Why Do Disability Claims Get Denied?


Insurance companies have a habit of denying claimants without properly investigating the validity of the claim in the first place. There are some instances when it makes sense for a claim to be denied, while other claims filed by deserving policyholders are denied for no apparent reason.

But how can you tell whether your disability claim was wrongfully denied or you genuinely don’t qualify for the benefits of your policy? Continue reading to learn more about what makes a claim valid or disqualifies it.

How to Recognize a Bad Faith Disability Denial

Once you’ve filed a claim for disability benefits, it’s up to the insurance company to do its homework. Even something as simple as not thoroughly investigating the claim is grounds for a bad faith appeal. Unfortunately, insurance companies are in the money-making business and lose money by paying on claims, which means they’ll resist compensating you for the smallest reason.

Some warning signs that could suggest that your claim has been wrongfully denied include an insurance adjuster offering you less than your policy is worth, denying your claim due to your collection of benefits in the past, and misrepresentation of the facts of your case.

You purchased your disability insurance policy with the idea that, if you fell under difficult times and were unable to work due to a disabling condition, you’d still be able to support yourself with the assistance of your disability policy. An insurer failing to deliver is unacceptable.

Common Concerns

There are situations in which an insurer has every right to deny your claim, although these kinds of denials can usually be reversed through addressing concerns the insurance company has. For example, you could have failed to file your paperwork correctly or provide adequate evidence of your condition.

Certain circumstances, such as your condition not being covered under your policy or the insurance company claiming you are not disabled “enough,” are grey areas that can be dealt with in the appeals process with the written opinion or medical record provided by your physician.

Contact a Disability Lawyer in Toronto

If you have specific questions about your denied disability claim or would like legal representation as you fight for your benefits, reach out to a Toronto disability lawyer with Mirian Niroomand Lawyers today. Give us a call at 647-556-5888 or complete the form below to schedule a free consultation with us.