Disputing a Denied Disability Claim Successfully in Ontario

Disability insurance is a type of policy that protects the insured when an accident or illness occurs that renders him/her unable to work. With this policy, the insured will get a regular income when they are unable to work as a result of an accident or illness. Insurers also review the application for insurance when adjusting a disability claim.  If inaccurate answers were given on the application for insurance the insurer may deny the claim and return insurance premiums and cancel the policy.  An experienced disability insurance lawyer is needed to determine if  there was a misrepresentation made in the application for insurance that entitles the insurer to cancel the policy and deny the claim.  Firstly, the misrepresentation must be material to the risk insured and if the policy was issued more than two years before the onset of disability then the misrepresentation must be fraudulent to be relied upon by an insurer. Additionally , it is possible that any material misrepresentation may have occurred as the result of the negligence of an insurance salesperson and this possibility should be investigated as well by an experienced disability insurance lawyer.

Unfortunately, insurance companies that offer these policies often deny claims. One of the common reasons why claims are denied is when insurance companies believe that the victim is faking or exaggerating their disability, an allegation known as ‘malingering’.  Victims who are said to be ‘malingering’ have to put up a strong legal defence to avoid losing important benefits that could impact their life forever.

Malingering isn’t completely unheard of. There are indeed patients who exaggerate their condition or pretend in order to get compensated and avoid getting back to work after the accident or illness. This allegation can be extremely difficult to prove. The claimant’s medical test results, as well as the physician’s opinion, will greatly determine the ruling of this case. Insurance companies have highly experienced litigators who will use the evidence presented to dissuade the court and undermine the victim’s credibility. These lawyers lookout for gaps in treatment or unclear test results that could hinder the success of your claim insurers also routinely place claimants under surveillance to attack the claimant’s credibility. It’s critical to work with an experienced lawyer who understands what it means to put up a good fight and get the client a deserving compensation.

Get medical assistance

When an accident occurs, seek medical help immediately. It doesn’t matter whether you see any symptoms or not immediately after, receiving treatment is important as you could have underlying symptoms that don’t show immediately after the accident occurs. Don’t just assume that you are fine and walk away from the accident scene. You could have underlying symptoms that prevent you from going back to work or carrying out your day-to-day activities.

Keep a journal

Some conditions get worse over time and it’s important to have a journal where you document this progression. It can be difficult to remember all the details pertaining to your accident and how the condition has evolved. Keeping a record with information such as the level of pain you feel at certain times of the day or how the issue has affected your daily activities can help to further prove your disability.

An experienced long-term disability lawyer

When an accident occurs that renders you unable to work, speak to a lawyer immediately to help you in the process of filing a claim. Disability claims are complex, and you need the right lawyer to help you prove your case and prepare a strong defence to avoid your claim being denied.

Disability lawyers work with their clients to gather all the necessary evidence from third parties to prove that your life has drastically changed since the accident or illness. They speak to people who are close to you, get expert opinion, and gather medical reports and all that it takes to strengthen your case. A lawyer will protect your rights and ensure you get the settlement you deserve.