Articles & Media


Insurance Company Disability Rulings are not Binding

25-Nov-11

by Hugh McPhail, Q.C.

We are aware of a few times recently when employers assumed that an insurer’s denial of disability payments meant definitively that the employee was not disabled and therefore should be at work. While an insurer’s decision is relevant information, it is not the last word. Denials of disability coverage can be based on grounds other than medical conclusions. More importantly, these decisions might be wrong. There could be a difference of medical opinion. These rulings can be appealed or otherwise challenged.

Don’t be too quick to jump to conclusions about any medical issues like fitness/unfitness. The stakes are way too high. You need to reach your own conclusions and may require independent information. These questions often involve complex and contestable medical judgments. We recommend that you get legal advice before taking any steps to deal with an employee who has been denied disability payments.


 

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