Individual vs. Group Long Term Disability Insurance

If you’ve been involved in an accident or diagnosed with a degenerative condition, you understand the financial impact a significant injury can have. Recovery can extend for months, years, or even become permanent; making your long-term disability (LTD) benefits essential to supporting you and your family. In this post, we will explore an important first step to filing a claim: clarifying which type of LTD insurance policy, or policies, you are covered by.

In Ontario, workers are often initially covered by short-term disability benefits, which can last between 15 to 52 weeks before their LTD benefits begin. Once your doctor has agreed that your disability will extend beyond a year or has become permanent, individuals will start to investigate their long-term disability coverage.

Group LTD insurance

The first step for many is to review the coverage provided by their employer’s group benefits package, which is intended to help employees who are temporarily or completely disabled and unable to work due to a medical condition. These policies can provide a percentage of your former monthly income if you can’t work.

While the coverage usually provides for sick leave and short-term disability, the quality of long-term disability benefits can be questionable. Some of these policies are limited; or may not provide LTD disability benefits, turning instead to government-provided Employment Insurance (EI) disability benefits.

Government disability insurance

Another possible form of disability benefit may come from provincial or federal government programs. If you were injured during the course or scope of employment, you may be able to file a claim with the Workplace Safety and Insurance Board or WSIB.

If you have contributed to the Canada Pension Plan (CPP), as many have, you may qualify for the CPP disability benefit. A claimant is entitled to Canada Pension Plan disability benefits if they have made sufficient contributions to the plan and their injuries are “severe and prolonged”.

Individual LTD insurance

The final policy type that you may be able to make a claim with is an individual disability insurance plan. Individual disability insurance will have been purchased privately through a broker, and may be held in addition to group insurance. Individual LTD policies are also common for those who are self-employed or without group coverage.

Individual policies are often considered the gold standard, and noted to be the most costly to obtain for the policy holders. These benefit plans should therefore also prove their worth by providing more flexible terms. As an example, some individual plans will include a “partial disability” clause, expanding on the more common “total disability” clause found in many group policies.

Like all forms of long-term disability insurance, there will be both an appeal process when dealing with the insurance company decisions, along with the potential for disputes to be resolved through litigation.

LTD Claim Denied? We can help

If you have been seriously injured and are considering a Long-Term Disability claim, contact Van Dyke Law to see how we can help. We offer a free consultation and can help you negotiate the LTD benefits you are entitled to.