When your disability claim is denied in Vancouver, it can be one of the most frightening things. When you become unable to work due to injury or illness, the long-term disability insurance you expect to be able to rely on denies your claim.

It doesn’t matter if your doctor or other treatment medical professionals agree with the decision; an insurance company can still deny legitimate long-term disability claims.

This isn’t only for new long-term disability claims. Quite often, individuals who have been receiving long-term disability, some for years, will find that their insurance company has decided that they are no longer disabled and cut off disability benefits.

People in Vancouver and everywhere else in British Columbia will notice that more and more long-term disability claims are being denied ever since the NDP created legislation ending the right of subrogation for long-term disability payments related to motor vehicle accidents.

Where once ICBC had to pay back insurance companies for long-term disability companies for benefits paid out in motor vehicle accidents, this is no longer the case, which will mean a huge loss of money for the insurance companies that operate in British Columbia. How do insurance companies recoup these losses? By denying other claims.

Long-term Disability Claims

What Steps Can You Take After Your Long-Term Disability Claim is Denied? If your long-term disability benefits are a group plan out of your employment, you can always contact HR to see if they can assist you in dealing with your insurance company. Ensure they also give you a copy of your policy for review.

When your long-term disability claim is denied, you first need to make sure you have the reason for the denial in writing and that it clearly explains the insurance company’s basis for denying your benefits.

This will normally come in the form of a denial letter. Ensure that the letter outlines the insurance company’s decision to deny your long-term disability claim.

It’s often helpful to follow up with your long-term disability insurance adjuster to clarify their decision and the information it was based on.

Make sure any follow-up questions are in writing so you can refer to them later. The documents surrounding the initial denial are often the most helpful if you have to sue your insurance company.

What Are Your Legal Options After a Denied Long-Term Disability Claim?

After your long-term disability is denied, you have three options. You can either roll over and accept the denial, go through the insurance company’s appeal process, or start a lawsuit.

David A. Goldberg, an insurance denial lawyer and Partner at the Vancouver law firm of Taylor & Blair LLP, says, ” Insurance companies have internal appeal processes for denied long-term disability claims.

These processes are designed to be long and drawn out, and the chances of actually changing an insurance company’s mind about the denial of your benefits are almost non-existent.”

So why do insurance companies want to push people into their appeals process? The appeals process will often take months and months to complete, and this will let the insurance company run out the clock on your claim.

Most people do not realize that if you do not file a lawsuit within the limitation period, usually two years from the date your long-term disability is first denied, you are statute barred from challenging your long-term disability denial in Court.

Not even the best lawyer can get around a limitation defence. The insurance companies know this and want you to give up.

Your insurance company has an obligation

Whether you plan to appeal first or decide to sue for your long-term disability benefits, you should contact your insurer and request a complete copy of your insurance file.

Your insurance company must provide you with your insurance file in a timely fashion, and it will contain all the information they have on you. Not only can this information help to appeal a long-term disability denial, but if you have to sue, your lawyer will need it anyway.

Cases That Made The News

In a high-profile case that recently hit the headlines in Vancouver, British Columbia, the denial of a long-term disability claim has sparked a significant public outcry and stoked a heated debate on the nation’s insurance laws.

This case revolves around Michael Stevens, a 45-year-old IT professional who has been struggling with a debilitating neurological disorder, yet whose long-term disability claim was denied by his insurance provider despite his evident incapacitation.

Stevens had worked for a leading tech company in Vancouver for nearly two decades before his life took an unforeseen turn. In early 2021, he was diagnosed with Multiple Sclerosis, an unpredictable and often disabling disease of the central nervous system that disrupts the flow of information within the brain and between the brain and the body.

Over two years, Stevens’ health deteriorated to the point where he was unable to continue his duties, leading him to file a claim for long-term disability benefits through his workplace insurance coverage.

Providing substantial medical evidence

Despite providing substantial medical evidence, including reports from neurologists and his primary care doctor, to support his claim, Stevens was stunned when his insurer, Provident Life Assurance, denied it, citing “insufficient medical evidence” to prove the severity of his condition and his inability to work.

The denial of Stevens’ claim has drawn significant media attention and sparked public outrage.

Leading news outlets, including The Globe and Mail and the Vancouver Sun, reported extensively on the story, focusing on Provident Life Assurance’s controversial decision.

They underscored how the denial resonated deeply with the public, as many Canadians grapple with similar concerns over insurance coverage and the potential precariousness of their financial future should they become unable to work due to a long-term illness or disability.

What made Stevens’ case even more contentious was his previous outstanding work record and his employer’s testimony regarding his incapacitation due to his medical condition.

His colleagues, superiors, and even the CEO of the tech company publicly expressed their support for Stevens and their dismay at the denial of his claim. This high-profile backing fueled the media fire, leading to intense scrutiny of Provident Life Assurance and insurance industry practices more broadly.

Implications of Stevens’ claim denial

This controversial case quickly transcended the local boundaries of Vancouver, generating nationwide discussions. Advocacy groups for disability rights, legal experts, and even political figures voiced their concerns about the implications of Stevens’ claim denial.

They raised critical questions about insurance companies’ fairness and transparency, the validity of their claim assessment procedures, and the protection available to policyholders.

Stevens refused to accept his claim’s denial. Backed by a prominent legal team, he filed a lawsuit against Provident Life Assurance, accusing the insurance provider of bad faith, breach of contract, and emotional distress.

Arbitrary practices of insurance companies

His legal battle has become symbolic for thousands of Canadians facing similar struggles and, for many, a beacon of hope in challenging insurance companies’ sometimes opaque and seemingly arbitrary practices.

While the outcome is yet to be decided, the case has already had a profound impact, leading to renewed calls for insurance reforms and greater transparency and fairness in treating long-term disability claims.

It has prompted serious reconsideration of policy language, claim evaluation procedures, and the responsibility insurance companies should bear toward their policyholders.

Disability Claim is Denied in Vancouver – Conclusion

If you must start a lawsuit to get the long-term disability benefits you are entitled to, find an experienced insurance denial lawyer to assist you. Most work on a contingency fee basis, meaning you don’t have to pay any fees unless they collect money from the insurance company.

This can be done by getting you put back on policy (i.e., you get your benefits paid in a lump sum from when you were first denied and then continue to receive your monthly benefits going forward as if you were never denied) or by what is called a “buyout” of the policy, where you get a lump sum in exchange for closing your claim forever.

Lump sum buyouts are usually for a reduced amount whereby the plaintiff gets a reduced amount of money but gets the benefit of receiving all of the money at once and, as such, can invest it to earn more in the long run.

Most people prefer a buyout of the policy to ensure they never have to deal with their insurance company again.

If your long-term disability claim is denied in Vancouver, speak to a law firm today.