Denied LTD by Manulife? What to Do Next (Ontario Claimants’ Guide)
During all your years as an Ontario employee, you had relied on your long-term disability coverage from Manulife as a safety net, there to protect you in case an illness or injury prevented you from earning enough money to care for yourself and your dependents.
The short-term benefits from your employer’s pan are due to expire and you were counting on your LTD benefits from Manulife to take over…
For the past year and a half, you have been receiving LTD benefits from Manulife, but have just been notified that those benefits will cease at the 24-month mark, because, while you cannot perform the duties of your former occupation, they believe you do have the capacity to function in a less challenging line of work…
While Manulife had been paying a Long-Term Disability benefit, they are cutting off those benefits, alleging you have been non-compliant with your treatment plan…
Reading through all that legal jargon in the denial letter, it is all too easy to give in to your feelings of helplessness and fear for the future. Can this denial of benefits be overcome? What are the next best steps for you to take?
Denial of Benefits — Understanding the Why
The language in the denial letter from Manulife is not only upsetting – It’s confusing. While the letter includes instructions on how to request a copy of your claim file, no specific steps are being recommended for you to take in order to get your case re-evaluated and have hopes of having the “verdict” changed…
Why do denials happen? Isn’t the purpose of having insurance in the first place to help support individuals who are willing to work, but who are unable to do so because of a physical or health setback?
Some uncomfortable possible causes of denial of LTD benefits by Manulife:
- Manulife’s definition of disability changes after two years, going from “own occupation to “any occupation”, The company will often claim that, because (they believe) you are able to work, even if that work is not in the field in which you specialized training and experience. Even if they consider you able to do sedentary work only, they are not obligated to honor your claim of being totally disabled.
- The long-term disability claims forms you submitted were completed by the doctors and therapists who actually saw you in person. When Manulife had its own medical consultants review the paperwork; (people who never examined you or processed your test results), they may disagree with the conclusions reached by your own medical providers.
- As is true of all long-term disability insurance providers, Manulife is in business to make a profit. Yes, they are obligated by contract to pay all legitimate claims. But they are in business, and minimizing payouts increases their profit.
- In the past, some lawyers have accused Manulife and other insurers of purposely denying legitimate claims — or threatening to deny claims — in order to pressure claimants into accepting low settlements.
- Manulife consultants will have examined your social media posts, perhaps interpreting things you’ve shared with friends to mean you are not as “disabled” as you have claimed.
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A Manulife LTD denial letter sets the clock ticking
Read the denial letter carefully too discover how much time is allowed for you to file an appeal. Manulife’s internal appeal deadline in Ontario is often 30 to 90 days. For filing a lawsuit, the legal limitation period is two years, beginning on the date of denial of benefits.
3 things to try to turn around the denial of your LTD claimand file for reconsideration:
- Go back to each of your medical providers to get additional details about your limitations. Have them clarify any areas of misunderstanding about your condition.
- Arrange for an examination from a new specialist.
- Consult a vocational advisor, asking for a letter explaining why you are unable to work at, not only your former occupation, but any
This information should be included in your reconsideration appeal
Do not miss these deadlines:
- Internal appeal: often 30-90 days from your denial letter. Check the exact date.
- Lawsuit: generally, 2 years from the denial date.
If you are close to either deadline, get legal advice right away so you do not lose your rights.Â
Appeal or legal claim: which path serves you best?
|
Question |
Internal Appeal |
Legal Claim in Ontario |
|
Who controls the process |
Manulife controls the review |
Court rules apply, with discovery and mediation |
|
Evidence tools |
Mostly new medical records and letters |
Examinations for discovery, cross‑examination on affidavits, expert evidence, mediation |
|
Typical timing |
30–90 days per round |
Several months to resolve. Many cases settle at or after mediation |
|
Best when |
A single, fixable gap explains the denial and new evidence is coming soon |
Repeated denials, approaching limitation, need leverage and full evidence rights |
|
Risk |
You may lose time if the appeal fails |
More formal process with legal costs and deadlines |
Decision rule:Â try an appeal for quick, fixable gaps you can prove in writing now. Start a legal claim when you need control, timelines, leverage, and full evidence rights.
Read more: Should You File a Legal Claim or Internal Appeal for Long-Term Disability in Ontario?
As Rob Konduros of Hilborn and Konduros asserts, “I am committed to obtain — or restore — the long-term disability or benefits you deserve!“
“And remember,” he adds. “We don’t get paid unless you do. There are never any upfront charges.”
Work with an Ontario disability lawyer, Keeping 3 goals in mind: Â
- Making your limitations undeniable, building the medical and functional proof showing you deserve the benefits
An experienced Ontario disability lawyer who is well-versed in the laws and regulations that govern long-term disability claims can review the denial letter you’ve received from Manulife, comparing each point the insurer is making in that letter with the evidence of treatments and evaluations from your own medical providers
- Making your timeline clear, by confronting change-of definition termination of benefits after 24 months.
If your LTD benefits have been denied by Manulife or cut off after 24 months, get a clear plan before you appeal.Â
- Making the insurance company respect your rights, negotiating from strength, and suing in court when needed
Remember, insurers like Manulife have their own teams of adjusters and legal advisors. You need someone who will fight for your rights. If Manulife refuses to reconsider your case, your Ontario disability lawyer can request a hearing with an administrative law judge.
Timelines and costs at a glance:
- Appeals
Usually 30–90 days per round. Some policies allow multiple rounds. - Legal claims
Steps often include pleadings, document exchange, discovery, independent assessments, mediation, and, rarely, trial. Many cases resolve at or after mediation. - Fees
Many LTD cases proceed on a contingency fee basis set out in a written agreement. No upfront fees. Out‑of‑pocket disbursements may be payable. Costs between parties are governed by court rules and outcomes.
This information is general and not legal advice. Get advice about your situation and deadlines.
FAQs: Denied LTD by Manulife?
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Mark your deadlines, gather your policy and denial letter, and decide appeal or legal claim based on the evidence gap and timing.
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