What is Your Duty to Disclose When Applying For Long-Term Disability?
While most applicants for long-term disability benefits do so through an employer’s policy, many have taken out disability and critical illness policies on their own. And if certain health issues have not been disclosed on the application, these policyholders may be out of luck when it comes to collecting benefits.
Qualifying for These Benefits
Private insurance policies require you to submit an application to qualify for their coverage. They will make decisions on your qualification ability as well as your premium amounts by examining your application in detail. Qualification and premiums will be dependent on many factors, including your age, health, lifestyle choices, and other risk factors.
Weighing Their Risk
Insurance companies are for-profit businesses, and their goal is to provide less benefits than they take in premiums. Consequently, their underwriters focus sharply on potential risk when considering an applicant. This risk is assessed by how you have responded to questions on your application. If an applicant doesn’t tell the truth on their application, the company can’t assess risk. They also may use that information to deny benefits to you should you need them. And in most cases, those denials are upheld in court if you decide to legally pursue it.
Your Duty to Disclose
When you are applying for life insurance, critical care insurance, or individual long-term disability insurance, you are required by law to tell the truth about your health. Under Section 183 (1) of the Insurance Act, an applicant for insurance must disclose “every fact within the person’s knowledge that is material to the insurance….”
Getting Legal Guidance
If you have been denied long-term disability benefits or other insurance benefits unfairly, you may have legal recourse. But if the denial involves your own duty to disclose, you may be out of luck. Getting legal guidance is critical. If you believe you have been unfairly denied insurance benefits, the Cambridge ON long-term disability lawyers at Hilborn and Konduros may be able to help. Contact or call us at (519) 658-6341 to schedule a complimentary consultation to discuss your case.
