Disability insurance lawyer in Quebec
A contract of insurance is a contract whereby the insurer undertakes, for a premium or assessment, to make a payment to the client or a third person if a risk covered by the insurance occurs. (…)
Disability insurance lawyers protect you in case of disability, illness or injury
Has your insurer refused to pay your disability benefits, reduced them, or suspended them without a satisfactory explanation? You are not alone. Every year, many policyholders are denied the coverage they have paid premiums for, just when they need it most.
MedLégal’s disability insurance attorneys will review your insurance policy, identify questionable grounds for denial, and act on your behalf to ensure your insurance company honors the terms of your contract. Our approach combines legal rigor with a strong human touch: we know that behind every case is a person in a vulnerable situation.
Do you feel that your insurance company is refusing to honor your contract? Contact us, the initial consultation is free of charge.
What is disability insurance?
Disability insurance offers financial protection in the event of a physical or mental illness, or a personal injury that prevents you from working and earning an income.
Whatever the nature of your disability – partial or total, temporary or permanent – this insurance is designed to provide you with a replacement income to support you through difficult times.
Disability insurance is distributed via tax-free monthly payments, allowing you to cover some or all of your living expenses.
Disability insurance plans can also be customized. For example, by adding a return of premium (ROP) rider to your long-term disability insurance policy, you can receive up to 50% of your annual premiums. By opting for a cost-of-living rider, you can benefit from an annual increase in your payments to counter the effects of inflation.
Our Quebec health lawyers can guide you through the process of choosing an appropriate plan. Relying on their extensive legal expertise, they can help you understand what your policy covers and ensure you receive the benefits you are owed.
Our legal services can help you protect yourself financially and legally in the event of disability.
How can our disability insurance lawyers help you?
MedLégal provides comprehensive support for your disability insurance case, from the initial assessment through to the resolution of the dispute.
Analysis of Your Insurance Policy and Grounds for Denial
Your insurance policy contains complex clauses, precise definitions, and exclusions that insurers use to their advantage. Our attorneys scrutinize every term to identify contestable arguments and build a strong case on your behalf.
Direct Negotiation with Your Insurance Company
In many cases, firm and well-documented legal intervention can secure the reinstatement of benefits without going to court. MedLégal negotiates on your behalf with the insurer to obtain a swift and fair settlement.
Engaging Medical Experts and Gathering Evidence
When an insurer relies on a disputed medical assessment, we can retain our own experts to refute their conclusions and strengthen your position.
Litigation if necessary
If negotiations fail, our attorneys are prepared to take your case to civil court. Your right to the benefits provided for in your contract will be vigorously defended until the very end.
Some common reasons for denial that we handle
For example, our attorneys specializing in disability insurance can assist and represent you when your insurance provider stops or refuses to pay the benefits you believe you are entitled to for the following reasons:
Your insurer believes you are not disabled from performing your current job
Despite your physical or mental condition, the insurer disputes that your condition prevents you from performing the specific duties of your position. This assessment is often based on an independent medical evaluation commissioned by the insurer, which can be challenged.
Your insurer believes you are capable of holding another job
After 24 months, the definition of disability changes in most policies: the insurer no longer assesses your ability to perform your own job, but rather any job suited to your training and experience. This interpretation is often applied too restrictively.
The illness you are suffering from is not recognized as a serious illness
Insurers frequently dispute conditions such as burnout, fibromyalgia, or depression, on the grounds that they are not sufficiently objective. However, Quebec case law protects policyholders in these situations.
You failed to disclose a pre-existing condition or illness
The insurer may cite an omission during the application process to cancel or reduce coverage. For this omission to be valid, it must have been intentional and must have had a decisive impact on the insurer’s decision to accept the risk, which is not always the case.
The policyholder’s death is not due to an accidental cause
In cases involving a death benefit or accidental death coverage, the insurer may dispute the nature of the cause of death to deny compensation to the beneficiaries.
Disability and Public Programs: CNESST and RRQ
Even if you have disability insurance, you may still be eligible for benefits under public insurance plans.
For example, if your disability is the result of an accident at work, you could receive compensation from the Commission des normes, d’ équité, de la santé et de la sécurité du travail (CNESST).
If your health condition prevents you from holding any job permanently and you have contributed to the Quebec Pension Plan (QPP), you may be eligible for a disability pension.
Depending on the terms of your insurance policy, your insurance benefits may be adjusted according to the amount you are entitled to receive from a public plan.
Are there any statutes of limitations for challenging a denial?
By law, the holder, beneficiary or insured of a disability insurance policy must inform the insurer in writing of their claim within 30 days of becoming aware of the disability. The insured must also provide the insurer with documentation to prove the validity of the claim within 90 days.
Your disability insurance policy may include a waiting period between the onset of your disability and the start of benefit payments. You can choose between waiting periods of 30, 60, 90 or 120 days. Opting for a longer waiting period may reduce your premiums, but this varies from policy to policy.
Why choose MedLégal for your disability insurance claim?
MedLégal is not a general practice firm. Our attorneys have dedicated their careers to health law and the defense of patients’ rights, including disability insurance disputes. This specialization translates into concrete results:
- A human approach: you are a person, not a case number. We take the time to understand your health situation and its real impact on your life.
- Complete transparency: our lawyers give you a “straight talk” assessment of your chances of success from the very first consultation.
- A turnkey service: gathering information, analyzing the contract, retaining experts, negotiating, and, if necessary, representing you in court.
- Easy access: we offer free advice on how the system works and on your disability insurance rights.
Contact our disability insurance lawyer
Do you believe that your insurance company has refused to honour your policy and pay benefits to which you are entitled? Contact our disability insurance lawyers or medical liability experts now.
Our Other Areas of Expertise
In addition to disability insurance, we offer other essential legal services: medical malpractice, health law, forensic psychiatry, human rights, and personal injury. MedLégal even offers training in health law and class actions.
Areas Served by Our Disability Insurance Lawyers
MedLégal serves clients throughout Quebec. Although our firm is based in Montreal, we assist clients in Laval, Longueuil, Brossard, Gatineau, Quebec City, Sherbrooke, Trois-Rivières, Saint-Jérôme, Terrebonne, and throughout the province. Consultations are available in person or remotely.
Frequently Asked Questions About Disability Insurance Disputes
1. Can my insurer require a medical evaluation even if my doctor has confirmed my disability?
Yes. Your insurer may require you to undergo a medical evaluation to confirm or refute your inability to work due to an illness or injury, even if your treating physician has completed an assessment concluding that you are unable to work. However, this evaluation may be challenged if it is biased or incomplete. A disability insurance lawyer can represent you in this process and request a second opinion.
2. What is the deadline for challenging a denial of disability insurance benefits in Quebec?
Under Quebec private law, you generally have three years from the date you receive the denial decision to file a claim. However, some policies set shorter internal deadlines for requesting a review. It is essential to act quickly and not let this deadline pass.
3. My insurer stopped my benefits after two years, saying I can work in another field. Is this legal?
This practice is common and does not automatically mean the insurer is correct. The definition of disability after 24 months must take several criteria into account: your education, your experience, your previous earnings, and the jobs that are actually available to you. An attorney can analyze whether this decision has a legal basis and challenge it.
4. Does disability insurance cover burnout or depression?
Yes, subject to the terms of your policy. These conditions are legally recognized as potentially leading to disability. Insurers often dispute them due to the lack of objective biological markers, but Quebec case law protects policyholders in these situations. MedLégal has experience handling these cases.
5. Can I combine my private insurance benefits with benefits from the CNESST or the RRQ?
Not automatically. Most policies provide for coordination of benefits: your insurer may reduce its payments based on what you receive from public plans. A lawyer can verify whether this coordination is being applied correctly and ensure that you are not subject to undue deductions.
6. What happens if I am self-employed and my insurer denies my benefits?
Self-employed individuals can purchase individual disability insurance. In the event of a denial, the same remedies apply as for those covered under a group plan. MedLégal also assists self-employed individuals with their appeals.
7. How much does a disability insurance lawyer cost?
Fees vary depending on the nature and complexity of the case. MedLégal offers a free initial consultation, allowing you to get an assessment of your situation before committing. Depending on the type of case, fees may be structured differently. We are committed to providing you with a clear and transparent fee structure before undertaking any work, with no unpleasant surprises.
8. What should you do first when you receive a denial letter?
Receiving a denial letter does not mean your case is hopeless. Here are the steps you should take immediately:
- Carefully read the reasons given. The insurer is required to provide you with the specific reasons for the denial in writing. These reasons will determine your appeal strategy.
- Do not sign any documents without consulting a lawyer. Some insurers send forms or acknowledgments that could limit your future recourse. Do not sign anything before obtaining legal advice.
- Act quickly. Statutes of limitations apply. The sooner you seek advice, the more options you’ll have.
- Keep all your documents. Insurance policy, correspondence with the insurer, medical reports—everything could become a useful piece of evidence for your case.
9. Can I challenge a settlement if I have already signed a document or accepted a settlement?
Not necessarily. A release signed under pressure, without you being fully informed of your rights or the true value of your claim, may in certain circumstances be challenged in court. Quebec law provides safeguards against invalid consent, particularly when a party was in a vulnerable position at the time of signing. If you believe you accepted an insufficient settlement or signed without understanding the scope of the document, consult a lawyer to evaluate your options.