The Truth About Disability Insurers’ Internal Appeal Process

Most disability insurance companies, including Sun Life, Manulife and Great-West Life, have an internal appeal process that they offer in their disability claim denial or termination letter.  They use such phrases as “there is insufficient medical evidence to establish that you meet the definition of disability as set out in your insurance policy.”  They then offer a glimmer of hope by stating that you have 90 days to submit further medical documentation to be reviewed.

So guess what happens next?  Your claim is denied again and you are offered another 90 days to submit more evidence – but behold – your hopes are dashed again with another denial.  Does this sound all too familiar?

Unfortunately, we see this cycle described above quite often.  The disability insurance company internal appeal process is patently unfair and unhelpful.  Below is a list of reasons for this:


A claims examiner from the insurance company will purport to review a decision from an employee of the same company.  The review is therefore not being done by an independent decision maker.  They answer to the same boss and are being asked to either support or go against a fellow colleague.  You already can guess where that will go.


You have been fighting the denial by your insurance company alone.  You may have dealt with an unsympathetic claims representative. This has undoubtedly made you feel anxious, humiliated and frustrated. You are now being asked to go on a never ending mission of securing and sending documentation, all by yourself, to a person who is doubting your claim.  This is an unfortunate recipe for a worsening of your condition.  Many people simply give up because they are so frustrated by the process.


There is a limitation period to sue your disability insurance company.  If you delay in going to a disability lawyer and engage in the futile internal appeals process you may find yourself forever out of time and barred from starting a law suit.


Consult with an experienced short and long term disability claim lawyer if your claim is denied or terminated. Your lawyer can give you advice as to the process of starting a law suit quickly and obtaining the right medical evidence to get your claim approved or settled.  Your disability lawyer will take that burden from you so you don’t have to deal with your insurance company.

At Kotak Law our disability insurance lawyers have been successful in suing disability carriers and securing significant lump sum settlements for our clients who suffer from illnesses such as chronic pain, chronic fatigue, depression, anxiety, panic attacks, fibromyalgia, colitis, cancer, heart disease or even stress alone.


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 (Toll Free for all of Canada), or (416) 816-1500 (Local Number for Ontario Residents), (403) 319-0071, (587) 414-1010 (Local Numbers for Alberta Residents). 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 and Alberta, including Toronto, Mississauga, Brampton, Milton, Georgetown, Orangeville, Oakville, Burlington, Hamilton, St.Catharines, Niagara Falls, Stoney Creek, Kitchener/Waterloo, Cambridge, London, Windsor, Markham, Pickering, Oshawa, Peterborough, Keswick, Kingston, Ottawa, Banff, Brooks, Calgary, Edmonton, Fort McMurray, Grande Prairie, Jasper, Lake Louise, Lethbridge, Medicine Hat, Red Deer, Saint Albert 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.