Certain types of insurance are intended to protect a person if they become ill for an extended period of time. The type of insurance that does this is called long term disability insurance, and it provides some financial security for those covered who are unable to perform the duties of their regular occupation due to an illness or disability.
Sometimes insurance companies don’t want to pay or don’t want to provide full coverage. Or something else happens that’s making payment a challenge. If this happens, legal action is required. During the litigation process, the personal injury lawyer in Vaughan needs to determine the amount of benefits the claimant is entitled to. The amount a claimant is entitled to depend on the insurance policy, which means that sometimes a claimant may only qualify for partial or residual benefits.
It’s important to remember that not all disability policies are the same in what they cover or pay out in long term disability. Some policies require that the claimant be totally disabled and completely unable to work before the claimant can file for full benefits.
On the surface this may sound good. However, there are plenty of injuries that allow a person to only work a few hours a day. Not all employers are able to accommodate changes in an employee’s ability, which provides a financial shortfall for the employee. It’s important to know if your long term policy will provide partial coverage in a case like this. Understanding exactly what your policy defines as “total disability” is also important. A lawyer can help you understand your policy better.
Qualifying Periods
All insurance disability plans have qualifying time periods that are often called elimination periods. This is the time period in which a claimant absolutely cannot work or must be unable to work before they qualify for payment of the benefit coverage. The waiting period for long term disability is significantly longer than the waiting period for short term disability. To qualify for long term disability, you must be unable to work for a few months to up to a year, depending on the policy. The lower the policy cost, the longer the waiting period. Elimination periods for long term disability can range from a few months up to a year. In general, lower the policy cost, longer the elimination period.
Partial and Residual Benefits
There are many variations in insurance policies when it comes to the payment of partial and residual benefits. In many policies, partial benefits are only payable to those who are still able to perform some of their work related duties. In some policies that claimant needs to be totally disabled during the waiting period, or elimination period.
Residual disability benefits are for those who have an illness or disability that isn’t permanent. In some policies with residual disability benefits, it may not be necessary for the claimant to be completely disabled during the waiting period. Policies with residual disability coverage generally provide employees with the best income protection.