Time Limits to Dispute the Denial of Disability Claims

 In Personal Injury

If you are prevented from attending work due to injury or illness, you may have access to short-term and long-term disability benefits through your employer or your own private insurance policy. Disability benefits replace your income while you are unable to work. In most cases, this coverage is divided into short-term disability coverage (which may replace 80%-100% of your salary for 3-6 months) and long-term disability coverage (which usually replaces 50%-70% of your salary and is often available until the age 65).

Two-years after you first start receiving disability benefits, long-term disability coverage usually has a change in the definition of disability. For the first two years, disability is generally defined as the inability to complete the essential tasks of the job you were doing when your disability started. After two years, the definition typically changes to an inability to perform the essential tasks of any job for which you are reasonably suited by virtue of education, training, and/or experience.

It is not uncommon for an insurance company to terminate payment of benefits at the two year mark even if the insured person is not yet able to return to work. Every disability insurance policy is worded differently and, therefore, the policy in question must be reviewed carefully in order to determine whether the termination of benefits was in accordance with the wording of the policy.

If you have had your disability benefits terminated, you should contact a lawyer as soon as possible so that they can review your case and determine if the termination was supportable. The need to consult a lawyer without delay arises from the fact that there are many deadlines and limitation periods that can terminate your right to dispute the termination.

Most policies give the insured a right to appeal, which often must be commenced in a very short period of time. In addition, there is a time limit for commencing a lawsuit for breach of the insurance policy caused by the inappropriate termination of benefits. The Insurance Act sets a one year time limit, from the date of termination of benefits, to commence a lawsuit. An insured who has had their benefits improperly terminated may have less than one year, depending on the circumstances of the case.

This blog post was written by Edward (Ted) Masters, a member of the Disability Insurance Claims and Personal Injury teams.  He can be reached at 613-566-2064 or at ted.masters@mannlawyers.com.

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