Suing the Insurance Company for Disability Benefits

If you were wrongfully denied Long-Term Disability benefits (or they were wrongfully terminated), you may consider suing the insurance company to obtain your benefits.

Who do I sue?

In most LTD cases, you sue the insurance company that is refusing to pay your benefits. Sometimes it may be necessary to sue your employer or a non-profit board of trustees that administrates your LTD plan. In some rarer cases you may need to sue the broker who sold you the policy.

What do I sue for?

In all LTD lawsuits, you sue for the payment of the disability benefits to which you are entitled. If the denial of your claim caused you to suffer a great amount of stress, you can sue for compensation for “mental distress“. You can also claim pre- and post-judgment interest on the amounts claimed, as well as a contribution from the defendants towards your legal fees.

Some lawsuits may also include punitive damages for “bad faith“. This is rare and only awarded if the insurance company has acted in a particularly malicious, vindictive and harsh manner.

What is the process involved in suing the insurance company?

Generally, the court process begins by delivering a Statement of Claim (commonly called a lawsuit) which sets out the allegations you are making against the insurance company.

Once the insurance company receives it they will immediately stop any ongoing internal appeal. The insurance company will then file a defence against your lawsuit and documents will be exchanged. At some point you will be asked questions under oath and you will likely need to undergo medical assessments, both with your own doctor and the doctor for the insurance company.

Usually there are then settlement negotiations, where both sides attempt to come to an agreement. This may lead to a mediation or settlement conference. If that is not effective, the matter will go to trial.

Do I have to go to court?

If the settlement negotiations (and mediation, if it happens) fail, your case will end up in court and a judge or jury will decide whether your benefits will be reinstated or not. However, most lawsuits settle before going to court.

To get more information specific to your case, you can contact our disability lawyers for a free consultation.