Insurance Denial Lawyers and The Policies and Insurers We Deal With

Long-Term Disability Denial Occupations

Not only the nature of your disability matters when considering a denied claim for long-term disability.  The type of work you did prior to your disability, and your education and training you’ve gone through throughout your life also factor into not only whether you are able to perform your job due to disability, but whether or not you meet the test of being unable to perform any occupation once the definition of disabled changes under your policy.  Understanding the nature of your occupation and the day-to-day realities you face can help strengthen your denied long-term disability claim.  The experienced insurance denial lawyers at Taylor & Blair LLP have dealt with disabilities in a number of different occupations, including:

  • Trucker Disability Claims
  • Dock Worker Disability Claims
  • Nursing Disability Claims
  • Teacher Disability Claims
  • Correctional Officer Disability Claims
  • Paramedic Disability Claims
  • Dentist Disability Claims
  • Canada Post Disability Claims
  • Business Owner Disability Claims
  • Lawyer Disability Claims
  • Doctor Disability Claims
  • Accountant Disability Claims
  • Banking/Financial Advisor Disability Claims
  • Plumber or Other Trades Disability Claims
  • Executive Disability Claims

Types of Long-Term Disability Policies

Long-term disability insurance provides income replacement to individuals who are unable to work due to a disability lasting an extended period, typically beyond 120 days. This type of insurance can cover a portion of your salary, helping you maintain your financial stability while you recover.

Generally speaking, there are two types of disability insurance policies, Group Policies and Individual or Private Policies.

Group Long-Term Disability Policies

Group long-term disability policies are typically offered by employers as part of an employee benefits package.  While policies can differ, some features commonly found in group disability policies are:

  • Basic Coverage -Group plans generally cover all eligible employees and provide a standardized level of benefits. The coverage amount is often based on a percentage of the employee’s salary, commonly ranging from 60% to 80%.
  • Employer Paid – Premiums for group policies are usually paid by an employer, although some plans may require employees to contribute. Because the risk is spread across many participants, group plans can be more cost-effective compared to individual policies.
  • Less Investigation & Underwriting – Group disability policies typically have significantly less rigorous underwriting requirements than individual or private policies. Employees may not need to provide extensive medical histories or undergo medical examinations to qualify for coverage. This can be advantageous for individuals with pre-existing conditions.
  • Non-Transferable – One significant drawback of group disability policies is that they are often tied to employment. If you leave your job, you may lose your coverage unless the plan allows you to convert it to an individual policy, which may come with higher premiums and reduced benefits.
  • Plan Limitations – Group disability policies can have limitations or exclusions that may not be present in individual plans. These could include specific conditions not covered or a limited duration for benefits (e.g., benefits may only last for two years for certain mental health conditions).  This is done in consideration of the fact that group policies often come with less investigation and underwriting than individual or private disability policies.

Individual or Private Long-Term Disability Policies

Unlike group disability policies which usually come from employers, individual or private long-term disability policies are purchased directly from an insurance company, often through an insurance broker or insurance agent and are tailored to the policyholder’s needs. Features of individual or private disability policies include:

  • Customizable – Individual or private disability policies can be tailored to fit your specific needs and financial situation. You can choose the coverage amount, benefit period, and additional riders, such as cost-of-living adjustments or future purchase options.
  • Cost & Benefit – While individual or private disability policies can be more expensive than group coverage, the premiums reflect the personalized nature of the coverage, and the potential size of the benefit should you need to make a claim. Factors such as age, occupation, health status, and the chosen benefit amount influence the cost.
  • Underwriting and Approval – Individual or private disability policies require a more thorough underwriting process. Applicants must provide detailed medical histories and may need to undergo paramedical exams. This process can result in exclusions for pre-existing conditions or higher premiums based on health risks.
  • Portable – A significant advantage of individual or private disability policies is their portability. Once purchased, the coverage remains in effect regardless of employment status. This means you can retain your benefits even if you change jobs or become self-employed.
  • Longer Periods of Entitlement – Individual or private disability policies often offer longer benefit periods. While group policies might limit benefits to a specific time frame, individual policies can provide coverage until retirement age, depending on the plan.

Not everyone has the choice as to what type of disability policy they enjoy coverage under and more often than not most people fall under the coverage of a group policy.  At the end of the day every policy is different and the coverage and entitlement to benefits depends strictly on the wording of the specific policy.  Experienced insurance denial lawyers can review your policy and ensure that you get the benefits you are entitled to when your claim is unjustly denied.

Insurance Denial Claims with British Columbia Insurers

Not only does the language of the policy matter but often the insurance company you are dealing with can matter for denied insurance claims.

We have represented clients in British Columbia with claims against the following insurers: