Applying for Long Term Disability (LTD) Benefits
Long Term Disability (LTD) Benefits
Like any other insurance product, Long Term Disability (LTD) insurance is designed to provide “peace of mind” to an insured person, the understanding being that if a disability arises affecting an insured’s capacity to earn income, the LTD benefits will supplement lost income. This income replacement, which amount varies depending on the policy purchased, could determine whether an insured can purchase groceries for their family, pay their mortgage and utilities, or afford their rent or car payments. When battling a condition, illness, or disease resulting in a disability, you want to focus on your heath and not on these financial stressors.
This is where LTD comes into play. An LTD policy can be purchased by you as an individual or as part of a group benefits package by your employer. If you have not purchased your own policy, it is important to determine whether you have coverage under a group policy and, if not, consider whether you might benefit from an LTD policy.
If you do have coverage and you find yourself unable to work on account of your disability, you can make an application for LTD benefits. Typically, this application includes forms that must be completed by you, your physician, and your employer (if applicable). The insurer will then process your application, which may include making requests for medical records or other documentation that will assist in establishing whether you have met the policy definition of “Disability” (note that there may be separate definitions for “Partial Disability” and “Total Disability”). The insurer may also send these records to a regulated health professional of their own choosing to review and render an opinion on the nature and prognosis of your disability.
Approved Application
Depending on the nature of your disability, if your application is approved, LTD benefits can provide income replacement up to age 65. However, your benefits may be terminated on the grounds that you are no longer under a disability as defined by the policy. Fortunately, there are avenues available by which you may be able to overturn the decision to deny the application or the decision to terminate benefits. You can commence an internal appeal with the insurance company and/or commence a lawsuit against the insurer within two years from the date of the failure to pay benefits or the refusal of benefits. A lawsuit may seek more than just reinstatement or payment of benefits; a claim may also be made for bad faith and mental distress.
If you find yourself with a disability and facing a decision by your LTD insurer denying or terminating your benefits, contact Singer Kwinter today for a free consultation.
