Genetic Testing and Insurance Denials: What the Genetic Non-Discrimination Act Means for Canadians

Posted on by Brian Jacobson Posted in Insurance DenialsTagged ,

As genetic testing becomes increasingly accessible and integrated into modern healthcare, it has also raised complex legal and ethical questions, particularly in the realm of insurance. In Canada, the Genetic Non-Discrimination Act (GNDA), enacted in 2017, plays an important role in protecting individuals from being compelled to disclose genetic test results, especially in the context of employment and insurance relationships. But what exactly does the GNDA mean for insurance underwriting and the denial of insurance claims?

This interesting question came to our attention after reviewing an article posted by BRCAinBC, an organization that brings attention to and assists British Columbians affected by the BRCA gene mutations and associated hereditary cancer syndromes. Their article “What Can I Do If I Suspect Discrimination Due to a BRCA Gene Mutation” looks at potential discrimination due to an individual’s genetics, what implications that might have in the insurance realm, and potential remedies … Continue reading

Relief from Forfeiture & Long-Term Disability Claims

Posted on by Brian Jacobson Posted in Long-Term DisabilityTagged ,

Relief from forfeiture is an equitable legal remedy that can help insureds when they lose their insurance benefits and/or coverage due to imperfect adherence to the terms of their policy.

What is Forfeiture?

While the concept of “relief from forfeiture” is a common phrase in the area of insurance law, very rarely do people ask what forfeiture itself is and in order to understand the concept of relief from forfeiture, you first need to understand that concept.

Generally speaking, the word “forfeiture” refers to the loss of something as a penalty for doing something wrong or failing to do something you should have done. In the insurance context, forfeiture occurs when an insurance company denies a claim based on specific policy provisions which were not met by the insured. In denied long-term disability claims, this often involves situations where the insured fails to comply with policy requirements … Continue reading

Long-Term Disability Denial Claims for Teachers

Posted on by David Goldberg Posted in Insurance Denials, Long-Term Disability, Long-Term DisabilityTagged , ,

In British Columbia, long-term disability claims are typically governed by the Insurance Act and the specific terms of insurance policies. Teachers often have coverage through their employer’s group insurance plan which outlines the eligibility criteria, the definition of disability, and the process for making a claim. The definition of “disability” can vary significantly between policies and often an insurance plan will require that the individual be unable to perform their own occupation for the first two years of disability and thereafter that they be unable to perform any occupation in order to qualify as “disabled” under the policy.

Common Injuries & Conditions Leading to Teacher Disability

Performing your job as a teacher can have different requirements depending on the age of your students and the subject matter(s) you teach.

As with anyone working a job, teachers can be subject to the same illnesses and conditions that can lead to disability … Continue reading

Can You File Your Long-Term Disability Claim Late?

Posted on by David Goldberg Posted in Insurance Denials, Long-Term DisabilityTagged , ,

At the end of the day, your relationship with your insurance company is based on contractual obligations. If you become disabled pursuant to the definition of your insurance policy, your insurance company is required to pay out long-term disability benefits.  However, this obligation cuts both ways and your insurance policy most likely has strict timelines in which you need to file your application for long-term disability benefits. While these timelines can differ depending on the insurer and the terms of the policy, failure to file your claim for long-term disability benefits on time can result in a denial of what would otherwise be a legitimate claim.

Unfortunately, not every application for long-term disability is made on time, for a variety of reasons. This leads to the question of whether you can file your long-term disability later than the time period for furnishing proof of a disability that is specified in … Continue reading

The Financial Implications of a Disability Denial

Posted on by Brian Jacobson Posted in Long-Term Disability, Long-Term DisabilityTagged ,

No one ever wants to have to deal with a disability, but the reality is that sometimes, from injury or illness, disabilities do occur. When a disability does materialize, the hope is always to just have it be a transient issue necessitating the use of short-term disability benefits, but if your injury or illness does not resolve, you may have to move from seeking short-term disability benefits to long-term disability benefits.

The purpose of disability benefits is to help you financially at a time when you are medically unable to work. However, many rightful claims for disability benefits are denied by insurance companies. While a lawyer can help you fight against your insurance company for the disability benefits you are entitled to, the legal process usually takes quite some time. This can leave people who are suffering from a disability with the question of how to deal with the financial … Continue reading