Whenever starting an LTD claim or appeal, our clients always have dozens of questions on what they can expect. How long will it take, how much it will cost, and what do I need to do to prepare are some of the most common questions we are asked.
The answers to these questions depend on the many factors of your case. The nature of your disability, the opposing counsel, the insurer/plan provider, court schedules, your doctor(s), whether you decide to conduct your own appeal(s), and the insurance company all play a significant part in determining how your case will play out. The disability litigation process is different for everyone, as, unlike motor vehicle claims, there is no standard LTD insurance policy. The clauses and provisions found in your LTD insurance contract are critical to determining your rights in your LTD insurance lawsuit.
We understand our client’s financial challenges when denied LTD benefits, and how difficult it can be to live without the income you should be entitled to. Our team of experienced long-term disability lawyers makes every effort to resolve your case as quickly as possible so you can return to normalcy and focus on what matters most, battling and fighting to overcome your disability.
What is Litigation?
Before understanding what to expect in LTD litigation, you need to understand the basis of litigation. Litigation, by definition, is the process of taking legal action.
LTD litigation is the process of taking legal action against the denial or termination of your LTD benefits. In the vast majority of LTD insurance claims, you are suing an insurance provider such as Manulife Financial, RBC Insurance, or Sun Life Insurance. However, this is not always the case. Sometimes a lawsuit is made against your employer, a Board of Trustees who oversee your Plan, or, in certain cases, the broker who sold you the policy.
How Long Does LTD Litigation Last?
How long LTD litigation lasts is usually the first question a client will ask. Many clients wonder if it’s worth continuing with their LTD claim or if they should give up and return to some form of work, despite their new or worsening disability. We have seen potential clients take the latter option, as they did not want to live without the income, only to end up in an even worse physical or mental condition. Before deciding against pursuing LTD litigation, we strongly advise everyone to book a free consultation with our LTD lawyers to understand what a lawsuit might look like for them, given the specifics of their case.
There is no standard answer for how long a disability insurance lawsuit is going to take. As mentioned before, it depends on a variety of factors. But the most important factor that determines the length is whether you wish to resolve the claim via a buy-out, or whether your wish to receive/resume benefits. Most LTD Insurers/Plans prefer to resolve cases via a buy-out. The decisions you and your LTD lawyer make, the court schedules, and the availability of your doctors and specialists can draw out the time it takes to resolve your case. This is why it’s always best to start your case as soon as possible.
The actions you take also affect the length of your lawsuit. If you or your treatment providers delay responses, filling out forms, requests for further information, or do not adhere to the insurance company’s deadlines, your case will more than likely be drawn out even further. Cooperation, quick responses, and staying on top of your claim is key to speeding up the disability litigation process. We also do not recommend that you proceed with an internal appeal. The internal appeals are almost always unsuccessful and only serve to create more delays for you, and more leverage for the Insurer/Plan.
Your insurance company’s actions are one of the most significant factors determining how long your litigation process will last. Your Claims Adjudicator could get back to you with decisions or responses in days or in weeks. It’s essential to know that the insurance company’s representative is required to get back to you within a reasonable amount of time so as not to delay your claim. If your responses from them are unreasonably delayed, it can lead to a claim for bad faith.
Settlement, Mediation, or Court?
The overwhelming majority of LTD lawsuits do not go to trial (over 99% settle in this part of the country). Most lawsuits are finalized between 6-14 months. Settlements can be achieved by the lawyers talking, or by using a private mediator. Our courts also have a process called a judicial settlement conference. This is when a judge acts as a mediator. In Atlantic Canada, the majority of litigation is settled with the assistance of a mediator.
In the unlikely event that your case does proceed to trial, it will be up to a judge or jury to decide whether your LTD benefits should be reinstated. If your case goes to trial, your lawsuit will undoubtedly take longer. Our lawyers will always continue to push your case forward as quickly and efficiently as possible to get you the LTD benefits you have been entitled to all along.
How Much Does a Litigation Lawyer Cost?
At Valent Legal, we work on a contingency fee basis, which means there are no fees until you get a settlement or win a judgment in court. Even our initial consultation, before we know you or your case, is entirely free.
There are costs associated with proving your case. However, we recognize that when you cannot work, your finances can be affected as well as your health. We want to be part of the solution for you. Therefore, in any case, that we are prepared to act for you on a contingency fee basis, we will also fund the costs required to advance your claim, and we will not ask you for any upfront money to cover these expenses. These expenses are paid back to us when we resolve your claim, and we generally are able to get the opposing party to pay for all, or the vast majority, of these expenses as part of the settlement.
How to Prepare for LTD Litigation
The first step in preparing for LTD litigation is to gather all the facts, documents, and any supporting evidence to strengthen our client’s case. There is a vast amount of information required to build a solid case, but all of it is important.
Some information commonly requested during the disability litigation process includes:
- Official diagnosis
- Physician statements
- Medical assessment results
- Employer statements and files
- Treatment records
- Medical test results
- Medical scans and X-rays
- Your statement about the effects of your disability on your daily life
- Insurance claims file
- CPP Disability files
- Income documents
The gathering of this information and making these requests takes time and money and forms part of our client’s disbursements. As mentioned before, we aim to be part of the solution, and we pay for these documents if we have been retained to act on your behalf.
Although you may have to repay us for disbursements depending on the outcome with your insurance company, the cost of these documents is minuscule compared to the value of having your benefits reinstated. The more high-quality evidence we can provide, the better chances we have to prove your total disability claim. These documents can also be used in other related scenarios, such as applying for WCB or CPP-D.
LTD Litigation Tips
Tip #1: Obtain your actual disability policy and the LTD insurer’s claims file.
After examining the policy, our LTD lawyers will understand the specific stipulations behind your insurance to understand better if and how you’re entitled to benefits and how much you should receive (usually 60-75%).
Tip #2: Be aware of limitation periods.
If you start your claim outside of the limitation period, you could lose all chance of filing a lawsuit for your LTD benefits. The provincial government of Nova Scotia has passed legislation that defines the limitation period as one year for LTD claims. However, your LTD insurance contract could have a limitation period of its own, which is also typically one year.
Tip #3: Consider how an insurance company might use surveillance to dispute your claim.
Although it may seem like something you only see in movies or on TV, insurance companies regularly use different forms of surveillance to gather evidence against you. Insurance companies might enlist a human investigator, use surveillance or tracking devices, and will likely also conduct a thorough background check. Our advice is to live your life normally, and to always be honest in reporting your level of function and abilities. By doing so, you cause their surveillance to be of no value.
Tip #4: Understand your rights.
An insurance company has obligations to you, and they must adjudicate your claim in good faith. That means they must be fair. If you have any concerns about how you are being treated, it is a good idea to call an LTD lawyer. They are normally very happy to give you some general advice, even before your claim has been accepted or rejected. At Valent Legal, we routinely provide this service at no cost, and we believe that we have helped several people successfully obtain LTD benefits without having to resort to litigation or internal appeals.
Our Nova Scotia Long-Term Disability Lawyers Can Help
Each LTD ligation case is different with unique contracts, disabilities, decisions, and outcomes. Exactly how your case is likely to play out depends on a wide variety of specifics surrounding your situation.
If you do not know what to expect during LTD litigation, you can contact our experienced team of LTD lawyers at Valent Legal in Halifax, NS for a free consultation.