Sun Life Financial is one of the oldest insurance companies in the world. Founded in 1865, this Canadian company bases its U.S. operations out of Wellesley, Massachusetts. It has the sixth-largest group benefits business in the United States, serving more than 60,000 employers.
Sun Life Financial offers a range of insurance products, including long-term disability insurance. This type of insurance is particularly valuable for employees, as it can protect your income if you are unable to work due to a disability. Unfortunately, insurance companies like Sun Life Financial often deny or delay LTD benefit claims — leaving policyholders without a financial safety net.
If you have an LTD policy through Sun Life Financial, a New Jersey disability benefits lawyer can help you file for benefits. If the company has already denied your claim or is delaying your claim in some way, an attorney can advocate for your rights under your policy. Read on to learn more about LTD insurance and how to file a claim with Sun Life Financial.
What Is Long-Term Disability Insurance?
Long-term disability insurance provides a percentage of your salary (usually 50 to 60%) if you are unable to work due to a disability. These benefits are paid on a monthly basis and may last for anywhere from 24 months or until retirement. This type of insurance is usually available through your employer, or you can buy an individual policy from an insurance company.
LTD benefits are usually subject to a waiting period of anywhere from 90 to 180 days. This means that you cannot be approved for LTD benefits until 90 to 180 days after you become disabled. In most cases, you may be able to receive short-term disability from the date of your disability and then apply for LTD benefits after the short-term benefits expire.
To be eligible for LTD benefits, you will need to prove that (1) you have a qualifying disability; and (2) that disability renders you unable to work. Depending on the type of policy that you have, you may need to demonstrate that you are unable to perform your own occupation or any occupation. An attorney can evaluate your policy and help you put together an application for benefits that includes the necessary supporting documentation.
How Can You File a Claim for LTD Benefits with Sun Life Financial?
Sun Life Financial offers three options for filing a claim for LTD benefits:
- Filing a claim through their website (for group plan members);
- Filing through your Sun Life account; or
- Submitting a paper application by mail or fax.
Although Sun Life Financial offers a variety of ways to file a claim, that doesn’t mean that the process is easy — or without traps for the unwary.
The application form requires you to provide Sun Life Financial with information about yourself, including your condition, training, education, and work experience. You must also submit supporting medical evidence of total disability, such as doctor’s notes, test results, or lab work. In addition, both your employer and your treating physician will need to fill out forms. All of this documentation must either be submitted online, by mail, or by fax.
Too often, Sun Life Financial and other insurance companies will use any inconsistency or gap in your medical documentation as a way to deny or delay your claim. For example, if you forgot to include one test result, that may be the basis for a claim denial. Alternatively, the company may continue to ask for additional documentation to delay making a decision on your claim.
Options if Sun Life Financial Delay or Deny Your LTD Claim
Sun Life Financial is notorious for denying legitimate claims for LTD benefits, or for cutting off benefits after it determines that a policyholder has improved. In one recent example out of Canada, Sun Life Financial initially approved LTD benefits for a woman whose doctors determined that she was unable to work due to anxiety disorder and other physical health issues. The company paid benefits for about a year, then terminated coverage because the woman takes care of her 9-year-old disabled son. The woman has sued Sun Life Financial — one of many insureds who have filed lawsuits to force the insurance giant to cover their claims.
There are many reasons that Sun Life Financial may use to deny a claim for LTD benefits. For example, the company may deny your claim on the basis that you have a preexisting condition, that there is no objective evidence of your disability, or that your doctor failed to return forms or questionnaires. These types of denials are often unfair — and not in line with what your LTD policy states.
If Sun Life Financial does deny your claim for LTD benefits, they will send you a letter that outlines the reason for the denial as well as your rights. The letter will also contain information about how to file an appeal. If you do not file an appeal within the deadline specified in the letter, you may be barred from appealing the decision or filing a lawsuit against Sun Life Financial.
In addition to denying claims outright, companies like Sun Life Financial may seek to delay a decision on your claim for an extended period of time. For example, the company may not respond to your claim for a lengthy period of time or may request more information that is duplicate of what you already submitted. A lawyer can advocate for you in these situations, demanding a decision based on the evidence that Sun Life Financial already has, in accordance with the policy.
How a New Jersey Disability Benefits Lawyer Can Help
Insurance companies like Sun Life Financial don’t make a profit by approving claims. Instead, they make millions — or billions — of dollars by minimizing the number of claims that they approve. If Sun Life Financial has wrongly denied or delayed your claim for LTD benefits, a New Jersey disability benefits lawyer can intercede, and help you get the benefits that you are entitled to under the terms of your policy.
At Bross & Frankel, we have represented individuals who are unable to work due to a disability for more than 20 years. We put our substantial experience to work for each of our clients, helping them get the benefits that they need to maintain financial stability. To schedule a free disability claim review, contact our office today at (856) 795-8880 or reach out online.
Rich Frankel is the managing partner of Bross & Frankel. He is a member of the New Jersey and Pennsylvania bars. He has focused exclusively on disability and social security benefits since 2005.
Mr. Frankel joined what is now Bross & Frankel after having watched his father struggle with disability, fighting a lengthy illness. Mr. Frankel founded the firm’s veteran’s law practice and substantially grew the social security disability practice, focusing Bross & Frankel’s ability to fight for all of the disability benefits available to his clients.
Mr. Frankel additionally fights for clients in court, obtaining frequent victories in Social Security appeals and against insurance companies in Federal court.