Different group policies may have different wording and different clauses. The idea is that the insured person participates actively in their recovery.
Toronto, ON (PRWEB) August 26, 2014
A person who makes an application for long-term disability benefits wants his or her claim to run smoothly as he or she is in need or income replacement as a result of a disability that renders him or her unable to work. This is not always the case and it is important to understand the technical terms of a long-term insurance policy.
For example, a claims adjuster has certain obligations including to properly adjudicate a claim. The claims adjuster also attributes certain responsibilities to the claimant.
Different group policies may have different wording and different clauses.
The idea is that the insured person participates actively in their recovery.
What do long-term disability insurers typically ask of claimants?
- Make a reasonable effort to recover by participating in reasonable treatment or rehabilitation program;
- Participate in a return to work program, and accept a reasonable offer of modified duties from your employer or return to work during the “own occupation period”, which is usually the first 24 months that benefits are payable;
- Make a reasonable effort to obtain training to qualify for another position/occupation if you are not able to return to your own occupation and try to obtain work in another occupation once the “any occupation” period begins. Your insurer will assign a rehabilitation worker to identify prospective jobs for you;
- Attend and participate in independent medical examination(s) arranged by the insurance adjuster, to the best of your ability;
- Attend and participate in a return to work program, if medically able to;
- Provide updated medical information when requested;
- Apply for benefits from other sources, including Canada Pension Plan Disability Benefits, as your long term disability insurer is entitled to deduct this amount from your monthly long-term disability benefit.
If you have hired a lawyer, your lawyer can explain to you what your rights and obligations are as an insured person under a group long-term disability policy. It is important to seek legal advice and medical advice before participating in a return to work program or independent medical examination. You need to be aware of your medical restrictions and limitations before participating in any activity that could exacerbate your symptoms.
If you or someone you know has applied for long-term disability benefits and your application was denied at the outset, or your benefits have been terminated, consult an experienced long-term disability lawyer as soon as possible.
Aaron Waxman and Associates is a Toronto law firm whose practice is focused on long- term disability claims, short term disability claims, psychological illness claims, critical illness claims, life insurance claims, slip & fall claims, occupier’s liability claims, automobile accident claims, traumatic brain injury claims, and other types of personal injury 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.
t: 416 661-4878
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