Sun Life Long-Term Disability Claims Denied in Canada

Being denied your Sun Life Long-term Disability (LTD) claim in Canada can feel devastating. You’re likely struggling with a disability, facing lost income, and navigating a complex insurance and legal system. But before you give up, know this: you have rights and options.

This resource will explain what happens if Sun Life denies your LTD claim in Canada, why they may decide to deny your benefits, what actions you can take to win your benefits and get compensation, and other information about LTD denial by one of Canada’s notable insurance companies.

Can Sun Life Deny My Claim?

Sun Life can only deny your claim for long-term disability benefits if you are not legitimately disabled and unable to work.  If your treating doctor (or doctors) do not provide the correct documentation or the documentation provided does not state that you are unable to perform your duties due to an injury or illness, Sun Life may deny your claim.  By denying your claim, they will refuse to pay you any benefits under the terms of the policy.

Why Does Sun Life Deny Claims?

There are a few reasons why Sun Life might deny claims. They include:

• Medical evidence: Sun Life may argue your medical documentation doesn’t sufficiently prove the severity of your disability or its impact on your ability to work.
• Policy exclusions: Your policy may have specific exclusions that apply to your condition.
• Procedural errors: Mistakes during the claim process, like missing paperwork or delays in communication, can lead to denial.

Remember: Sun Life denying your claim does not necessarily mean that their decision was a correct or accurate one. Insurers often make mistakes or misinterpret information, meaning their decisions might be premised on inaccurate or incomplete facts. Additionally, insurers may try to deny claims based on their own best interest as each claim they pay out reduces their profit margins. Insurers make decisions motivated by affordability first instead of whether their policyholders truly deserve a payout on their claim. It’s not fair, but it happens often – and that’s truly unfair to anyone in need of an LTD claim.

What to Do if Sun Life Denies Your Claim

If your claim is denied, you’re probably feeling angry and hopeless. However, you don’t have to accept it as your final answer. There are steps you can take in the face of a denial that can help you change their decision! Here are some things you can do:

1. Review your policy: Understand the specific terms and conditions of your LTD coverage, including exclusions and appeal procedures.
2. Gather evidence: Strengthen your case by collecting additional medical records, doctor’s notes, and any evidence supporting your disability and its impact on your work.
3. Appeal the decision: Most LTD policies allow internal appeals. Follow the outlined process and submit a well-reasoned appeal document, highlighting the errors or inconsistencies in Sun Life’s decision.
4. Seek legal advice: Consider consulting a disability lawyer who has experience litigating LTD claims in Canada. They can:

• Assess your case and identify weaknesses in Sun Life’s denial.
• Help navigate the appeals process and craft a strong appeal document.
• Represent you if you need to proceed to litigation.

Appealing Sun Life’s Denial

You have the right to appeal Sun Life’s decision to deny your long-term disability claim in Canada. This does involve going through a review process, but keep in mind that this review will be led by the insurance company itself and often results in another denial. What this means in practice is that you’re asking Sun Life directly to review its reasons for rejecting your LTD benefits request in the hopes that it will change its decision. As this isn’t a governmental body or a third party but the insurer itself, appeals are often unsuccessful, which is why litigation is generally the only practical option moving forward.

In fact, the truth is that experience shows that it’s exceedingly rare for an appeal to lead to approving benefits for someone who has already been denied. Remember that insurers are in an advantageous position if they continue to deny your LTD payments while you’re unable to work. Additionally, 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 to get the compensation you deserve.

A Better Way than An Appeal

There is always a chance that you can get your benefits through an appeal, however, there’s a better way for people living in Canada: pursuing a legal claim through a skilled, experienced long-term disability lawyer.

Dealing with an insurer denying your long-term disability benefits can be overwhelming to say the least. That’s why a good disability lawyer is critical, as they will understand how challenging it can be for you when you feel abandoned by an insurance company. Law firms with experienced LTD lawyers for Canada offer many benefits for anyone who’s been denied disability by Sun Life, such as:

• 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 Sun Life: Disability lawyers can represent you directly, which means that they can help with reducing your stress and anxiety through the whole process – and that includes communicating with Sun Life directly, leaving you to focus on your recovery instead of fielding phone calls, emails, and whatever else Sun Life throws at you.
• Navigating the complexities of Canada law: Disability lawyers can quickly and efficiently navigate the respective provincial law.
• Understanding how insurance companies operate: Disability lawyers who frequently litigate against Sun Life allow them to know all the insurance companies’ tricks and thought processes, which means they can see what’s coming and know how to deal with it effectively.

The Clock Is Ticking

It’s your legal right to file a claim for compensation if Sun Life denies your request for LTD benefits, however, there is a time limit and each province may have a different limitation period.  For instance, in Ontario, you have up to two years after your denial to file a claim.  What this means in practice is that you’ve got to act fast if you want to claim the money your disability insurance policy provides if you are no longer able to work. However, there are some circumstances where you still have legal options even if that two-year window has closed. This is yet another reason to speak to a disability lawyer!

How Long Can The Process Take?

There are several factors that can influence how long it might take to possibly win an LTD claim against Sun Life. This is because the circumstances of each case are different; some may be more complex than others. In some cases, it may take a few months or years to get your claim resolved; in others, it may only take a handful of exchanges before your claim can be resolved in your favor or at a minimum, to get your benefits instated or re-instated.

What Does Fighting an LTD Denial in Canada Cost?

Disability lawyers work on contingency fee arrangements. This means that you don’t have to pay anything to a disability lawyer unless you win your claim against Sun Life for compensation or benefits. This makes it easier for people to access justice throughout Canada who might not otherwise be able to. Upon winning your case, your lawyer will take a percentage of the damages recovered as their fee, all of which will be explained to you upfront in the process.

Preszler Injury Lawyers: We litigate against insurance companies

If your LTD claim is denied by Sun Life, Preszler Injury Lawyers can help.  For over 63 years, Preszler Injury Lawyers has litigated against all the largest insurance companies that offer disability policies.

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 your options. Call us toll-free at 1-800-JUSTICE® or fill out our Case Evaluation form to speak to an experienced personal injury lawyer today.