Many of us will experience a disability period of 90 days or more before the age of 65, and some may even experience a disability period that extends over several months or years.

Disability insurance guarantees an income if someone becomes disabled and unable to work, either temporarily or for life.

Insurers may have various reasons for refusing to pay disability insurance benefits that an insured person claims to be entitled to. What should you do in this case? Our disability insurance lawyers answer this question.

What does it mean to be disabled?

Being disabled means being unable to work or perform daily tasks required for your job due to a disease, illness or personal injury. Disability can occur suddenly or as a result of an illness that renders the person unable to work. It can be temporary or for life.

Disability insurance benefits are typically used to replace the person’s salary, either partially or in full.

The types of disability insurance

There are two types of disability insurance: group insurance, which is offered to all members of a group, and individual insurance, which is issued to an individual.

Disability insurance disputes can involve either of these insurances.

Different disability insurance disputes

Various disputes may arise with the insurer when an insured person tries to benefit from their disability insurance.

The insurer may refuse to pay for the benefits if:

  • They assess that the insured does not meet the disability definition provided for in the insurance policy.
  • They evaluate the claim as a work accident that should be addressed to the CNESST.

After a certain amount of time, the insurer can also terminate benefits being paid for if the person concerned does not meet the new disability definition applicable as a result of a change in definition.

What to do if an insurer refuses to pay your disability insurance benefits

Insurance contracts contain clauses that are sometimes long and difficult to understand. You may therefore easily lose hope when dealing with an insurer who is refusing to pay your disability insurance benefits.

Lawyers can help you take the necessary steps with much more ease and confidence if this situation occurs.

Consultation service

Involving the legal services of a disability insurance lawyer helps you understand your rights and challenge the insurer’s decision if necessary. You will also understand the steps involved in the procedure and the chances of success.

Representation service

Disability insurance lawyers can also represent you. They can contact the insurer and obtain a copy of the file to review if the client agrees. They can also discuss the claim with the insurer’s representative and obtain the required medical documents.

The lawyer can also obtain an additional medical evaluation to support the client’s position and initiate a civil action in the Court of Quebec or Superior Court of Quebec against the insurer if appropriate.

Disability insurance lawyers to your rescue

Giving up can be tempting if an insurer refuses to pay you the benefits stated in your disability insurance contract. A lawyer can help you analyze your insurance policy and advise you on the various resources available.

A lawyer will maximize your chances of obtaining the benefits you claim to be entitled to.

To know more about your rights or to discuss your situation with one of our lawyers, contact us.

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