LTD insurance claim denied due to misrepresentation Where the insurance provider takes the position that the policy holder misrepresented a fact, or lied, during the application process and there was a subsequent approval of LTD insurance, the insurer will deny benefits. Applicants for insurance coverage have a duty to disclose any material facts requested by […]
LTD Benefits: Obligation to seek medical treatment
There are various reasons for which insurance providers may deny LTD benefits to a policy holder even though he or she has become unable to work due to a medical condition. These reasons may be found in the policy in the form of exclusion clauses or in the common law, that is, the Courts’ interpretation […]
Mental Distress and Punitive Damages. if LTD benefits are unreasonably withheld.
What happens if LTD benefits are unreasonably withheld? Where policy holders have been forced to commence litigation against the insurance company due to the denial of their LTD benefits, they may also seek damages for mental distress and punitive damages. These claims seek compensation for unfair treatment or unreasonable delays caused by the insurance provider. […]
Can LTD benefits be denied based on surveillance evidence?
Surveillance evidence generally becomes relevant when policy holders are receiving LTD benefits, or when litigation is taking place where payment for benefits is being sought. This occurs where the insurance provider is attempting to prove that the policy holder is not credible, or that the disability giving rise to benefits has been exaggerated or is […]
Are my Long-Term Disability Benefits Taxable?
Are my Long-Term Disability Benefits Taxable? All LTD insurance policies indicate the amount of benefits that the policy holder will be entitled to upon becoming unable to work due to a medical condition. This amount will generally be a percentage of the person’s income prior to becoming unable to work. However, the benefit amount outlined […]
Pre-existing conditions and other exclusions; how do they affect your LTD Policy?
Many Long-Term Disability insurance policies include provisions indicating that, under certain circumstances, you will not receive LTD benefits even if you have been found to be unable to work due to a medical condition. These are commonly known as exclusion clauses. Insurers will often rely on these provisions in an attempt to avoid liability under […]
