How Can I Change my Insurer’s Mind Once They Deny My Benefits at the “Change of Definition” Point?

How Can I Change my Insurer’s Mind Once They Deny My Benefits at the “Change of Definition” Point?

In a long-term disability claim, “change of definition” usually refers to a change in the definition of what disability means in the insurance policy. This change of definition usually occurs after you have been receiving benefits for 24 months. The change of definition usually refers to a transition from an “own occupation” definition, to an “any occupation” definition. During the initial disability period, benefits are payable if you are unable to work at your “own occupation.” After the change, benefits are payable only if you cannot work at “any occupation” for which you have the required education, skill, or experience. There are variations on the wording, but this summarizes the typical “change of definition”.

Once you reach the change of definition point, it can be difficult to change your insurer’s mind, short of taking formal legal action, unless there is some dramatic medical evidence or change in your condition that makes it clear that you are totally disabled from working in any capacity. Keep in mind that the initial denial is only their interpretation of your case, using the expertise of their team of doctors to review your medical records, none of whom have your best interests in mind. Their concern is the savings they have if they don’t pay your claim.

Many insurers believe that very few people can actually qualify for benefits in the “any occupation” period. However, our legal system doesn’t look at this the same as an insurance company. At Share Lawyers, we are often successful in winning these claims on behalf of our clients. Our concern is getting you the benefits you deserve in order to live without financial worry while you look after your health. Therefore, the reason for denial needs to be reviewed carefully by reading the insurance policy and by reviewing your individual circumstances. Let us put our years of experience to work for you and help you win back the benefits you deserve!

Has your long-term disability claim been denied? Contact Share Lawyers and put our experience to work for you. We offer free consultations and there are no fees unless we win your case.

We have recently settled cases against National Bank Insurance, La Capitale Group, Liberty, Empire Life, The Co-Operators Life, and AXA.

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