Toronto Lawyer Explains Critical Illness Claims

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Aaron Waxman and Associates handles Critical Illness Claims Denials.

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Another potential issue that can affect the approval of a claim is the medical diagnosis itself.

Critical illness insurance helps you pay costs associated with a life changing illness. Critical illness is a newer type of life insurance product in Canada. It is available as part of a living benefits portfolio. This type of insurance is medically underwritten, meaning your medical records are thoroughly reviewed prior to your policy being issued. Your insurance company is aware of any potential pre-existing conditions.

Critical illness pays you a one-time lump sum benefit after a medical diagnosis of a defined critical illness has been confirmed, and a survival period has been met.

A survival period means that the policyholder must survive a certain period of time after being diagnosed with the qualifying illness. Most policies have a 30-day survival period.

Critical illness insurance covers various types of illness.

Covered illnesses will typically include heart attack, stroke and cancer.

Conditions that most policies cover include coronary artery bypass surgery, neurological conditions (Parkinson’s, MS, ALS, Alzheimer’s), major organ transplant, kidney failure. Coverage may also extend to accident related incidents, which include burns, paralysis, blindness, loss of speech, loss of limbs, occupational HIV infection. Other conditions that policies may cover are bacterial meningitis and anemia.

Sometimes a critical illness claim is denied because the insurer feels the policyholder withheld information or didn’t disclose pre-existing health conditions. The insurer will try to take the view that this is misrepresentation or non-disclosure, and rescind the policy (meaning the policy is void). The insurer can rely on the Insurance Act to say that every fact has to be disclosed, and if not, the contract can be rendered voidable.

Another potential issue that can affect the approval of a claim is the medical diagnosis itself. In order to receive the critical illness payment, the insured must seek a diagnosis from a qualified medical specialist, and the insurance company’s doctor (s) have to agree with that diagnosis.

If you have critical illness insurance and believe your claim for benefits was improperly denied, you should immediately contact a lawyer to review your claim. The lawyers at Aaron Waxman and Associates can review your claim and answer any questions you may have about critical illness claims.

About us:

Aaron Waxman and Associates is a Toronto law firm whose practice is focused on long- term disability claims and other types of personal injury claims including critical illness claims, life insurance claims, slip and fall claims and automobile accident claims.

We only help injured persons; we do not work for insurance companies.

We offer a free, no obligation initial consultation.

We can help you get your life back on track.

Contact us:

t: 416 661-4878
tf: 1-888-955-5342
e: awaxman(at)awaxmanlaw(dot)ca

twitter: @InjuryLegalFirm

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