Disability insurance can provide crucial financial assistance to you and your loved ones if an injury or illness keeps you from working and earning a living. However, many people encounter obstacles on the path to obtaining the benefits they are rightfully entitled to. Getting help from an experienced Vancouver disability claims lawyer as early as possible when seeking benefits can help you avoid common blunders that lead to delays and denials. A lawyer can assist you in appealing a decision to deny your claim or stop payments.
To learn more about how a disability insurance claims lawyer in British Columbia can help you, contact Warnett Hallen LLP today. We can review your case in a free consultation, explain how the disability claims process works, and start immediately on pursuing the full amount you are due. We believe you should never settle for less than what you deserve.
What is Disability Insurance?
Disability insurance serves as a financial safety net when the unexpected occurs, such as an accident that leaves you with severe injuries or the diagnosis of an illness such as cancer. For this reason, most employers in British Columbia provide disability insurance or cover premium payments. These benefits are taxable as income.
You can also get disability coverage on your own, or a private plan, or purchase insurance to supplement your employer’s plan. These benefits are not taxable as income. Unions, guilds, and other professional and educational associations may offer disability insurance plans as well.
The amount of coverage will depend on your plan and provider. However, most plans go beyond what the Government of Canada provides through Employment Insurance (EI) sickness benefits, which covers 55 percent of your pre-disability income and can last for up to 15 weeks. An employer-provided or private plan typically covers between 65 to 85 percent of your income. Long-term disability payments could go on for many years.
Keep in mind that disability insurance is separate and distinct from EI sickness benefits, workers’ compensation benefits, and from payments that you could be eligible to receive through the Canada Pension Plan or the British Columbia Pension Plan.
What are the Different Types of Disability Insurance?
If you cannot work for medical reasons and have exhausted all your paid sick leave, you may be eligible to file a claim for short-term disability insurance. A plan may provide coverage for a few weeks or up to six months. If your short-term disability insurance coverage expires, and your condition still prevents you from earning income, you may qualify for long-term disability insurance that covers you for up to two years or beyond.
The types of disability insurance plans generally fall into two categories:
- Own occupation – Provides coverage if you cannot work at the current job you had before your disability arose. Many people call it “regular” coverage.
- Any occupation – Provides benefits only if you cannot work for any employer or at any other job due to your disability. Your education, training, skills, and experience factor into this determination.
Many long-term disability insurance plans start as “own occupation” coverage and change to “any occupation” after a period. Unfortunately, disputes often arise when insurers insist that a person can work at another type of job despite the limitations brought on by their disability.
When Should I Submit My Disability Claim?
An insurance company will likely make you go through a waiting period while a claims representative reviews and investigates your claim. If you have exhausted all your paid sick and/or EI sickness benefits, you should file your disability insurance claim as soon as possible to start the process.
Generally, when you file for disability insurance benefits, you must submit three forms to the insurance company:
- Notice of Claim – This is your statement. You should describe the nature of your medical condition, when it became disabling, and how it prevents you from earning an income. You must also identify all conditions that cause you to suffer from a disability.
- Employer’s Report – In this report, the employer should inform the insurer about your length of employment, job duties, salary, and whether your job involves specialized skills.
- Attending Physician’s Report – You should get your treating doctor to provide this report. The report will describe your diagnosis, restrictions caused by your condition, the date your condition became disabling, your treatment plan, and your prognosis.
The insurance company should send you a letter acknowledging receipt of your claim. A claims representative may contact you for more information, such as medical records or to schedule an interview. When dealing with the insurer, you should have a lawyer on your side to protect your rights.
What if My Claim for Disability Payments Gets Rejected?
Insurance companies are for-profit businesses. They make money by collecting as much as they can in premiums and paying as little as possible to resolve claims. When you file a claim, you should expect the insurer to give it a high level of scrutiny and look for ways to deny it. For instance, the insurer may claim that you failed to provide medical documentation or that you are not totally disabled and can do your current job or some other type of work.
If the insurance company denies your disability claim or if the company stops making payments, you can appeal. The insurer should provide you with information about its appeals process. When you appeal, you have the right to get a copy of your claim file and any other information the insurer acquires while trying to fight your appeal.
If your appeal succeeds, you should start receiving your disability payments and be paid retroactively to the date when they should have started. An insurer may also offer a lump-sum settlement.
If the insurer does not reverse its decision on appeal, you can file a lawsuit against the company. Generally, you must file the lawsuit within two years from the date your claim is denied or it could be dismissed.
Why Should I Consult a Lawyer?
When you work with a disability insurance claims lawyer at Warnett Hallen LLP, you can count on us to provide highly personalized service and tireless dedication to your case.
If an insurance company denies your claim, it is critical for you to work with a lawyer. At Warnett Hallen LLP, our lawyers can take steps such as:
- Reviewing your case and answering any questions you have about your disability insurance claim
- Ensuring you properly submit all required forms to the insurance company, including working with your doctor to make sure the insurer gets the information it needs to make the right decision
- Communicating directly with the insurance company on your behalf (and sparing you the stress and anxiety that insurers can often cause)
- Preparing you for any interviews or medical examinations
- Determining why your claim was denied (or payments stopped) and working quickly to gather evidence to support your appeal and/or lawsuit
- Negotiating with the insurer for a full and fair settlement or, if necessary, advocating for you in court
- Coordinating your disability insurance payments with all other forms of assistance you may receive
Get Help from a Vancouver Disability Insurance Claims Lawyer Today
At Warnett Hallen LLP, we never want you to settle for less than what you deserve. Whether you are in the process of filing your disability insurance claim or appealing a denial, we will protect your rights and seek the maximum amount for you. Call or reach out to us online today for a free case review.
