Ontario LTD Disputes: Should I Appeal, Sue or Settle? 

If your application for LTD benefits has been denied, or your benefits have been discontinued, it can be incredibly stressful. Worrying about how you’ll meet your day-to-day financial obligations is hard enough. Not knowing how you’ll meet your family’s future needs will be met is another level of stress.

When you’re faced with a denial, you have the option of going through the insurer’s internal appeals process, or pursuing what’s known as an external appeal, which means starting a lawsuit. There are some instances where it makes sense to do an internal appeal, but you can also spend a lot of time on internal appeals and not wind up any further ahead. See our post on Internal vs External Appeals for more on that.

If you and your lawyer decide to pursue litigation (also known as suing or starting a lawsuit), it’s important to understand that very few cases wind up at trial. Most often, a settlement is negotiated before it goes that far. Settling your case can have several advantages.

  • It creates closure. The matter is finished and you will never have to deal with this insurer again.
  • It gives you more certainty. Once your settlement is finalized, you know exactly how much money you have to work with.
  • It’s less adversarial. The insurer usually prefers to negotiate a settlement rather than go to court. This helps them control their costs and time.
  • It can be less stressful than trial. This frees up mental and emotional space to take care of your health.

The main drawback of settling is that it may pay less overall than if you had received benefits in the past and continued to receive them into the future. But again, the trade-off is certainty. If you remain disabled, the insurer might continue to pay your benefits–but they could also cut them off again. It’s impossible to know the future.

In many instances, the main benefit to suing the insurer is to get their attention and get them to the table to negotiate a settlement.

After learning about your unique circumstances, an experienced disability insurance lawyer will be able to advise you on what course of action makes the most sense. Contact us to set up a free consultation about your case.