Receiving a denial letter for your long-term disability claim can be devastating. You’ve paid your premiums and relied on this support for financial security, but now you’re left wondering what to do next. While the road ahead may seem overwhelming, you’re not alone. If your claim has been denied, don’t lose hope. By taking the right steps, you can challenge the insurance company’s decision and fight for the benefits you deserve.
At Kotak Law, we’re here to guide you through this difficult time. Our firm specializes in long-term disability claims, and we’re proud to have Lexpert-recognized lawyers in this area of law. This prestigious recognition reflects our expertise and commitment to achieving outstanding results for our clients. We also work on a contingency basis, so you don’t pay us unless we’re successful in winning your case.
Here’s what steps you need to take if your long-term disability claim has been denied in Ontario.
Step 1: Understand the Denial Letter
The first critical step is to carefully review the denial letter from your insurance company. This document will typically outline the reasons for the denial, such as lack of sufficient medical evidence, a disagreement about the severity of your condition, or claims that you do not meet the definition of “disabled” under the policy. Understanding why your claim was denied is essential to building a strong case for overturning this decision.
Step 2: Gather Your Documentation
After identifying the reasons for the denial, focus on gathering relevant documentation. This could include detailed medical reports from your healthcare providers, employment records, and any correspondence you’ve had with the insurance company. Comprehensive and accurate documentation will support your claim and counter any claims made by the insurer.
Your physician’s role is particularly important at this stage. Their medical findings should clearly explain the severity of your condition, your limitations, and why you’re unable to work. Insufficient or unclear medical records are often used by insurers to justify denials, so addressing gaps in documentation is key.
Step 3: Avoid the Internal Appeal Process
Many insurance companies encourage claimants to pursue an internal appeal as the next step. While this option may seem appealing because of its simplicity, it’s often a strategy designed to benefit the insurer rather than you. Internal appeals are typically handled by the same people who denied your claim in the first place, which means the chances of a reversal are slim.
Rather than wasting time and energy on an appeal that is likely to fail, it’s more effective to take legal action with the help of a disability lawyer.
Step 4: Retain an Experienced Disability Lawyer
One of the best decisions you can make after a denial is to consult with an experienced disability lawyer. At Kotak Law, our legal professionals specialize in long-term disability claims and have been recognized by Lexpert for their expertise in this field. This recognition ensures you’re working with a team that has a proven track record of success.
Here’s how our lawyers can help you:
- Navigate the Complex Legal Process: Filing a lawsuit against an insurance company can be intimidating, especially if you’re unfamiliar with the legal system. A lawyer will handle all the paperwork, court processes, and deadlines so you can focus on your health.
- Deal With Insurance Companies on Your Behalf: Fighting a major insurance company often feels like an uphill battle. With a lawyer by your side, you won’t have to communicate with adjusters or worry about being pressured into unfavorable settlements.
- Increase Your Chances of Success: The fact that our firm has Lexpert-recognized lawyers means you’re working with professionals who are considered leaders in their field. Their knowledge and expertise significantly boost your chances of a favourable outcome.
Most importantly, Kotak Law works on a contingency basis, meaning you only pay us if we win your case. This ensures that legal representation is accessible to everyone, regardless of their financial situation, and shows our confidence in securing the benefits you deserve.
Step 5: Be Prepared to Act Quickly
When a claim is denied in Ontario, there are strict deadlines for taking legal action. If you wait too long, you may lose your ability to sue the insurance company and recover the benefits you’re entitled to. Contacting a lawyer promptly will ensure your case is handled within the required timeline and avoid costly delays.
Final Thoughts
Being denied long-term disability benefits is not the end of the road. With the right steps, you can push back against the insurance company and secure the benefits you need. The internal appeal process may seem like a viable option, but it often leads to frustration and further delays. Retaining an experienced disability lawyer is the most effective way to fight a denial, protect your rights, and improve your chances of success.
At Kotak Law, we combine compassion with unmatched legal expertise to fight for our clients. With Lexpert-recognized lawyers on our team and a contingency fee structure that ensures you only pay if we win, we are fully committed to helping you achieve a positive outcome. Contact us today for a free consultation and take the first step toward reclaiming your peace of mind.