Desjardins Long-Term Disability Claims Denied in Canada

Being denied a Long-Term Disability (LTD) claim by Desjardins can feel devastating. It’s not enough that you’re facing a debilitating disability; now you’ve got to worry about the financial stresses of being out of work as well. But just because Desjardins denied your disability claim doesn’t mean you should give up hope. There are actions you can take to address the denial. This guide will help you understand your options when it comes to pursuing the disability benefits you deserve from Desjardins.

Can Desjardins Deny My Claim?

Insurers can and do deny LTD claims all the time – and that includes Desjardins. They’re fully within their right to do so, provided they have valid reasons for making the decision. They must also follow a fair evaluation process and use valid reasoning to make such decisions. There are plenty of reasons why they might deny your claim, including:

• Insufficient medical evidence: To avoid your claim being denied for this reason, ensure your doctor clearly documents the impact of your disability on your ability to work.
• Failure to meet policy terms: Review your policy for eligibility criteria like elimination periods or specific covered disabilities.
• Pre-existing conditions: Be upfront about pre-existing conditions, as your policy may have limitations regarding them.
• Incorrect information: Double-check your application for any inaccuracies that could raise doubts or result in automatic denials.
• Surveillance: Desjardins might monitor your activities to assess your work capacity. Be mindful of inconsistencies with your disability claim and your actions in real life.

Why Does Desjardins Deny Claims?

Your frustration is understandable if Desjardins has denied your claim. Remember, though, there are a few factors that your insurer can use to justify their decision. They include:

• Cost management: Like any insurance company, Desjardins prioritizes managing costs, leading to stricter claim assessment.
• Fraud prevention: Thorough verification safeguards against false claims.
• Misunderstandings: Complex policy terms or lack of clear communication can create discrepancies.
• Lack of Information: Insurers require medical documentation that clearly demonstrates your disability and it’s impact on your employment. Failure to provide such information can lead to denials.

Insurance companies can and do make mistakes or even misinterpret information they have been provided in applications. This can lead to decisions being made based on incomplete or inaccurate facts. Sometimes, insurers may also attempt to minimize payouts to save money.

What to Do If Desjardins Denies Your Claim

If your claim is denied, you may feel overwhelmed. You’re not alone, though; plenty of people face an initial LTD denial. Here’s what you can do next:

1. Review your denial letter: Understand the specific reasons for the denial and gather any supporting documents to address them.
2. Gather additional evidence: Consider requesting further medical tests or specialist opinions to strengthen your case.
3. Request reconsideration: You can formally request Desjardins to re-evaluate your claim based on new evidence.
4. File an appeal: If reconsideration fails, you have the right to appeal the decision through their internal process. Remember, deadlines for appeals are typically outlined in your policy or denial letter, so be mindful of those.
5. Litigate your claim: Skip all internal appeals and go straight to Court by filing a lawsuit. You may also go to court if your internal appeal is denied.

Appealing Desjardins’ Denial

In Canada, you can appeal your insurer’s decision if they deny your long-term disability claim. This process normally involves asking your insurance provider to review their decision, which they will do internally. Unfortunately, this can often lead to another denial, as there will be no neutral third party involved in the process, like a governmental body.

It can be hard to have an initial appeal approved. In addition, insurers may use the appeal process as a stalling tactic to let the clock run out on the time you have to take legal action against them. Here’s why you should keep the following in mind if you’re filing an appeal:

1. Meet deadlines: Appeal within the timeframe stipulated in your policy or denial letter.
2. Present your case: Submit a written appeal outlining your reasons for disagreement and highlighting new evidence.
3. Seek legal advice: Consult a lawyer who is experienced in handling disability claims for guidance and representation.

A Better Way Than an Appeal

You could win your appeal and receive your benefits. If this doesn’t happen you do have other options available to you. You can file a legal claim against Desjardins in court.  It may be more complex, but necessary for you to receive the benefits you deserve. At this stage it’s critical that you have a good disability lawyer on your side. Qualified and experienced LTD disability lawyers understand how challenging it can be for you when you feel abandoned by an insurance company. They can help you in many ways to get what you deserve by:

• Helping you understand your rights: Disability lawyers will review the details of your denial and provide you with an explanation of what your next steps should be. They can help you make informed decisions on what to do next and how filing a legal claim might be a viable option.
• Dealing directly with Desjardins: Disability lawyers can represent you directly, which means that they can help with stress and anxiety reduction through the whole process – and that includes communicating with Desjardins directly. You can focus on your recovery instead of fielding phone calls, emails, and letters from your insurer.
• Navigating the complexities of provincial laws: Disability lawyers are focused on efficiently navigating your province’s laws. They practice exclusively in winning LTD benefit claims for clients without getting bogged down by bureaucratic red tape.
• Understanding how insurance companies operate: Disability lawyers often begin their careers working for large insurance companies like Desjardins. They know all their tricks and their thought processes, which means they can see what’s coming and know how to deal with it effectively.

What’s the Time Limit For Filing an Appeal?

If you’ve been denied, you have some time to act, but not long. In Canada, you typically have two years from the date of denial to file a legal claim against Desjardins, but each province may be different, so you must check the limitation period in your province. Don’t let the deadline pass before seeking legal advice! Even if you do miss the deadline, you may still have options. An experienced LTD lawyer can help you understand alternative avenues available to you.

How Long Does the Process Take?

There’s no simple answer. The timeframe depends on dozens of factors; the complexity of your case, the appeals process, and whether it goes to court all influence the length of time the process can take. You need to be prepared for it to take months, or potentially even years.

What Does Fighting an LTD Denial in Canada Cost?

Wondering how you’ll pay for legal representation? Don’t. Most disability lawyers work on contingency fee arrangements where you don’t have to pay anything to a disability lawyer unless they win your claim against Desjardins. This makes it easier for people to access justice throughout Canada who might not otherwise be able to. Your lawyer will only take a percentage of what you’ve recovered (as permitted by provincial legislation) as their fee upon winning your case, and the law firm will explain to you how much this will be well before the case is closed.

Feel Like You’re About to be Denied?

If you have a bad feeling about the claim that you just made to Desjardins for your LTD benefits, don’t hesitate. Contact a disability lawyer immediately for a consultation. This way, you can prepare yourself for a denial. Then, your legal team can jump right in and get started on your behalf. Remember:

• You are not alone: Many Canadians face similar challenges with LTD claims.
• Stay informed and empowered: Knowledge is your advantage in this process.
• Seek support: Consider joining support groups or online communities for guidance and connection with others in similar situations.

Preszler Injury Lawyers: Helping Canadians one claim at a time.

If your LTD claim is denied by Desjardins in Canada, our disability lawyers at Preszler Injury Lawyers are standing by to help you. Our long-term disability teams know how to deal with insurers who deny disability claims.

With Preszler Injury Lawyers by your side, your health and safety is our first and biggest priority. Don’t let your insurer walk off with the money you may be entitled to. Talk to a trusted disability lawyer at Preszler Injury Lawyers for a free consultation to find out how they can help make a difference. Call us toll-free at 1-800-JUSTICE® or fill out our Case Evaluation form to speak to an experienced personal injury lawyer today.