Should I appeal my insurer's denial of disability benefits?

This article was published in The Hamilton Spectator.

Q: My disability insurer says I have 60 days to appeal their denial of my benefits. What should I do?

A: Both short and long term disability policies usually contain an internal appeals clause, by which a person applying can appeal the decision to deny or terminate benefits.

In my experience, unless there is dramatic new medical information to provide, these appeals are usually unsuccessful. Essentially, you’re asking the same people who just denied your claim to look at the same information and come to a different conclusion. Unfortunately, I have seen people who are in desperate need of assistance allow months to go by in multiple rounds of appeal without success. This creates significant financial strain, which can impact a person’s ability to get through the time a lawsuit takes to move forward. Call me a cynic, but when I see an insurer allow a person to go through four appeal rounds, I start to wonder if that is the point.

If you are faced with a denial of any kind by an insurer, contact a lawyer who specializes in disability claims immediately, even before appealing. We can assist you with the appeal if worthwhile, or immediately resort to litigation. Litigation allows you to put some pressure back on the insurer, and can quickly move them closer to a more reasonable position.

I am always happy to review your case to determine the best path forward. Those initial consultations are entirely confidential, and free of charge.

Brian Simo
Brian Simo
P: 905.572.5819