long term disability benefits - Individual Disability Insurance Policies
Individual Disability Insurance policies are purchased by doctors, lawyers, dentists and other professionals or self-employed people to provide income replacement in the event they are unable to continue to work in their occupation due to illness or injury.
Claims made under these policies tend to be scrutinized to the highest degree and may benefit from earlier intervention of legal representation. At Share Lawyers we have the expertise and experience to assist you at various stages of the claim process.
Litigating Long term Benefit Denials
If your LTD Insurance Benefits claim has been denied by your insurance company, Share Lawyers can take legal action against the insurance company to recover the benefits that you are entitled to.
When it comes to Individual Disability Insurance polices, there are additional issues to be aware of that require the expertise and experience to ensure that you are recovering your maximum eligibility. In particular, these policies usually contain the following provisions, which may differ in their details from one policy to the next:
Own Occupation Coverage… Learn More
Individual Disability Insurance Policies are sold as providing benefits if you are unable to work in your own profession or business and that benefits will continue even if you are able to work in another occupation. The fine print in these policies may show that your coverage is not as clear-cut as you may have originally thought. In many cases, the policy language does provide “Own Occupation” coverage, however, the benefit amount may be reduced or eliminated if you are able to work in another “gainful occupation”.
Residual Disability Benefits vs. Partial Disability Benefits… Learn More
Many policies include provisions that will provide for a reduced LTD benefit. You may be asked to choose between residual or partial and it is important to examine carefully which of these benefits makes more sense for your specific circumstances.
There are other nuances to these policies that need to be examined on a case-by-case basis. Denied LTD claims can occur when the application is initially made or at any time while the claim is ongoing. If your claim has been denied or cut-off contact our office to see if we can assist.
Applying for LTD Benefits… Learn More
If you are considering submitting an application for LTD benefits under your individual disability insurance policy, the application process is complex and with our years of experience in dealing with these types of claims we can offer assistance that will enhance your chances of having your initial claim approved. Whether you are doctor, business owner, lawyer, financial planner, accountant or other professional with one of these policies, do not assume that you know how to apply for disability benefits.
Always bear in mind that the application form is drafted by the insurance company with vague questions which can easily be misunderstood or misinterpreted by the uninitiated.
Monthly Claim Handling… Learn More
Once your claim is approved for LTD benefits, the insurance company will continually adjudicate your entitlement to ongoing benefits, which means that benefits can be stopped at any time. You may be required to provide regular updates (sometimes monthly) and to have your doctor(s) complete further forms.
Where Share Lawyers is handling the ongoing claim, the insurance company is required to route any requests through our office. All written correspondence and communication will come to our office for our review and response, and the insurance companies know that where a claimant has our office supporting their claim, that we are ready to take legal action if benefits are denied.
If you believe you may benefit from our assistance in handling your claim on an ongoing basis, do not hesitate to contact our office to discuss whether this makes sense for you.
Lump-Sum Policy Buyouts… Learn More
When you buy your disability insurance policy, you do so in the hope that you will never need to make a claim, and your insurance company is also hoping that you will never need to make a claim. Once a claim is made and payments are being made, the insurance company is losing money on your policy, and so, in some circumstances the insurance company may be interested in “buying-out” your policy for a one-time lump sum payment.
There are numerous factors that go into putting a value on your policy. Some of the factors that insurance companies will consider are:
- the life expectancy and mortality of the insured;
- the likelihood that the insured will remain totally or residually disabled;
- the amount of insurance company reserves for the specific policy;
- the present value of future monthly disability benefits;
In every lump-sum policy buyout, the value is arrived at by discounting for the present value based on actuarial principles. Insurance companies are required to pay out monthly benefits over an extended period of time. For instance, if you are 50 years old today and you could potentially receive benefits for the next 15 years (to age 65), the total paid out over the 15-year period, when added up, would be greater than the current present value of those benefits. This is because, if the insurance company pays out your claim today, they lose the opportunity to invest most of this money over the next 15 years.
Lump sum buy-outs of the policy are not advisable for everyone. However, it can be attractive to some for the following reasons:
- The settlement is usually tax free to be invested as you desire;
- Your claim is over, and you no longer have to continually satisfy the insurance company that you continue to be disabled;
- Cash received now can be used for estate planning or a new venture;
- You can try a return to work without insurance company scrutiny.
For legal services related to Individual Disability Insurance Policies we offer some options depending on your specific circumstances:
Litigated Claims and Lump Sum Buy-Outs – we offer our services on either an hourly rate basis, a contingency-fee basis or in some cases a combination of both. We invite you to discuss what sort of fee arrangement is most suitable for you.
Applications, Monthly-Claim Handling and Providing Opinions – we offer our services on an hourly rate basis, or in some cases we may consider a flat fee. Contact us to discuss our rates and fee arrangement that is most suitable for you.
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We understand the patience and compassion that is needed to handle such a case, together with the need for sound legal advice. When you are suffering you are not at your
best, and need the steady, compassionate advice of experienced Toronto long term disability claim lawyers to assist you in navigating your way to fair and equitable resolution of your claim.
There are time limits to all claims and any delay in
proceeding may be subject to a deadline so you should not delay in proceeding with your claim or obtaining
legal advice to clarify these deadlines.
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