Manulife is one of Canada’s largest insurance companies, offering both group and individual long-term disability (LTD) policies. These policies are designed to help replace a portion of your income if you’re unable to work due to a serious illness or injury.

Group plans are usually provided by your employer, while individual plans are bought directly by people, like self-employed professionals or business owners.

Denial of long-term disability benefits from Manulife can feel like a punch to the gut, especially when you’re already dealing with a serious illness or injury. You have rights, and there are clear, strategic steps you can take to fight for the benefits you’ve been paying a premium for all this while.

Why Would Manulife Deny Your Claim?

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Manulife may deny a claim for various reasons. Some of the most common ones include:

• Insufficient Medical Evidence: If the medical documents you submitted don’t clearly show how your condition prevents you from working, Manulife might argue that you don’t meet the disability criteria.
• Missed Deadlines: If you didn’t submit the required forms or documentation on time, this could be a reason for denial.
• Independent Medical Examinations (IME): Manulife may request that you attend an IME. If the doctor they choose disagrees with your own doctor’s findings, they might use this as a reason to deny your claim.
• Surveillance or Social Media Scrutiny: Sometimes, Manulife will conduct surveillance or review your social media accounts to look for signs that your condition is not as severe as you’ve claimed. Even innocent posts showing you doing things might be misinterpreted.
• Change in Disability Definition: After two years of being on LTD, Manulife may change the definition of your disability. Instead of just proving you can’t do your current job, they’ll require proof that you can’t do any job that fits your skills or experience.

Steps to Take After Your Claim is Denied

If your LTD claim has been denied, don’t panic. You can take several steps to appeal the decision and fight for the benefits you deserve.

Review the Denial Letter Carefully

Manulife will send you a letter explaining why your claim was denied. Make sure you read it carefully. Sometimes, the reasons for denial might be straightforward, like missing medical evidence or missing deadlines. Other times, it may be more complex, like a dispute over the definition of your disability.

Gather All Necessary Documentation

One of the most important things you can do is ensure that all your medical records and other supporting documents are in order.

If Manulife claims you don’t have enough medical evidence, it’s time to go back to your healthcare providers. Ask your doctors for more detailed reports or letters that explain why you can’t work.

Appeal the Denial

Once you’ve understood the reason for the denial and gathered the necessary documentation, you can begin the appeal process. Manulife’s process may seem complicated, but it’s important to stay on top of it. When appealing, make sure to:

• Submit additional medical evidence if necessary.
• Be clear about how your condition affects your ability to work.
• Respond quickly to any requests from Manulife for more information.

Consult a Disability Lawyer

If you’re unsure about how to proceed or if you’re facing challenges with the appeal process, it’s a good idea to seek help from a lawyer who specializes in disability claims. Many lawyers offer free consultations so you can get advice without worrying about upfront costs.

A lawyer can help you understand your rights, review your claim, and guide you through the legal steps to get your claim approved. They can also assist you with gathering the right documentation and communicating with Manulife on your behalf.

Don’t Forget About Employment Issues

While dealing with your LTD claim, you also need to be aware of any employment-related issues. For example, you may have concerns about how your employer is handling your position during your disability.

Make sure to review your employee benefits booklet or certificate of insurance to understand how your benefits should be treated. 

You may want to discuss these concerns with a lawyer as well to ensure your employer isn’t violating any rules related to your disability benefits.

What to Expect During the Appeal Process

The appeal process for a denied long-term disability claim with Manulife usually takes several weeks to months, depending on the complexity of the case.

During this time, you may be asked to provide additional documentation and medical updates or even undergo another medical examination.

While waiting, keep in mind that you still have options for interim support. You may continue to receive short-term disability benefits or other forms of income assistance, depending on your policy.

Make sure you understand the full scope of your coverage during this period. If there’s part of your coverage you do not understand, find a competent lawyer close by to break it down for you.