Dealing With Own vs. Any Occupation Insurance Denials in British Columbia
Long-term disability insurance coverage can be a lifesaver if you find yourself suddenly out of work due to an injury or illness. However, insurance companies don’t pay out benefit claims without substantial proof of disability.
Claimants must meet certain tests before a long-term disability (LTD) claim gets approved — specifically, the own occupation insurance or any occupation standards. A Vancouver disability insurance lawyer can help you appeal unfair denials or the elimination of LTD benefits.
How Do Long-Term Disability Policies Define Disability?
Long-term disability policies typically define disability as an inability to work. Some policies pay benefits if a disability prevents you from engaging in any type of gainful employment. Others only provide payments if you cannot perform your job duties due to a disability but could still work in another occupation. Often, the insurer’s definition of disability is masked by unclear language that gives them leeway to deny claims based on technicalities.
Own Occupation Disability Insurance vs. Any Occupation Insurance
Both own occupation disability insurance and any occupation insurance policies can provide monetary benefits if you become disabled and cannot work. However, their coverage works differently.
Own occupation insurance provides benefits if a disability prevents you from doing the tasks of your specific job for the first two years after stopping work.
By contrast, any occupation insurance only pays if your disability prevents you from working in any job suitable based on your knowledge, experience, and age. It doesn’t mean you cannot work in any capacity. It means you cannot perform jobs with a similar salary that you are reasonably qualified for.
Many times, insurance companies switch from own occupation to any occupation insurance after the two-year period expires. They don’t want to pay LTD benefits for an extended period, so they re-evaluate your case to make sure you still meet their definition of disability. Changing any occupation gives insurers room to argue you can reasonably work in some similarly suited job. This is when many clients turn to our experienced disability lawyers for help.
Why You Need Legal Representation for Disability Claims
Claim denials are common among insurance companies. They may cite various reasons for the refusal, ranging from a lack of proper medical evidence to pre-existing conditions or even a clerical error. An experienced Vancouver disability lawyer can assist with compiling additional medical records, a doctor’s letter, or other documentation to clarify your case and strengthen your claim. A lawyer can also represent you in negotiations with the insurance company to ensure you receive fair treatment and hold the insurer accountable if it acts in bad faith.
Contact a Long-Term Disability Lawyer Now
The knowledgeable lawyers at Warnett Hallen LLP each have over 10 years of experience helping clients file for long-term disability in Vancouver. Reach out today for help making the most of your disability claim. Call or contact us now for a free consultation.
