Many applicants frequently encounter issues on how to get long term disability approved. There are many unsettling factors put into the decision, so there is no sure-win process. This is also the case for Industrial Alliance insurance policy holders.
The case of a 12-year old girl from North Vancouver is noteworthy – she had sustained a serious eye injury during a soccer game in the fall of 2016. The girl, Emily Laprise, requested $50,000 for the required surgery to repair the damaged retina. However, the cheque they got from Industrial Alliance was only $8.40. The amount was reported to be the cost for the gas used to deliver the girl from the soccer field to the hospital.
This event was reported on the news, but Industrial Alliance refrained from answering any interview. Based on the information available, the Laprise family has bought coverage for Emily since her birth. This means the company has been paid premiums for the last 12 years to cover the cost of $50,000 in case the policy holder suffers from a loss of sight in one eye. However, there is a clause in the contract that states “must have a corrected visual actuality of less than 20/200” in order for Emily to qualify for compensation. The incident has led the child to wear high-grade prescription glasses to get passable vision. But, this has greatly impeded a lot of her usual activities significantly. However, this apparently disqualifies her for compensation.
This incident has greatly affected industrial alliance insurance reviews. The contract did not state that the use of paraphernalia to enhance visual capability like an eyeglass can disqualify an LTD appeal. However, the company refuses to give further compensation despite the family following the proper la appeal process.
There can be a lot of variations to this accident insurance situation. For instance, a lawyer from Vancouver pointed out that most accident insurance policies are designed to never pay-out. For instance, there are policies that provide coverage if a person loses a hand. Under normal circumstances, a person is more likely to lose a finger or the tip, but very rarely the entire hand. In the end, it means the policy is less likely possible to apply anytime soon.
CPP Disability Appeal Lawyers and How They Can Help
If you’ve been one of the persons of appealing long term disability denial, you know how helpless one can be in the eyes of the law. The denial letter from the company usually contains a very convincing argument and may render a lot of applicants discouraged immediately. However, this is not the end. Once denied, you can still try to appeal for a claim on your insurance company. This involves a basic legal process that is best done with the help of a lawyer. Once you get the letter, see a disability lawyer immediately for a proper explanation and advice. Only then will you know the best action to take.
You can find sample long term disability appeal letter online, if you want to take things into your hand. However, it is more advisable to get someone with experience because they know better the steps and the common dos and don’ts.
Another advantage of getting a specialized lawyer is the more refined process of appealing for a claim. Once your intent is set, you will be undergoing several organized steps in order to systematically build-up the necessary documents and evidence to support your appeal. This will all seem very quick and hassle-free because your attorney will take care of the difficult parts. The decision of the court will determine whether you will receive a claim or not.
Lump-Sum Buyout of Disability Policies
Another way to settle your long term disability denied Ontario claim is to enter into a buyout with your insurance provider. In this case, the company will provide a lump sum of money instead of monthly payouts equal to the total amount you are supposed to receive for your claim. This is when the company is appealing for long term disability termination, or wants you to relinquish your rights for further claims for your disability in the future.
The following are three points you need to be aware of.
- Determine how the company computes the lump-sum amount. You will be surprised to know that a lot of providers have their own formulas for this. Some are meant to mislead the policy holder into thinking that she/he is receiving a good amount, only to know later on that a few years-worth of coverage have been significantly omitted. Some of the factors that may be included in this are your future benefits, mortality risk, disability proof, fund reserves apart from your claim, and the yield of the commercial bonds.
- When suggesting your intent for a buy-out, think about how to approach the insurance company. You need to not appear desperate. There might be actions that might cause your insurance provider to think the wrong way, so you need to tread lightly.
- Lastly, think about whether you really need a lump sum payment. This arrangement is not for all. If you feel that you will be in a much better place receiving continuous payments in the long run, do not appeal for this arrangement.