A Guide to Disability Insurance in Canada

February 2, 2021

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The Beckett team of experienced lawyers specializes in a variety of different insurance claims, including disability insurance. Dealing with insurance companies can be daunting, especially during a time of illness or injury. Given our team’s knowledge and expertise, we will make sure you’re treated with fairness and compassion, and that you receive the compensation you deserve.

What is Disability Insurance?

Disability insurance is a type of insurance product that helps protect you and your family. If your ability to work is impacted by an unexpected illness, disability, or accident, disability insurance can help protect you. Typically, disability insurance replaces 60% to 85% of your regular income for a specific period of time, up to a maximum amount, as defined by your plan. Coverage might be provided if you are temporarily unable to work due to injury, illness, or if you suffer a permanent disability. Many employers offer disability insurance as part of their group benefit plans. Policies are also available for individuals outside of the group benefit context.

Disability insurance gives you peace of mind so that you focus on getting better instead of how your bills are going to get paid. There are many different plans available to suit a variety of specific needs, lifestyles and budgets.

Short-Term vs Long-Term Disability Insurance

Short-term disability insurance typically provides coverage and benefits for up to six months; however, every plan is different. The specific parameters within which you are eligible to claim short-term disability coverage are outlined in your individual plan. If you don’t have short-term disability coverage and your employer doesn't offer a plan, you may be eligible to claim Employment Insurance sickness benefits instead.

Alternatively, long-term disability insurance coverage generally begins when other shorter-term coverage ends. Short-term disability insurance, employer-granted sick leave, or Employment Insurance benefits often must be exhausted prior to claiming long-term disability insurance. This coverage typically replaces 60% to 70% of your regular income earnings; however, each plan is different, outlining specific conditions and timelines for receiving benefits.

Do I Qualify?

The key to knowing if you are eligible to claim disability insurance lies in understanding the details of your specific plan. Insurance companies can define ‘disability’ in a variety of different ways, even within different plans they offer. Ensure that you are familiar with your plan’s terms and conditions so you know exactly what to expect if you need to make a claim. Ask your insurance provider specific questions that relate to your plan such as:

  • How does my specific plan define disability?
  • Are there any exclusions to the plan that I should be aware of?
  • Does this plan have any pre-existing condition clauses that could personally impact my ability to receive benefits?
  • In the event of a claim, will my benefits be taxable or non-taxable?

These questions will help you determine what parameters must be met within your specific plan to qualify to claim disability insurance.

How to File a Claim

There are a variety of different ways your insurance provider may require you to submit a disability insurance claim. Some offer online portals, while others require you to contact one of their agents to get started. You will have to ensure all necessary claim forms are filled out and submitted. Additionally, many plans require your primary healthcare physician to provide information about your condition and abilities.

In the event that your benefits are terminated or your claim is not accepted, you have the right to appeal this decision to the insurance company directly. In the event the insurer still refuses to pay or continue benefits, a lawsuit may be necessary. The lawyers at Beckett can help ensure you receive the compensation and benefits you’re entitled to. It is wise to seek legal advice as soon as a denial of benefits is made.

If your claim has been denied or your benefits terminated, you will need support and proven expertise. Contact our experienced team of personal injury lawyers today.

Published on February 2, 2021

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