News of Upcoming Events

September 30, 2015: Long Term Disability Insurance Seminar – Resident Doctors of BC

Kirk Wirsig and Martin Willemse, as counsel for the Resident Doctors of BC on insurance matters will be presenting a seminar to members of the Resident Doctors of BC on long term disability insurance coverage. Discussion topics will include what policy riders are available when purchasing an individual long term disability insurance policy, for example:

  • Own Occupation rider – a rider that insures against a disability from your own occupation for the lifetime of the policy, as opposed to the usual coverage which provides long term disability coverage for a numbers of years, often two, of your own occupation and then switches to coverage for long term disability from any other occupation after the first two years of own occupation coverage;
  • Future Income Option rider – a rider that allows the insured under a long term disability policy to increase the monthly benefit amount annually for a set number of years to a set maximum monthly benefit amount, without having to provide further proof of good health; and
  • Cost of Living Adjusted Benefit rider – a rider that provides for periodical increases in the monthly long term disability benefit amount based on rate changes in the Consumer Price Index and other factors.

October 28, 2015: Long Term Disability Seminar – BC Psychological Association

Martin Willemse and Kirk Wirsig have been invited to present a seminar on Long Term Disability claims at an Ethics Salon hosted by the BC Psychological Association. The seminar will focus on long term disability claims based on subjective conditions, such as mental health illnesses including major depression and anxiety disorders. The opinion of treatment providers, in this instance a psychologist treating a long term disability claimant suffering from a mental health illness, is often crucial to the claim. However, a treatment provider should be wary not to be seen as an advocate, as this will influence the weight a trier of fact may give to his or her opinion.

Martin Willemse has presented papers and power point presentations on these conditions at other conferences which can be viewed here:

 

Is my Insurance Company Delaying Approval of my Claim?

We often get this question from people who are off work due to an injury or illness and the insurance company is taking a long time to decide whether the application for benefits ought to be accepted.

To start, make sure that you complete the form within the time required under the policy; that the form is completed properly; and, if the insurer asks for additional information, obtain that information as soon as possible.

While most insurers do not deliberately delay the process, we have heard from frustrated callers complaining that the insurance company’s agents ask for information that has already been provided, do not return phone calls, and request answers to questions that have nothing to do with the claim.

The initial decision should only take a few weeks but we have seen this initial period drag on for many, many months. In circumstances where the insurance company denies the claim, the process takes even longer as claimants attempt to appeal the decision, sometimes through multiple rounds of appeal. During this timeframe, the disabled employee is without income, getting behind financially and under added stress in dealing with the insurance company. Even more concerning, your time to take legal action continues to tick away during this entire time. This means that if your latest appeal is denied after the limitation period to sue has run out, you will likely be barred from taking legal action against the insurance company.

If your claim has been denied and the insurance company invites you to appeal, it is time to call a disability lawyer.  When a disability claim is denied, we can help you decide whether it makes sense to pursue the appeal or look at your legal options.