, her family physician, indicated that she could not do lifting or prolonged sitting and may need a different job. Based on the information from the claimant’s family physician, in August 2000, Canada Life informed the woman that, in their opinion, she is not totally disabled from work duties as the diagnosis indicates she may need a different job. As a result of this assessment, Ms. Cross consulted with a lawyer to represent her in further dealings with the insurer.
In November 2000, the claimant submitted a more extensive “Attending Physician’s Statement for Disability Benefits” which indicated that she was suffering from a herniated cervical spine disk, shoulder and neck pain, and rheumatoid arthritis. The physician’s report also indicated that she was unable to use her fingers and hands on a repetitive basis and he wasn’t sure when she could return to work. Canada Life acknowledged receipt of Ms. Cross’ long-term disability claim in November and indicated that they would need to complete an assessment. They also requested additional medical documents and in mid-December, an X ray was forwarded to the insurer. Finally, in mid-January 2001, after having the plaintiff’s application reviewed by their medical consultant, Canada Life informed Ms. Cross that the limited information they had received did not support a disability.
On January 29th, Ms. Cross commenced a lawsuit against Canada Life. At the Examination for Discovery in April 2001, some additional medical reports were made available to the insurer; however, Ms. Cross’s lawyer did not produce all of the requested reports and clinical notes written by the claimant’s physicians until July, arguing that they were irrelevant. After receiving all the medical documents, a rheumatologist employed by Canada Life assessed the information in late August, and as a result of his report, Canada Life finally approved Ms. Cross’ long-term disability application and paid all her past-due benefits, including interest, on November 2, 2001.
After receiving her owed benefits, Ms. Cross commenced an action for aggravated and punitive damages, which alleged that due to the delay in receiving disability benefits, she had to cash in her RRSPs and experienced other difficulties and damages. In his consideration of the facts of this case, the Ontario Supreme Court judge noted that some of the delay in approving benefits was exacerbated by the adversarial approach taken by the claimant’s lawyer in refusing to produce certain medical information. However, the court concluded that, regardless of this fact, Canada Life did not process her application on a timely basis; they could have requested their own medical information much earlier; and the substantial delays caused by the insurer constituted a breach of duty and lack of good faith in dealings with Ms. Cross.
The standard for awarding punitive damages is quite high and citing Whiten v. Pilot Insurance Co., requires “malicious, oppressive and highhanded behaviour” on the part of a defendant. The actions of Canada Life were deemed to fall short of this standard and therefore, punitive damages were not granted in this case. However, the judge concluded that Ms. Cross was entitled to aggravated damages, based on Clarfield v. Crown Life Insurance Co., wherein it was stated that aggravated damages may be awarded where the plaintiff demonstrates an actionable wrong, such as a breach of the insurer’s duty of good faith. For her financial loss resulting from having to withdraw RRSP funds, the judge awarded the plaintiff $11,000. She was awarded an additional $18,000 for emotional distress and anxiety due to the drawn-out delay in payment of benefits.
If you have been denied owed long-term disability benefits, call a skilled disability insurance lawyer at Kotak Law. We have considerable experience and success in representing Brampton clients whose disability insurance was denied and will work zealously to obtain owed benefits for you.
Source:
the Canadian Life and Health Insurance Association Inc. (CLHIA): CLHIA article on disability
Disclaimer: This article is intended to supply general information to the public. We make every effort to ensure the accuracy of this information. However, as laws change quickly, the reader should always ensure the accuracy and applicability of such information with respect to their particular case. The information contained in this article cannot replace a thorough and complete review of the reader’s situation by competent legal counsel who has had an opportunity to review all of the facts.
Kotak Personal Injury Law
80 Maritime Ontario Blvd, Suite 240
Brampton Ontario L6S 0E7
Phone: (905) 791-8018
Toll Free: 1‑888‑GO‑KOTAK
Fax: (905) 755-8901
Email: info@kotaklaw.com
