Frequently asked questions
If you have any general questions We recommend check our all faq. This includes common questions and queries.
What is long term disability insurance?
What is the difference between short term disability insurance and long term disability insurance?
Short-term disability insurance provides replacement wages if you are unable to work temporarily. Long-term disability insurance provides permanent income replacement after a medical condition prevents you from working for a prolonged period.
Disability benefits differ markedly from workplace insurance benefits. The illness or injury that leads to a disability must not arise from the job/workplace to qualify for disability benefits. Workplace insurance benefits are provided if you get injured on the job.
What is the difference between individual disability insurance and group disability insurance?
Group disability insurance is bought by businesses/organizations to provide disability insurance for employees that become temporarily or disabled due to a medical condition. For the group plan, premiums are paid through employee paychecks or partly and fully by an employer. Always ask if you are covered under the group plan.
Individual disability insurance policies contain a wider range of features compared to group disability insurance policies.
What types of disability insurance are there?
Short-term disability insurance offers temporary income replacement if you cannot discharge your duties due to a medical condition. It acts as income replacement for the first 120 days.
Long-term disability insurance provides income protection if you can’t return to work due to a medical condition. It offers a portion of your income so that you can cover medical treatment expenses.
Critical illness insurance offers financial support if an individual is diagnosed with a critical illness. Some of the conditions covered in the policy include stroke, heart disease, cancer, and as many as 20 other medical conditions. The benefit is paid as a lump sum after a 30-day survival period after the diagnosis of a medical condition.
Disability mortgage insurance offers financial support when you become disabled and are unable to work again. It covers part or all of your mortgage payments, either bi-weekly or monthly, after a 60-day waiting period. The policies have limitations concerning the amount and duration of coverage provided.
Who pays for long term disability coverage?
What type of disability allows me to qualify for long term disability benefits?
You qualify for long-term disability benefits if you are unable to complete all or some of the functions of your job. Some policies may demand proof that the disability prevents you from doing your job and any other job you are qualified to do with respect to your education, training, and experience.
Will I have to file a claim in order to receive long term disability benefits?
What information is required on my disability claims form?
The information required for the disability claim form includes:
- general demographic information
- information on how, when, and where you suffered the injury or illness
- symptoms, when you stopped working
- healthcare professionals that you have consulted
- diagnostic and treatment information for your disability
- duties you are unable to perform in your job
- income sources
- banking information
- occupational information, and any other requested information
The claim form will have different segments to be filled by you, your employer, and your doctors. Ensure that you provide accurate information in the claim form.
Are there deadlines when making a claim for long term disability insurance benefits?
To receive disability benefits, is it required that I be confined to a hospital?
No. A hospital stay is not a requirement in getting approval for a disability claim. Many medical conditions don’t require long hospital stays since treatment can be completed from home.
If your policy demands that you must be completely disabled or have a total disability, check to see the definition attached to the term total disability in your policy. In most instances, it means that you are unable to carry out the normal functions of your job in the period required to recover from your medical condition.
Why does the insurance company require me to have an assessment done with a doctor they have chosen even though I have already gone to see my doctor about my long-term disability claim?
Most long-term disability policies demand that you are assessed by a medical professional chosen by your insurance provider to determine if you qualify to receive disability benefits. However, the insurance company is required to choose healthcare professionals who are reasonably qualified to carry out the assessment.
If you feel that there was unprofessional conduct in how the assessment was carried out, contact a qualified personal injury lawyer to help you out.
Is it legal for insurance companies to hire someone to follow and videotape me?
Contact the police if you feel that the investigators are trespassing, putting you in danger, breaking the law, and violating your privacy.
How long do I have to wait to collect long-term disability benefits?
You must be out of work for several months to access long-term disability benefits. That waiting period is referred to as an elimination/qualifying period and may range from 90 to 180 days. Ask your insurance provider or employer for clarification.
How much will I receive from long-term disability insurance benefits?
Many policies put a limit to the amount of monthly benefit you can receive. In most individual disability policies, the benefits to be received are pre-determined so that people know what their monthly disability will be when they are unable to work.
I think that I need to sue for disability benefits, but I have no income. What if I cannot afford a lawyer?
When I sue the insurance company for disability benefits, what do I sue for?
If the insurance company agrees that I am still entitled to benefits, what are the different ways my settlement can be paid to me?
Most cases are settled based on a full and final payment that sums the amounts for past and future benefits. The agreed amount is determined between the claimant and the insurance company.
How long do the long-term disability insurance benefits last?
Are my benefits taxable?
Can other benefits be deducted from my long-term disability payment?
- Benefits from a Workers’ Compensation plan such as Workplace Safety Insurance payments.
- Disability benefits paid by a government program such as Ontario Disability Support Program, Canadian Pension Plan- Disability, Employment Insurance- Sickness Benefits, etc.
- Income earned from the Criminal Injuries Compensation Act.
- Wages or remuneration payable from any employer, including any statutory or common law termination and/or severance pay.
Your long-term disability benefit can also be reduced by payments made to your dependents, including minors in any of the above-listed areas.
Can my long-term disability insurance company force me to apply for Canadian Pension Plan (CPP) Disability or other benefits?
What policy ‘riders’ can you purchase with long-term disability policies?
- Cost of living adjustment that considers annual inflation and adjusts your benefits accordingly.
- Own occupation to 65 eliminates the ‘any occupation test’ and offers disability benefits until 65 years if an individual is unable to complete the functions of their occupation.
- Future earnings protection option allows you to avoid getting a new medical every time you get a wage increase. Additionally, it helps prevent a new application or premium increase in case your health has since deteriorated.
Does long-term disability provide extended medical or dental care as well?
I am on long-term disability, and my employer terminated my employment. What does this mean for my long-term disability entitlement?
After being unable to work at my job for two years, can my insurance company stop paying me my benefits?
Why has my long-term disability claim been denied? Why have my long-term disability benefits been terminated?
The insurance provider may argue that you do not have a claim since you do not suffer a total disability that prevents you from working. They will argue that you can work part-time or with modified tasks. In such cases, loss of earnings may be considered as a result of the medical condition.
I just received a letter from my insurance company terminating my benefits. What should I do?
Contact a disability insurance lawyer to contest contentious reasons provided by your insurance provider.
I was recently denied long-term disability benefits. When should I get a lawyer involved?
Do I need a lawyer to handle my long-term disability insurance claim?
How much will it cost to sue my insurance company?
What can I do to maximize my chances of success in filing a disability insurance claim?
Always go to a medical professional who specializes in the medical condition that you are dealing with. You will be better placed to describe accurately, and exhaustively the prognosis faced and necessary treatment. Ensure that you have described the duties and responsibilities of your job. The information on the mental and physical demands of your job is useful in assessing your limitations. The assessment will determine if you fulfill the ‘own occupation test.’
Who do I sue if my disability benefits are denied?
What is the process for suing the insurance company?
You will be questioned under oath and/or asked to undertake medical assessments with your doctor and another doctor chosen by the insurance company.
The process will entail taking part in settlement negotiations and even mediation. A full trial is a final step which is not common since a settlement is always made before it gets here.