When you take out insurance coverage, you expect that your insurer will indemnify you when the need arises. However, in many instances, the insurance company may delay payment; pay less than you expect or even refuse to pay at all. In Oakville, things are not any different. It is particularly depressing when your disability claim is denied and you have bills to pay and probably a family to feed but no source of income. You expect your insurer to help you but you realize it won’t happen any soon, if at all. To be safe, you need to know how to avoid claim denial and how to respond when it is denied.
Denial of Claims in Oakville
Every year, insurance companies in Oakville deny various claims made by their insured. The most commonly denied claims are:
– long term disability claims;
– own occupation insurance claims;
– property and casualty claims;
– life insurance claims;
– critical insurance claims; and
– flood and fire insurance claims.
What is a Long Term Disability Claim?
A long term disability claim arises when you are disabled by reason of an illness or injury so that you cannot continue working for a considerable period of time. During such a time, you are entitled to get a percentage of your monthly income from your insurer to help you continue meeting your financial obligations.
How to Make a Successful Long Term Disability Claim in Oakville
Many long term disability claims are denied, sometimes out of the insurer’s bad faith and other times because of the mistakes of the insured. To be safe,you should always avoid things that may give the insurer a reason to deny your claim. If you do everything perfectly, even if the insurer wishes to deny your claim, it cannot do so because if you decide to go to court your chances of success would be overwhelming. If the court finds that the company denied your claim in bad faith, it would be forced to pay more than your initial claim. Do not give your insurer a reason to deny your claim! Follow these guidelines:
Your LTD Application Should be Complete
Insurance companies usually have standard application forms consisting of a series of questions which you are required to complete. The success of your claim can be determined by how you fill the forms. Answer every question clearly and correctly. Do not answer a question that does not apply to you – indicate in the space provided, that it does not apply to you. Where you are not sure about any question, consult a long-term disability lawyer who will review your policy and interpret the questions.
Provide Sufficient Medical Evidence
Inadequate medical evidence is one of the grounds of denial of long-term disability claims in Oakville. You will need to provide a detailed report from your doctor explaining clearly why your disability limits your functionality at the work place thus making you unable to work. This is specifically important when your claim is based on symptoms like chronic pain and depression. A mere note from your doctor is not enough.
Submit your Claim on Time
Long term disability claims are subject to limitation of time. Failure to submit your application in time may be a ground of denial. If in doubt, contact your long-time disability attorney for advice and appropriate action. Even where you are not able to make the application personally due to pain from your injury or any other reason, your attorney can pursue the claim on your behalf.
Do not Resign, Apply for Sick Leave
Resigning from work may lead to denial of your claim because you are deemed to have forfeited the claim. The best thing will be to apply for sick leave from your employer. Being on leave means that you are still an employee and therefore entitled to long-term disability benefits.
Be Tenacious
Do not give up on your claim even when it is denied. It is possible that the company is acting in bad faith. Do not accept a simple telephone communication, ask the company to furnish you with a written statement of the policy provisions that formed the basis of the denial. This will give you the grounds of appeal. It may be necessary to seek services of a long-term disability lawyer if you had not engaged one from the beginning.
