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How to appeal a LTD insurance claim denied by Sun Life?

Remove the stress you and your family are experiencing due to a denial by the insurance company.

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Denied Disability Benefits by Sun Life in Ontario

It is not uncommon to hear from workers who hold a Long Term Care or Disability Insurance policy with Sun Life that their long-term disability benefits claim has been denied, or cut-off by the insurer after 6 to 12-months or at the 2 year mark, when the definition of disability changes. They are typically surprised, distressed and wondering the reason of the denial, feeling helpless about their options. Some stated the reasons for refusals were insufficient medical evidence, or a claim they could hold another type of work because total disability tests had changed.

As we’ve helped many of our clients face this exact situation, we totally understand the stress such an event creates for you and your family.

For various reasons, most people will not challenge Sun Life’s initial decision to deny or cut-off long-term disability benefits mentioned in their policy; Insurance companies typically count on their customers to not appeal their decision, for their own financial benefit. Often, people don’t know how to successfully appeal after receiving the LTD denial letter.

Here is what you need to know when a disability insurance company such as Sun Life denies your long-term disability claim, and what you can do using the Sun Life appeal process.

Common Reasons Why Sun Life Could Deny Your LTD Claim

  • Insufficient Evidence
  • No Objective Evidence
  • Pre-Existing Condition
  • Policy Exclusions
  • Contractual Eligibility
  • Misrepresentation on the Insurance Application

Regardless of the reason mentioned in Sun Life’s denial, you can still get the decision reversed using their appeal process if you build a winning case and a court decides in your favor. You will most likely need the help of a seasoned Toronto-area LT disability lawyer who has previously challenged Sun Life’s denials to prove your case and navigate the legal system efficiently.

About Sun Life: the Canadian company’s origins date back more than 150 years, initially starting with the sale of insurance, then adding health and financial solutions to their range of products and services. Sun Life is among the top 5 Canadian Health Insurance companies in terms of total policy values. Sun Life offers Long Term Care and Disability insurance policies, and is considered a leader in Group benefits in Ontario and Canada in general.

5 Tips for Appealing a Denied LT Disability Insurance Claim by Sun Life

A denied LTD insurance claim by Sun Life is not the end of the game. Long-term disability claims are routinely denied by insurance companies. In most instances, you should use the appeal process to fight your case. However, it’s important to do it right to preserve your credibility and build a winning case. A Toronto-area long-term disability lawyer from Himelfarb Proszanski can help.

Timing your appeal is crucial for success: there is a 2-year window to file a claim in court, which starts when the applicant receives a “clear and unequivocal denial” of the claim from Sun Life. There is also an internal appeal timeline to obey, which can vary depending on your Sun Life disability insurance plan. Most appeals are no successful, meaning the insurance company will not reverse their denial. The appeal, therefore, has just wasted time. It is important to have your matter reviewed by our lawyers right away before you appeal as we will be able to advise you if you are wasting your time with the appeal and that you should head straight to litigation.

It’s important to gather as much evidence and information as to why your claim has been denied. You can also ask Sun Life to see your insurance claim file and any other documentation your insurance company may have about your claim.

Each disability insurance plan has its own particularities and terms for coverage. It’s important to understand how the terms relate to your situation so you can provide the right evidence to back your claim.

After Sun Life denies your long-term disability benefits, you have 2 options to ask the insurer to reconsider their decision: an internal appeal process within Sun Life, and a court action decided by a judge . It’s critically important to choose the right process, which depends on your specific situation. An LTD lawyer who has challenged Sun Life’s denial decisions successfully can help you make that choice.

Timing is Critical. Help is Free.

Recover Your Disability Benefits

Denied or Cut-Off? Don’t wait. Time is of the essence to recover your benefits.
Book a Free Claim Assessment now with our disability lawyers by completing the form below.

Please enable JavaScript in your browser to complete this form.
Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

Please enable JavaScript in your browser to complete this form.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

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Sherene AlySherene Aly
16:02 23 Mar 24
I was very pleased with my decision to retain David and his team for my case. Melissa Gizzo was simply amazing and was able to secure a fair settlement for me.
T TT T
17:46 16 Feb 24
Experienced and excellent law firm. Their lawyers are wonderful, articulate, dilligent, amicable, calm, respectful, responsible, resourceful and have good human and customer relationships Especially DAN HOLLAND 👌 He is an amazing lawyer as regards dealing with any of the Accident case.I was involvedIn an accident in 2019 February. He was God sent as he dutifully and relentlessly worked hard until the case was settled
LizLiz
22:43 18 Jan 24
I highly recommend Dan Holland as a disability lawyer. His commitment to my case made the process seamless. Dan's clear communication and ability to simplify complex legal matters made it easy for me to understand every step. He demonstrated genuine concern for my best interests, making him not only a skilled attorney but also someone easy to talk to.Dan’s support extended beyond legal expertise; he alleviated my stress during the long-term disability case. His calm approach and unhurried demeanour ensured that there was no rush in our collaboration. This, coupled with his dedication, made the entire experience more manageable, fostering confidence in his ability to handle the case with meticulous care.I wholeheartedly endorse Dan for anyone seeking a lawyer who not only gets results but also prioritizes your peace of mind.
Neeshanth SritharanNeeshanth Sritharan
21:49 01 Jan 24
My mom was involved in an accident impacting her daily life and ability to work. Dan Holland has worked with us during the duration of our case and has been helpful in fighting for her and supporting us, and organizing the things we needed. Our family is incredibly grateful of the outcome Dan was able to obtain for us. I would highly recommend him!
Faiza HamidFaiza Hamid
01:26 22 Dec 23
I'm so happy I chose Mena Brar and her team represet us . We could not ask for a better team she is so kind, loyal, and honest. she spoke to me as an equal and made me feel as if my case was definitely important and that I deserved to be fairly compensated. I appreciate you. Did it for me and how this will help me get back on track with my life. keep helping others. You are doing amazing works, Mena Brar. I wish you all the best.
Brenda FurtadoBrenda Furtado
23:38 12 Dec 23
Many thanks to Silene Malhao for settling my husband's TORT claim and to Mena Brar for settling his accident benefits claim. These ladies made themselves available any time we had a question. They were very understanding and compassionate. We were completely taken care of throughout this process. We would definitely recommend this team to friends and family!
ShaunaShauna
15:52 06 Dec 23
We are so happy that we had David and his team represent us. We couldn't have asked for a better team. Not only is David incredibly skilled and experienced, he is kind and compassionate and it is clear how much he cares for his clients. Megan was also absolutely amazing to work with and was always on top of everything and there to answer any questions we had! Thank you!
Andrew CoutoAndrew Couto
23:10 21 Nov 23
I'm so happy I chose David as my lawyer. I spoke to a few lawyers before finding David and I noticed majority of them spoke to me in a way that felt demeaning or that my case wasn't big enough or important enough to take. One phone call with David and my opinion on lawyers changed. He spoke to me as an equal and made me feel as if my case was definitely important and that I deserved to be fairly compensated. The whole process was wonderful. From dealing with David's law clerk Ingrid whom is an amazing and kind woman to his legal assistant Melissa whom is another amazing kind and talented young woman. I was so stressed about this case but from day 1 they helped ease that stress and always answered all my questions promptly and respectfully. I couldn't believe David got me to mediation within 6 months of being cut off my LTD and got me a settlement way beyond my expectations. I can't say enough good things about this law firm but I guarantee you that if you need a lawyer to fight for you David is your guy! . Believe me when I say this is the law firm for anyone dealing with personal injuries especially LTD denial claims. Thank you so much to David, Ingrid and Melissa you truly don't know how much I appreciate all you did for me and how this will help me get back on track with my life. Keep helping others you guys are doing amazing work! I wish you all the best!
Rose RegazziRose Regazzi
21:15 11 Oct 23
I sustained a relatively painful injury, affecting me long term.I wouldn't otherwise had pursued it, as it involved a relatively large corporation, but felt it necessary to do so. However, many lawyers were daunted, with one, who actually referred me to HIMPRO.I was connected with Dan Holland, who reviewed the case, provided with me realistic expectations, sound advice and had a willingness to move forward and represent me.His calm and professional demeanor, brought me to a place of reassurance. His ease in addressing all facets of this process, clearly demonstrated a wealth of experience. There was never any hesitation, when being challenged, and felt my best interest was always in the forefront.This case has since been resolved, to my complete satisfaction.Without reservation, HIMPRO (and Dan Holland, in particular), would be the only firm I would recommend for these type of cases.
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