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You relied on Canada Life as your disability carrier to support you by paying your disability claim – a denial can feel devastating. The insurer may say there is not enough medical evidence or that you are still able to work, but a denial is not the end of the road: you can appeal the decision or pursue legal action to challenge it.
The loss of monthly benefits can put immediate pressure on your income and financial security while you are already dealing with serious health challenges. This guide explains why Canada Life denies LTD claims, how the application and appeal process works, the most common reasons claims are refused, and how an experienced disability lawyer can help you fight the denial and secure the benefits you deserve.
If Canada Life denied your LTD claim, you are not alone. Denials are common—especially at key transition points such as the change from the “own occupation” definition of disability to the stricter “any occupation” test at 24 months.
A denial letter typically states that:
In addition to these common reasons that disability claims are refused, and Canada Life may also deny a claim on a contractual basis such as due to your disability being caused by a pre-existing condition, if you are not following treatment recommendations or if you miss contractual deadlines.
The denial letter is important because it outlines Canada Life’s reasoning, and missed deadlines can sometimes trigger an automatic denial and affect your next steps. Taking time to read it carefully and understand the insurer’s rationale is the first step toward challenging the decision.
Canada Life provides LTD benefits through employer group plans and individual policies. LTD benefits are designed to replace a portion of your income when illness or injury prevents you from working, with monthly payment amounts ranging from 60–70% of pre‑disability earnings.
Key features of Canada Life LTD coverage include:
To qualify for LTD benefits, you must meet the policy’s definition of disability and provide medical evidence showing that your condition prevents you from performing your job—or any job, depending on the stage of your claim; benefits may continue until age 65 if you keep meeting that definition.
The LTD application process involves several steps:
Even small gaps or inconsistencies in your application can lead to a denial. Insurers often rely heavily on internal medical consultants who never meet you but review your file and provide opinions.
Canada Life frequently denies LTD claims based on predictable patterns. Understanding these reasons helps you prepare stronger evidence and anticipate the insurer’s arguments.
Canada Life may argue that your doctor’s notes do not provide enough detail or objective findings. Brief, vague, or inconsistent medical records can weaken your claim, and Canada Life often expects strong medical evidence that explains functional limits, not just a diagnosis. Insurers often expect clear documentation of functional limitations, not just a diagnosis. Even conditions such as multiple sclerosis can be denied when the records do not clearly document your inability to work.
Canada Life may rely on internal medical consultants who claim you can perform full‑time or modified duties despite your doctor’s opinion. It may also rely on internal reviewers whose opinions contradict those of your treating physicians. These consultants often focus on what you can do rather than what you cannot do.
During the first 24 months, Canada Life may argue that you can perform your own job, even if your symptoms prevent you from meeting essential duties. Insurers sometimes oversimplify job descriptions or misunderstand cognitive, psychological, or physical demands.
After two years, Canada Life often applies the stricter “any occupation” test. Canada Life assesses whether you can perform gainful employment under that standard. The insurer may claim you can pursue alternative work, even if that is unrealistic given your limitations, education, experience, and other circumstances.
Missed appointments, inconsistent treatment, or sparse medical notes can raise concerns for Canada Life. The insurer may interpret gaps as evidence that your condition is improving or not severe.
Canada Life may rely on surveillance footage or social media posts to question your limitations. Social media posts may contradict the claim Canada Life has on file and be used in disability insurance disputes, while short clips can be taken out of context and misinterpreted as proof you can work in disability disputes. Surveillance and online evidence can arise unexpectedly and should be reviewed in context.
Canada Life may cite exclusions for pre‑existing conditions or non‑compliance with treatment. These issues often require careful review of the policy wording.
If Canada Life denies your claim, you typically have the option to submit an internal appeal. However, internal appeals are often unsuccessful because they are submitted to the same insurer who made the initial decision. There may also be a limited number of internal appeal options, so each opportunity matters and some claimants instead proceed to litigation.
A strong appeal includes:
You should also request your complete claim file, which contains internal notes, consultant reports, and assessments. Reviewing this file helps you understand how Canada Life evaluated your claim. Read the denial letter carefully, because limitation periods often run from the date of denial.
Get a copy of the actual insurance policy. You may have a copy of a booklet from your employer – that is not the policy. You are entitled to obtain a copy of the policy directly from Canada Life. You do not need to go back to your employer.
Section 293(5)(b) of the Insurance Act, RSO 1990, c I.8, provides:
Copy of application, policy, etc. — group insurance
(5) In the case of a contract of group insurance, an insurer,
(b) on request and reasonable notice, shall permit a group person insured or claimant under the contract to examine, and shall furnish to that person, a copy of the policy of group insurance. 2012, c. 8, Sched. 23, s. 36
Many claimants consult a lawyer before appealing to avoid missteps and strengthen their position. In some cases, skipping the internal appeal and proceeding directly to litigation is the more effective strategy. In many cases, you have two years to sue after a denial, subject to provincial limitation periods.
An experienced LTD lawyer and their team can provide ongoing support through both the appeal and litigation stages. A lawyer can:
For advice please text 613-777-0992 or contact us through our website to schedule a meeting with one of our lawyers. We provide a free consultation, in French or English, to ensure that your rights are protected. In most cases, we can offer to represent you on a contingency fee basis. This means that you do not pay legal fees unless you win or achieve a settlement on your case
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