Desjardins Long-Term Disability Claims Denied in Canada

Being denied a Long-Term Disability (LTD) claim by Desjardins can feel like you just lost everything. It’s not enough that you’re facing possibly debilitating levels of 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 things you can do. This guide will help you understand your options and what you can do next to get 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 also must follow what they say is a fair evaluation process and use valid reasoning to make such a decision. There are plenty of reasons why they might deny your claim, including:

  • Insufficient medical evidence: 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 the policy may have limitations regarding them.
  • Incorrect information: Double-check your application for any inaccuracies that could raise doubts.
  • Surveillance: Desjardins might monitor your activities to assess your work capacity. Be mindful of inconsistencies with your disability claim.

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 will say they base their decision on. 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 supports your disability. Failure to provide such information leads to denials.

Yet there’s something else at play when it comes to why insurers deny claims. Desjardins might say why they denied your claim, but that stated reasoning doesn’t mean they based the decision on accurate or correct information. Insurance companies can and do make mistakes or even misinterpret the information they have at their disposal, leading to decisions being made based on incomplete or inaccurate facts. Even worse, insurers have a vested interest in paying out as little as possible to protect their profit margins despite their duty to act in good faith. It’s inherently unfair, but it does happen— and more often than it should.

What to Do If Desjardins Denies Your Claim

If your claim is denied, you’re probably feeling angry and hopeless. You’re not alone, though; plenty of people face an initial denial. You also don’t have to take it lying down, either— here’s what you can do next:

  1. Review the 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.

Appealing Desjardins’ Denial

Thankfully, in Canada, you can appeal your insurer’s decision if they deny your long-term disability claim. The process involves asking your insurance provider to review their decision, which they will do internally. Unfortunately, this often leads to another denial rather than reversing their decision, as there’s no third party, like a governmental body, that has any say in this process.

In theory, you’re supposed to be given a fair shake. In practice, it’s quite rare that your appeal succeeds. That’s not the only thing you need to worry about – insurers often 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 to get the compensation you deserve. 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 — it’s been known to happen no matter how rare. If it doesn’t, though —and, let’s be honest, there’s a good chance that it won’t go through— you do have another option open 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 thought you could rely on. At this stage it’s critical that you have a good disability lawyer at 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 that could be beneficial.
  • 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. Now, you can focus on your recovery instead of fielding phone calls, emails, and whatever else your insurer throws at you.
  • Navigating the complexities of your provincial law: Disability lawyers are focused on efficiently navigating your province’s law. 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.

The Clock is Ticking

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, though, there might still be some things you can do. A smart LTD lawyer can help you understand the options left to you at this point.

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 wait for the other shoe to drop! 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 with both feet 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 key weapon in this fight.
  • 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, disability lawyers are standing by to help you. Teams of long-term disability lawyers located throughout Canada like Preszler Injury Lawyers know how to deal with insurers who deny disability claims.

Insurance companies don’t necessarily have your health and well-being in mind at the end of the day. However, with Preszler Injury Lawyers by your side, it’s 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.