Insights from SHIV GANESH — Personal Injury & Insurance Lawyers
When a long-term disability (LTD) claim is denied, delayed, or cut off prematurely, the consequences can be devastating — especially if you’re already coping with a serious injury or chronic illness that prevents you from working. Insurance was supposed to be your safety net, but too often insurers respond with complicated legal language, excessive delays, or outright refusals. That’s where an insurance dispute lawyer with experience in long-term disability claims becomes essential.
At SHIV GANESH, we understand how financial stress and medical uncertainty compound the challenges of disability. Having spent years working inside insurance companies, we now use that insider perspective to challenge unfair insurer tactics and fight for the benefits you’ve paid for.
In this article, we’ll explain what a long-term disability claim is, why disputes occur, how an insurance dispute lawyer helps, and what steps you can take to protect your rights.
What is Long-Term Disability Insurance?
Long-term disability (LTD) insurance provides income replacement if a serious injury or illness prevents you from working for an extended period — often until you’re able to return to work or reach retirement age. LTD benefits are designed to replace a portion of your income, typically between 60% and 85% of your pre-disability earnings, though specifics depend on your policy.
Many Albertans access LTD through employer-sponsored group plans or private coverage. Unfortunately, even when your medical condition is genuine and well documented, insurers frequently look for reasons to deny or prematurely terminate benefits.
Common Reasons LTD Claims Are Denied or Disputed
Insurance companies do not deny long-term disability claims at random — they use certain common strategies to minimize their payout obligations:
Insufficient Medical Evidence
Insurers often require detailed documentation showing how your condition prevents you from performing your job duties. If your medical records are incomplete, vague, or don’t explicitly link your symptoms to work limitations, your claim may be denied.
Failure to Meet Policy Definitions
Many LTD policies define “disability” in specific ways — such as your inability to perform your own job (“own occupation”) or any suitable occupation (“any occupation”). Insurers may claim you don’t meet their definition, even if your doctor disagrees.
Missing Deadlines or Forms
LTD policies often include strict timelines for submitting proof of loss and appeals. Missing these deadlines or failing to complete forms correctly can be used to justify a denial.
Disagreement With Insurer-Paid Assessments
Insurers may require you to attend an Independent Medical Examination (IME) with a doctor of their choosing. If that assessment contradicts your treating physicians, insurers may deny benefits based on the IME opinion.
Policy Exclusions
Some policies include pre-existing condition exclusions or other technical clauses that insurers use to deny claims.
These are just a few common tactics — and when they arise, an insurer may be in the wrong or misinterpreting its legal obligations. A skilled insurance dispute lawyer will scrutinize these decisions and identify when a denial is unjustified or unfair.
How an Insurance Dispute Lawyer Helps You
Long-term disability disputes are both medical and legal battles. Without legal support, many claimants struggle to navigate the complex interaction between medical records, policy language, insurer tactics, and legal deadlines. An experienced insurance dispute lawyer helps in several critical ways:
1. Understanding Your Policy and Rights
LTD policies can be confusing. A lawyer will carefully review your policy terms, interpret ambiguous language in your favour where permissible, and identify insurer misinterpretations that may have led to denial.
2. Evidence Gathering and Medical Documentation
Strong medical evidence is the cornerstone of any successful LTD claim. Lawyers know what documentation insurers demand, how to present it effectively, and when to procure additional expert reports to support your case.
3. Handling Communication With Insurers
Insurers often employ delay tactics, excessive requests for documents, and intimidating communications to pressure claimants. A lawyer takes over these interactions, so you don’t give insurers the leverage they seek.
4. Filing Appeals and Lawsuits
If an insurer denies your claim, you may have multiple avenues for appeal — internally with the insurer and, if necessary, through the courts. Lawyers prepare and pursue both types of challenges, ensuring critical deadlines aren’t missed.
5. Identifying Bad Faith Conduct
In Alberta, insurers owe a duty to handle claims fairly and promptly. When they delay without justification, misrepresent policy terms, or ignore evidence, they may be acting in bad faith — and you may be entitled to compensation beyond unpaid benefits.
Why LTD Disputes Are So Stressful — And Why You Don’t Have to Fight Alone
Long-term disability disputes often arise during the most vulnerable time in a person’s life — when they’re coping with serious health issues, mounting bills, and an uncertain future. Insurers know this, and many rely on overwhelmed claimants to give up or settle for less than they deserve.
Hiring a lawyer doesn’t just improve your chances of success — it levels the playing field. Legal representation allows you to focus on your health while experienced advocates push back against insurer pressure tactics, protect your legal rights, and work toward the full compensation you’re entitled to under your policy.
At SHIV GANESH, we’ve seen firsthand how people with clear disabilities have been denied or underpaid because insurers misinterpret evidence or prioritize profit over their contractual obligations. That’s why we’re committed to strategic, evidence-based representation that holds insurers accountable.
Steps to Take After an LTD Denial
If your long-term disability claim has been denied or cut off, here are critical steps you should take right away:
Read the Denial Letter Carefully
This document explains why the insurer refused your claim and outlines appeal rights and deadlines — information you cannot afford to miss.
Secure Your Full Claim File
You are entitled to the insurer’s internal notes, medical opinions, and communications used in making the decision. These materials often reveal weaknesses in the denial.
Document Your Medical Condition Thoroughly
Ensure your treating doctors provide clear statements on how your condition prevents you from working — and how it affects your daily functionality.
Consult an Insurance Dispute Lawyer Early
Early legal involvement prevents missing deadlines and strengthens your appeal or lawsuit strategy.
Why Albertans Choose SHIV GANESH
At SHIV GANESH, we bring a unique advantage to LTD disputes: we used to defend insurance companies. That experience gives us insight into insurer tactics others don’t have — allowing us to anticipate and counteract them effectively.
We guide clients through every step — from evaluation and evidence gathering to appeal and, if required, litigation. Our goal is simple: to secure the benefits you’ve earned and to hold insurers accountable when they act unfairly.
Importantly:
- We offer free initial consultations.
- You pay no legal fees unless we win.
- We handle communication with the insurer so you can focus on recovery.
Conclusion: Don’t Let an Insurance Company Decide Your Future
Your long-term disability benefits are more than income — they’re a foundation for your health, stability, and dignity during a difficult time. If your insurer has denied, delayed, or unfairly reduced your LTD claim, an insurance dispute lawyer can help you fight back.
With SHIV GANESH on your side, you get experienced legal advice, strategic advocacy, and a firm commitment to your rights as an Albertan policyholder. Contact us today for a free consultation — and take the first step toward securing the benefits you deserve.