Disability insurance is a tricky game. As a Canadian employee, it has long been a part of your worker’s compensation package. As such, gaining access to your benefits was as simple as going to your HR representative and filling out some paperwork. If you got hurt or sick, you would not have to deal with sneaky insurance agents or hope that you had purchased the correct insurance for your particular case.
However, a new trend in employee benefits has seen the number of Canadians insured for disability pay through employment dip below the halfway mark. Surprisingly, the vast majority of us have not taken it upon ourselves to correct this lapse in coverage on our own. More and more, insurance companies are beginning to insert confusing language into disability insurance contracts, leading to a natural confusion over your rights when you finally do receive the benefits you are paying for.
One trick insurance agents use is a request for you to see a company-approved doctor to corroborate your illness or injury. This seems like a simple request, but oftentimes these doctors are working with the insurance company and will underestimate the extent of your condition. As well, in some cases – like one Arizona health insurance dispute – the insurance company can make the final decision on whether your specific circumstances meet the criteria that they have secretly set as a general internal rule.
Once the insurance company doctor looks it over, a broken leg that should be kept immobile for six weeks may end up being covered for only four. Likewise, a bronchitis case may be deemed as simply not severe enough to warrant any payout, even if you have missed a week of work or more recovering. This is not the way disability insurance should work – it is meant to work to your advantage to take care of you in the event an accident leaves you unable to work. Instead, it has become a tool for insurance companies to get rich at your expense and then try to wiggle out of paying you what you are owed.
Also, insurance payouts often get delayed for weeks at a time. Your provider may try to tell you that there is some type of waiting or holding period before they can release the payout to you. In reality, this is a stall tactic that many companies use to try to disincentivize you from claiming the benefits owed. If you don’t constantly hassle them, you may never see the funds. However, calling to complain day after day can be a cumbersome chore, especially if you find yourself stuck at the hospital recovering. Tracking down the payment that should be in your bank account already is the last thing you want to worry about.
Another tactic they use to back out of paying is to quickly disburse a part of the payment claiming it to be the entire benefits package owed to you. The thinking is that you might see the payment and simply take them at their word that you have gotten what you are meant to have. If you find yourself pulling teeth to receive the benefits you are owed, chances are you may simply skip it the next time you fall on hard times. This is how the insurance company gets you.
When you feel like you are being taken advantage of, you should stop playing games and call a disability lawyer to handle the case for you. Many will schedule a consultation to discuss the specifics of your case for free or at a small cost. Even then, having a professional on your side to eliminate the stress in a claims situation and get you the compensation you rightfully deserve will be well worth it.