Common Insurance Company Tactics in Disability Denials
When you can't work because of injury, illness, or mental-health issues, your disability insurance should protect you. But for many Albertans, the opposite happens — instead of receiving financial support, they get a denial letter filled with technical language and vague justifications.
Insurance companies are not neutral. Their business model depends on collecting premiums and minimizing payouts. That means even legitimate disability claims often face aggressive scrutiny, delay, or outright denial.
As Alberta insurance-litigation lawyers who once defended these same companies, we know how adjusters and in-house medical teams are trained to limit claims. This article exposes the most common tactics insurers use in disability denials, how they work, and how an experienced lawyer can dismantle them.
This guide covers:
What Is a Disability Claim?
Disability insurance pays income replacement benefits when a medical condition prevents you from working. Policies vary, but most Alberta workers are covered through:
Types of Disability Coverage:
Common Insurance Challenges in Alberta
Even strong medical cases can face denials. Insurers look for ways to argue that:
Not Totally Disabled
You're not "totally disabled" under their definition.
Insufficient Medical Evidence
There's insufficient medical evidence.
Failed to Follow Treatment
You failed to follow treatment or missed deadlines.
Pre-existing or Excluded Condition
Your condition is pre-existing or excluded.
Key point: These aren't just mistakes — they're part of a system built to control claim costs.
Steps to Take Immediately After a Denial
Before diving into tactics, it's important to respond strategically when a denial occurs:
Request the Denial Letter in Writing
It must explain why the claim was refused and what evidence was used.
Collect All Medical Records
Gather reports from doctors, specialists, and therapists.
Avoid Insurer-Directed 'Appeals'
Internal reviews rarely succeed and can eat up limitation time.
Speak to a Lawyer Early
We ensure deadlines are met and evidence is framed correctly.
How a Lawyer Counters Insurer Tactics
Disability denials are not final. A lawyer can use the insurer's own rules and medical standards against them. Here's how we respond:
Demand Full Disclosure
We request internal claim notes, adjuster communications, and IME instructions.
Coordinate Independent Specialists
Neutral experts provide detailed medical evidence to counter insurer reports.
Engage Vocational and Functional Evaluators
These prove that 'alternate occupations' are unrealistic.
Quantify Arrears and Interest
We calculate unpaid benefits and legal costs to pressure fair settlement.
File Legal Action When Needed
Alberta courts frequently award back benefits and costs when denials are unreasonable.
Frequently Asked Questions
Conclusion
Insurance companies use delay, denial, and doubt as deliberate strategies to protect profits. Understanding their tactics is the first step toward defeating them.
Get all denials and communications in writing
Keep consistent medical documentation
Don't accept insurer IMEs as final
File your claim or lawsuit before the limitation deadline
Consult an Alberta disability lawyer early
Still have questions? Contact us today for a free consultation.
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