Equitable Life Long-Term Disability Claims

Equitable Life Insurance Company of Canada has been a trusted provider of insurance solutions for Canadians for over a century. However, navigating long-term disability (LTD) claims with Equitable Life can present challenges for claimants. Denials can be opaque, the appeals process rigorous and time-consuming, and can take away valuable energy that you should be spending on your recovery and healing.

Background:

Equitable Life Insurance Company of Canada, commonly known as Equitable Life, is a well-established insurance provider in Canada with a history dating back over 100 years.

Equitable Life was founded in 1920 in Waterloo, Ontario. Over the decades, the company has grown and evolved to become one of the largest mutual life insurance companies in Canada, serving individuals, families, and businesses nationwide. Equitable Life offers a diverse range of insurance products to meet various financial needs. Their offering includes life insurance (term life, whole life, universal life), critical illness insurance, disability insurance, group benefits insurance for employers, and segregated funds for investment purposes.

Claims Process Overview

Initiating an LTD claim with Equitable Life involves submitting detailed medical documentation, treatment records, and relevant information to support the disability claim. Understanding the specific requirements outlined in Equitable Life’s policies and effectively communicating during the claims process is crucial for claimants.

Can Equitable Life Deny My LTD Claim?

Equitable Life, like other insurance providers, can deny LTD claims based on factors such as inadequate medical evidence, failure to meet disability definitions in the policy, missed deadlines, or policy exclusions related to pre-existing conditions.

Why Do LTD Insurance Providers Deny Claims?

LTD insurance providers may deny claims due to discrepancies in medical documentation, conflicting medical opinions, lack of objective evidence supporting the disability, or non-compliance with policy criteria.

What Does the LTD Claims Appeal Process Involve?

The appeals process for denied LTD claims with Equitable Life typically requires submitting a formal appeal letter, providing additional supporting medical evidence, engaging in discussions with Equitable Life’s appeals representatives, and potentially undergoing independent medical evaluations.

Preparing for appealing an insurer’s LTD claim denial in Canada requires careful planning and attention to detail. Here are steps Canadian claimants can take to prepare effectively:

Review Denial Letter:

Carefully review the denial letter from the insurer to understand the specific reasons for the denial. Note any deadlines mentioned for filing appeals and gathering additional information.

Understand Policy Details:

Thoroughly understand the terms, conditions, and definitions outlined in your LTD insurance policy. Pay attention to the criteria for disability, exclusions, appeal procedures, and any time limits for filing appeals.

Gather Documentation:

Collect all relevant documentation supporting your disability claim. This includes medical records, treatment history, diagnostic tests, specialist reports, prescriptions, and any other evidence that validates your disability and inability to work.

Seek Medical Opinions:

Obtain updated medical opinions from treating physicians, specialists, therapists, or healthcare providers familiar with your condition. These opinions should clearly outline your medical condition, limitations, treatment plans, and prognosis.

Consult with Legal Professionals:

Schedule a consultation with a personal injury law firm that regularly practices in LTD claim denials. Disability lawyers can review your case, assess the grounds for appeal, and provide legal guidance throughout the appeals process.

Prepare a Strong Appeal Letter:

Draft a detailed and persuasive appeal letter addressing the reasons for the denial. Clearly explain why you believe the denial was incorrect based on medical evidence, policy terms, and legal standards. Include relevant supporting documentation with the appeal letter.

Engage in Dialogue:

Communicate effectively with the insurer’s appeals department or designated representatives. Keep records of all communications, including phone calls, emails, and letters exchanged during the appeals process.

Consider Independent Medical Evaluation:

If requested by the insurer or beneficial for your case, undergo an independent medical evaluation (IME) by a neutral healthcare professional. Ensure that the IME provider is qualified and impartial in assessing your medical condition.

Adhere to Deadlines:

Strictly adhere to deadlines for submitting appeal documents, additional information, or attending scheduled appointments such as IMEs. Missing deadlines could jeopardize your appeal rights.

Stay Organized:

Maintain organized records of all paperwork, correspondence, and developments related to your LTD claim and the appeals process. This includes keeping copies of all documents submitted and received from the insurer.

Seek Support Networks:

Consider joining support groups or networks for individuals dealing with similar disability challenges and insurance claim issues. These networks can provide valuable insights, resources, and emotional support during the appeals process. Sharing information can prove incredibly helpful if groups of claimants are being denied for the same reasons.

Are There Time Limits for Filing Legal Insurance Claims in Canada?

Yes, specific time limits and deadlines exist for filing legal claims related to denied LTD benefits in Canada. Claimants must be aware of these timelines and take prompt action, including seeking legal advice if their claim faces denial challenges.

How Long Does the Claims Process Take?

The duration of the LTD claims process with Equitable Life varies based on factors such as case complexity, availability of medical evidence, responsiveness of involved parties, and potential appeals. Claimants should anticipate potential delays and diligently fulfill all requirements within specified timelines.

What To Do If My LTD Benefits Have Been Denied?

If facing denial of LTD benefits with Equitable Life, contacting a reputable personal injury law firm specializing in LTD claim denials is crucial. Preszler Injury Lawyer’s team of disability lawyers can review denials, assess appeal grounds, gather pertinent evidence, and advocate for claimants’ rights during the appeals process or potential legal proceedings.