Personal Injury
Long-term disability denials
Group and individual LTD claims that have been denied, terminated, or cut off at the two-year change in definition.
Long-term disability benefits are contractual. When an insurer denies or terminates a claim, the question is what the policy actually requires and whether the medical evidence meets it — not whether the adjuster is sympathetic.
The two-year cliff
Most group policies pay benefits for the first two years if you cannot perform your own occupation, then switch to a stricter test of any occupation for which you are reasonably suited. Many terminations arrive precisely at that transition, and they can be answered with vocational and functional evidence.
Internal appeals and limitation periods
Insurer appeal processes do not pause the limitation period for suing on the policy. Appeals can be worthwhile, but they should be run with the litigation deadline in view.
Questions clients ask
Should I use the insurer's internal appeal?
Sometimes, when there is genuinely new medical evidence. It should never be relied on as a substitute for protecting the limitation period.
This page is general information about Ontario law, not legal advice for your situation. Book a consultation for advice on your own matter.
Consultation
Find out where your claim stands.
A short, confidential conversation is usually enough to tell you whether there is a claim, what the deadlines are, and what the next step would cost you.
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