Our Law Services

Long Term Disability Lawsuits

Facing a denial of your long-term disability claim can be disheartening, and it's natural to want to pursue an appeal or litigation in hopes of overturning the decision. It’s important to talk to a lawyer about whether an appeal or a lawsuit is the best approach for your denial. In our experience, it is typically advisable to skip the internal appeal process and to proceed directly to a lawsuit. This can result in quicker results and limit the risk of missing critical deadlines and limitation periods. However, there are circumstances where it might be preferable to file an internal appeal in the first instance.

Whether you file an internal appeal or a lawsuit, the process can be complex and challenging. Before making the decision, after legal consultation, it is important to consider the following factors:

• Strong Case: Ensure you have a solid legal basis for your claim. This includes having clear evidence and a strong argument that supports your position.
• Potential Compensation: Consider the potential financial compensation or other remedies you might receive if you win the case. This can make the effort and cost of a lawsuit worthwhile.
• Legal Support: Having a skilled attorney with expertise in the relevant area of law can significantly increase your chances of success. They can provide expert advice and represent you effectively.
• Precedent Setting: Winning a lawsuit can set a legal precedent that may benefit others in similar situations. This can be a motivating factor if your case has broader implications.
• Personal Satisfaction: Successfully pursuing a lawsuit can provide a sense of justice and personal satisfaction, especially if you feel wronged or harmed.
• Settlement Opportunities: Sometimes, the process of filing a lawsuit can lead to settlement negotiations, which might result in a favorable outcome without going to trial.
• Public Awareness: High-profile cases can bring attention to important issues, potentially leading to changes in laws or policies that benefit society as a whole.

At Weir Bowen, we have a team of experienced counsel who are more than willing to provide you with a free consultation to see if a disability lawsuit is right for you. We will thoroughly discuss your disability, your work history and experience, your claim and medical documents, and the reasons why the insurance company denied your claim in the first instance. This will assist in ensuring that you are provided with a comprehensive consult that is tailored to your particular situation and you can leave the call knowing that you have been provided with pragmatic and effective legal advice.

Damages That Can Be Claimed

An insurance policy is a contract that sets out the benefits a claimant is entitled to if they meet the necessary eligibility criteria. If an insurance company fails to pay those benefits properly, a court can award those monthly disability benefits as damages for breach of contract.

In the disability context, these damages can include:

• Arrears: Damages for the past payments the insurance company should have made but for their erroneous denial.
• Declaration of disability: A court cannot award any amount in respect of future payments that an insurance company may have to make, simply because no one can predict what the future will hold. Rather, the court will grant a declaration that, as of the date of trial, the claimant is “declared” to be disabled within the meaning of the insurance policy. If the insurance company decides to discontinue payments again, it would have to show that some change had occurred since the declaration was granted, such as an actual return to work, or death of the claimant. Without change to medical status, an insurance company could be subject to severe sanctions for again withholding payments.
• Mental Distress damages: A court can award damages for the mental distress caused by a denial in addition to the contractual damages for benefits in arrears, where the failure of the insurer to pay such benefits has caused the claimant severe mental or emotional distress.
• Aggravated and Punitive damages: An insurance company has an obligation to assess a claim for disability benefits in good faith, which means it must assess the claim impartially and fairly. Failure to meet this duty can result in damages awards for aggravated and punitive damages. In short, Aggravated and Punitive damages can be awarded in addition to the arrears where the court wishes to punish the insurance company for their conduct in the handling and assessment of a claim.
• Costs: After a trial, the successful party is usually awarded costs at some level. Normally, those costs would include two components: disbursements (out-of-pocket outlays to advance the lawsuit) and legal fees (usually a partial reimbursement, but occasionally a full reimbursement can be awarded)

Our team at Weir Bowen LLP is knowledgeable in Disability Law and is here to assist you when you are in need. Contact us for personalized guidance and support throughout the claims process.