If you can’t see it, then you can’t explain it and notes from family doctors, counsellors, social workers and psychiatrists saying their patient is disabled due to anxiety and depression, in the absence of more compelling medical evidence, which may not exist, just may not cut it with the insurance company.
This is often more to do with the unavailability of an appropriate specialist in a timely manner, rather than a failure to obtain appropriate treatment. This type of clause in an insurance policy is supposed to be used to terminate a claim where a claimant is refusing appropriate treatment, such as not taking prescribed medication, or attending rehab for substance abuse, but we often see this reason being mentioned where the claimant has not seen a psychiatrist and is only seeing a family doctor.
Where there are elements of issues in the workplace, such as harassment or bullying by a superior or co-worker, insurers often take the position that disability insurance is not designed to pay benefits when the problem is an inter-office issue. Where these types of issues are combined with a diagnosis of a mental health issue, benefits are often payable and this reason alone should not be a reason to lose hope that you may be entitled to recover benefits.
In certain cases, where the claimant has a history of mental health issues but has been able to work while managing their illness, insurers may suggest that you could work with this in the past and the symptoms are no worse now, so you are not disabled.
This searchable database contains information about disability, critical illness and life insurance claims, and what you can do if you are denied or cut off of your benefits. It is a collection of the most common questions we receive from our clients. General answers have been provided by our lawyers.