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Monkhouse Law is experienced fighting for LTD disability insurance. LTD or Long-Term Disability Insurance, as well as STD or Short-Term Disability Insurance, are frequently litigated by Monkhouse Law, with success for their clients.
Many individuals believe that their insurance provider, or plan administrator, has the last word when it comes to disability benefits. However, this simply isn’t the case. Many of these decisions have been challenged successfully before the courts.
In the case of long term disability benefits, the question is whether or not the claimant is “totally disabled” and prevented from working. The legal test for total disability was set out by the Supreme Court in Suchorov v. Paul Revere Life Insurance Co.  S.C.J. No. 86, and is as follows:
“The test of total disability is satisfied when the circumstances are such that a reasonable man would recognize that he should not engage in certain activity even though he is not physically unable to do so… There is total disability if the insured’s injuries are such that common care and prudence require him to desist from his business or occupation in order to effectuate a cure.”
Success stories include the recent cases of Fernandes v. Penncorp Life Insurance Co.  O.J. No. 4039 and Dodgson v. Great West Life Assurance Co.  O.J. No. 431, which both involved a question as to whether the plan provider was justified in denying the Plaintiffs’ benefits on the grounds that they were found to not be “totally disabled”.
Long Term Disability Insurance, how Employees can make sure to retain their benefit
In Fernandes, the Plaintiff at trial was awarded $236,773.00 for the failure to pay disability benefits, punitive damages of $200,000.00, and mental distress damages of $100,000.00. It is important to note that each case rests on its own merits and that this, or any other case, might not be representative of a new individual’s case.
It is crucial that you contact an experienced disability lawyer to ensure that you are receiving the benefits (and, in certain cases, damages) which you are entitled to. Being disabled and unable to work can be both an emotionally and financially straining situation, and it is easy for an insurance provider to get away with an unfair decision on benefit entitlements. The cases above illustrate that it is not only possible to recover the benefits you are entitled to but to receive compensation for the hardships placed upon you as a result of such a decision.
Many individuals find working through a lawyer takes the pressure off of them to correspond with a non-responsive or demanding company. Once you retain us all correspondence will go through us and we will direct you regarding the next steps on the legal, and medical, front.