Beyond the Big Names: Understanding LTD Policies from Empire Life, Securian, and Teachers Life

Start by identifying your Long-Term Disability policy and the company responsible for your claim 

Before you can respond to a denial:

1. Clearly identify which insurance plan is involved

• insurance company name
• administrator of the plan
• plan sponsor – (an employer you worked for? an association to which you belonged? an individual policy you bought?)

2. Find or request a copy of the policy

• the contract
• a certificate
• benefits booklet
• amendments, endorsement, riders

3. Confirm the version in force when the disability arose

Note: a current website summary may describe different coverage.

4. Distinguish the exact type of denial you received:

• initial denial of your first claim
• termination of approved benefits you had been receiving
• notice of a reduction of benefits through offsets

You need two numbers and a name: 

·      policy number

·      certificate or member number

·     legal name of the insurer

Empire Life long-term disability policies. What Ontario claimants should check

Empire Life provides group LTD coverage and publishes a claim guide requiring claimant, employer, and attending physician statements. Its guide says assessment considers medical information, occupational duties, and functional impact.

1. Study your policy:

• Find – the definition of disability (and any change in that definition).
• Find – the elimination period, benefit calculation, maximum payment period, exclusions, offsets
• Discover – whether the employer’s statement accurately describes the kind of work you had been doing

2. Read the employer’s statement:

• Does it accurately describe the kind of work you’d been doing?

3. Study your medical reports:

• Do the medical records explain how your symptoms affect your work –essential duties, hours, endurance, and attendance?

4. Study the denial letter:

• Compare each written reason for denial or termination of benefits with the relevant policy clauses.

5. What if Empire Life says the medical evidence is insufficient?

• Are there missing records?
• Have your functional restrictions been made clear?
• Have your job duties been correctly described by the employer?

Remember: The insurer’s website’s estimated processing time or typical waiting period is not a guarantee.

Securian Canada long-term disability policies. Check your association plan and riders

Securian Canada offers association LTD coverage, including a program for Canadian Association of Music Therapists members. That program identifies Canadian Premier Life Insurance Company as the underwriter.

1. Study your policy:
   

• Find – the association name and the certificate.
• Find – the coverage dates, the selected elimination period, and what income is insured
• Discover – whether an own-occupation rider changes the disability definition
• Discover – any partial or residual disability benefits are included, and whether there are any return-to-work provisions
• Learn – which legal insurer is named, both in the contract and in the denial correspondence

Note: The published program’s regular-occupational and different occupational tests may not apply to every Securian policy. After 24 months, subject to an own-occupation rider. This example must not be applied to every Securian policy.

Teachers Life long-term disability policies Understand OTIP’s role

Teachers Life states that OTIP administers its disability claims and provides early intervention and rehabilitation services. Its public information also explains that changing school boards can change whether coverage is through Teachers Life.

1. Study your policy:

• Confirm – the insurer and administrator (check the policy and correspondence)
• Check – the relevant provincial plan, the bargaining unit, school board, and coverage dates
• Review – waiting period rules, sick leave interaction, partial-work provisions, and retirement or pension-related eligibility clauses
• Understand – the practical roles of the school board, the union representative, treating clinicians, and legal counsel.
• Distinguish – insurance from an Ontario Teachers’ Pension Plan disability pension.

Note: Where a collective agreement is relevant, have counsel assess the correct dispute process and forum.

What evidence explains why you cannot perform your teaching duties?

Gather information on concrete job duties affected by your condition:

• classroom supervision
• sustained concentration,
• lesson delivery
• Standing
• managing student behavior
• reliable attendance.

The policy terms that can change your LTD entitlement

Note: CPP disability has its own eligibility test. An approval or denial does not automatically decide a private LTD claim, and an applicable offset may affect payments.  

What evidence helps explain your inability to work?

Create a useful claim file:

Purpose: connecting your medical condition to the work you no longer can perform reliably:

• treating-provider reports, clinical notes, and relevant specialist records
• medical findings, treatment history, medication effects, restrictions, and prognosis
• actual work duties, hours, physical demands, concentration demands, and attendance requirements
• records of attempted returns to work, accommodations, and their outcomes
• accurate symptom records showing frequency, severity, and recovery time

Example: A teacher with migraines may need evidence explaining how episodes affect classroom supervision and reliable attendance. A diagnosis alone may leave those effects unclear.

Note: Chronic pain, fibromyalgia, depression, and other conditions require evidence appropriate to the condition. Avoid suggesting that a particular scan or test is always required. Do not coach readers to exaggerate symptoms.

What to do if Empire Life, Securian Canada or Teachers Life denies or stops benefits

1. Save – the decision letter, email, and envelope or delivery record.
2. Request – the specific reasons, policy provisions relied upon, and relevant claim documents.
3. Gather – the policy, certificate, job information, medical records, and correspondence.
4. Record – claim-submission, internal-review, and legal deadlines separately.
5. Obtain – legal advice before relying on an internal appeal to protect your rights.

Know the deadline:   

Ontario’s basic civil limitation period is generally two years from discovery of the claim, subject to applicable exceptions. An internal appeal does not automatically suspend or restart the limitation period.