One common reason for denial of a long-term disability claim by Sun Life is the lack of sufficient medical evidence. If the documentation provided by the claimant does not convincingly demonstrate the severity or existence of the disability, the claim may be denied. This often includes incomplete medical records or insufficient details from healthcare providers.
Another frequent reason for denial is the failure to meet the policy’s definition of disability. Long-term disability policies often have specific criteria that define what constitutes a disability. If the claimant’s condition does not align with these criteria, the claim can be denied.
Sun Life may also deny claims based on pre-existing conditions. If the disability is related to a medical condition that existed before the coverage began, and this is explicitly excluded in the policy, the claim might be rejected.
Non-compliance with treatment plans is another reason for denial. If the claimant is not following the prescribed treatment or rehabilitation plan, Sun Life may argue that the claimant is not taking necessary steps to mitigate their condition, leading to denial.
Sun Life might deny a claim if the claimant fails to provide timely updates or additional information when requested. Insurance companies often require ongoing documentation to support the continuation of benefits, and delays or failures in providing this can result in denial.
The lawyers at Kotak Law can provide expert advice on the legal standards and requirements for long-term disability claims. This guidance can help you understand your rights and the best course of action to take.
Kotak Law can initiate a lawsuit against Sun Life for wrongful denial of your claim. They can represent you in court, presenting a compelling case based on the evidence and legal arguments.
They can represent you in negotiations or mediation sessions with Sun Life, aiming to reach a fair settlement without the need for prolonged litigation. Their negotiation skills can be pivotal in achieving a favourable outcome.
They will gather and organize all necessary medical records, employment documents, and other evidence that supports your claim. This comprehensive documentation will strengthen your case when disputing the denial.
Our lawyers at Kotak Law suggest that you continue to see your primary care doctor and any specialists is this is crucial throughout the claims process. Regular medical visits not only provide ongoing care for your condition but also ensure that your medical records are up-to-date and comprehensive. Often, they may request doctors’ opinions in a detailed letter format to strengthen your case further. These opinions can provide a professional assessment of your condition and its impact on your daily life and work capability.
If your long-term disability claim has been denied by Sun Life you know that Kotak Law is there to help. It’s frustrating and overwhelming to be told by Sun Life that your disability claim is denied but remember, you are not out of options. Call Kotak Law today for a free consultation.
