A Guide to Disability Insurance Claims

• What is Disability insurance?
• Short-term and long-term disability insurance
• Who should get Disability insurance?
• Are disability payments taxable?
• What is covered?
• Do I have to see the insurer’s doctor?
• What if I’m unable to work and do not have private disability insurance?
• Can my insurer force me to apply for CPP Disability?
• What should I do if my application has been denied, or my benefits are cut off?

What is disability insurance?

Disability insurance is a type of private insurance that can help replace a portion of your income if you become disabled due to an injury or mental health issues that prevent you from working.

You need to apply and pay for disability insurance before you become disabled in order to have access to the benefits if you are eventually unable to work.

Short-term and long-term disability insurance

There are generally two types of disability insurance available, known as short-term and long-term disability insurance. Short-term disability insurance will cover the initial portion of your absence from work, and long-term disability benefits will continue afterwards.

The length of time that would be covered by short-term disability insurance will vary depending on your policy. You may have to apply for each separately, or there may be one application for both types of coverage.

Who should get disability insurance?

Everyone should get disability insurance if they can qualify for it and afford the monthly premiums. If something should happen to you and you are unable to work for a period of time, Disability insurance will help you continue pay your bills and afford the treatments that can help you recover. If you are unable to qualify for or pay for disability insurance, there are other options for you which we will discuss below.

Many people have access to disability insurance through their employer as part of a benefit package. If your employer does not offer disability insurance, or if the coverage through your work is not enough, you can contact different insurance companies to assess your eligibility and get rates.

Are disability payments taxable?

Disability insurance benefits are sometimes taxable, and sometimes not. As a general rule, if your employer pays for the insurance premiums, your benefits are taxable, but if you pay for the premiums yourself, your benefits are non-taxable.

What is covered?

The coverage of your disability insurance will depend on your policy. There is no standard disability policy in New Brunswick, so each contract will be unique. You will need to refer to the specific details of your policy, but generally, it will provide you with a percentage of your pre-disability salary until you are able to return to work, or until the maximum age specified in your policy.

If your disability prevents you from performing the essential duties of your occupation, you should be entitled to your disability benefits. After a certain period, there may be a change of definition in the policy, and you may or may not continue to qualify for disability benefits. If you’re unsure whether or not you still qualify for disability benefits, contact a Fidelis Disability Lawyer.

Do I have to see the insurer’s doctor?

When you’re receiving disability benefits, the insurance company will ask that your doctor complete various forms and answer questions about your disability and inability to work. Sometimes, they will also ask that you undergo an assessment with a doctor of their choosing. The insurer has the right to send you to different experts.

If their expert’s conclusions do not support your disability, and the insurance company decides to no longer pay for your disability benefits, contact a Fidelis Disability Lawyer right away!

What if I’m unable to work and do not have private disability insurance?

You may also be entitled to EI Sickness Benefits which can provide you with financial assistance for up to 26 weeks if you are unable to work for medical reasons. You can learn more about EI Sickness Benefits by clicking here.

If you have been injured in a car accident and the car accident is the reason why you are unable to work, you may be entitled to Section B Weekly Indemnity Benefits. Learn more about Section B Weekly Indemnity Benefits by clicking here and contact a Fidelis Accident Lawyer to discuss your eligibility.

Finally, if you don’t have disability insurance you may qualify for disability coverage through the Canada Pension Plan. You can learn more about CPP Disability Benefits by clicking here.

Can my insurer force me to apply for CPP Disability?

If you do have disability insurance, your insurer may ask that you apply for CPP Disability Benefits in order to reduce your monthly benefits by what you are receiving from CPP. The insurer can force you to apply for CPP Disability if it is provided for in your policy. If you’re wondering if this is included in your policy, contact a Fidelis Disability Lawyer today.

What should I do if my application has been denied, or my benefits are cut off?

If your initial application for disability benefits has been denied, or if the insurance company has stopped paying your benefits, we recommend that you reach out to our disability lawyers as soon as possible. If you miss a limitation date, this is fatal to your case, meaning that you are not going to be able to pursue legal actions against the insurer. The limitation date is based on the type of insurance contract that you have.

If you have a policy that contains life insurance and long-term disability coverage, a limitation period of 1 year applies as per Section 168 of the Insurance Act of New Brunswick. The 1-year period starts running after furnishing the required information under Section 165 of the Insurance Act of New Brunswick to your insurer:

(a) the happening of the event upon which insurance money becomes payable,

(b) the age of the person whose life is insured,

(c) the right of the claimant to receive payment, and

(d) the name and age of the beneficiary, if there is a beneficiary,

However, if the long-term disability coverage is part of a group policy and governed by Part VI of the Insurance Act, meaning that there is no life insurance under this policy, a limitation period of 2 years applies as per the Limitation of Action Act of New Brunswick.  That 2-year period starts running when the claim is discovered.

Furthermore, if the long-term disability coverage is part of your own individual policy and governed by Part VI of the Insurance Act, meaning that there is no life insurance under this policy, a limitation period of one year after the date the insurance money became payable or would have become payable if it had been a valid claim applies as per Section 194. As per the same Section, moneys payable shall be paid by the insurer within sixty days after it has received proof of claim.

Additionally, your insurance policy itself could provide another contractual limitation date altogether.

The insurance company might ask that you go through an internal appeal of their decision after a denial. You need to keep in mind that the applicable limitation date is not extended by the internal appeal. Our disability lawyers will be able to advise you on whether you should go through the internal appeal process, or if the legal route is more favorable in your case. If you choose to undergo the internal appeal, our experienced disability lawyers can provide legal representation on a per-hour basis.

For questions about the limitation period that applies to your case, contact a Fidelis Disability Lawyer today. We understand the financial hardships caused by the inability to work and the stress resulting from a disability insurance denial. That is why our disability lawyers work on a contingency fee basis, meaning that you will not have to pay for our services until we settle your disability claim. We’ll also cover all necessary expenses and expert fees to prove the severity of your disability and its consequences.

If your disability insurance application has been denied, your benefits have been terminated or if you have any questions about disability insurance, do not hesitate to reach out to our disability lawyers today by calling 1-888-644-5587 or by sending us a message by clicking here.