A denial of long-term disability benefits by Sun Life Financial can feel like the ground has shifted beneath you. Most people apply for long-term disability only after their health has deteriorated to the point where continuing to work is no longer realistic. When Sun Life denies a claim, it often creates immediate financial stress and deep uncertainty about the future.
What many claimants do not realise is that Sun Life long-term disability denials are frequently challenged and overturned when addressed properly. However, Sun Life is a sophisticated insurer with internal medical consultants, vocational experts, and legal teams. The claims process is not designed to be navigated easily by someone who is already dealing with illness or injury.
At JEWELL RADIMISIS JORGE LLP, our Toronto long-term disability lawyers bring over 100 years of collective experience to long-term disability disputes across Ontario. We regularly represent clients whose Sun Life claims were denied despite strong medical evidence and genuine functional limitations. This guide explains the steps to take after a denial, while also highlighting where experienced legal representation becomes essential.
Step 1: Recognise That a Sun Life Denial Is a Strategic Decision, Not a Final Answer
A Sun Life denial does not mean you are not disabled. It means the insurer has taken the position that your claim does not meet their interpretation of the policy requirements at that moment in time.
Sun Life denial letters often rely on:
- Selective readings of medical records
- File reviews by insurer retained doctors
- Statements suggesting you can work with restrictions
- Alleged lack of objective evidence
- A narrow interpretation of policy definitions
Many claimants assume the denial reflects an objective medical conclusion. In reality, it reflects an insurer-driven decision. Understanding this distinction early is critical. This is also where many people make the mistake of trying to manage the process alone.
Step 2: Analyse the Denial Letter Through a Legal and Policy Lens
Sun Life denial letters are carefully written documents. They are designed to justify the decision and protect the insurer from liability.
Important points to identify include:
- Whether the denial is based on the own occupation or any occupation definition
- Which medical evidence Sun Life accepted or dismissed
- Whether functional limitations were ignored or minimised
- References to vocational assessments or transferable skills
- Any mention of surveillance, social media, or inconsistencies
At JEWELL RADIMISIS JORGE LLP, we review Sun Life denial letters in detail to identify weaknesses in the insurer’s reasoning and gaps that must be addressed. This review forms the foundation of a successful appeal or legal strategy.
Step 3: Identify and Protect All Deadlines Immediately
Sun Life policies often impose internal appeal deadlines. At the same time, Ontario limitation periods may apply even if you are appealing internally.
Common risks include:
- Assuming appeals extend legal deadlines
- Missing appeal submission windows
- Delaying legal advice while health worsens
Once a deadline passes, even a strong claim can be lost. One of the most important roles of a long term disability lawyer is protecting clients from procedural traps that insurers rely on.
Step 4: Demand the Full Policy and Complete Sun Life Claim File
You cannot properly challenge a Sun Life denial without knowing what information the insurer relied on. This includes internal materials that are not always disclosed unless specifically requested.
Key documents include:
- The full long-term disability policy and all amendments
- Internal adjuster notes
- Medical consultant reports
- Vocational assessments
- Surveillance reports, if any
- Communications with your employer
When we represent clients, we obtain and analyse the complete claim file to identify errors, bias, and unsupported assumptions that can be challenged.
Step 5: Reframe the Claim Around Functional Capacity and Sustainability
Sun Life often focuses on whether you can perform some form of work in theory, rather than whether you can work reliably, safely, and consistently in reality.
Strong evidence must clearly explain:
- Physical restrictions such as sitting, standing, lifting, or fine motor use
- Cognitive limitations including concentration, memory, and processing speed
- Psychological symptoms affecting attendance and interaction
- Fatigue, pain flares, and symptom variability
- The inability to sustain full-time work over time
At JEWELL RADIMISIS JORGE LLP, we ensure medical evidence directly addresses functional capacity and real world work demands, not just diagnoses or isolated clinical notes.
Step 6: Clarify the True Demands of Your Occupation
Sun Life often relies on generic job descriptions that fail to reflect the actual demands of your role. This is particularly damaging for professional, managerial, and cognitively demanding positions.
Employment evidence should address:
- Actual daily duties
- Cognitive and physical demands
- Productivity and performance expectations
- Safety-sensitive responsibilities
- Attendance and reliability requirements
Legal representation ensures Sun Life cannot rely on oversimplified descriptions to justify denial.
Step 7: Anticipate Common Sun Life Claim Tactics
Sun Life uses predictable strategies to support denials. Without experience, claimants often respond reactively rather than strategically.
Common tactics include:
- Cherry picking positive medical comments
- Overreliance on paper file reviews
- Suggesting transferable skills without meaningful vocational analysis
- Questioning treatment compliance
- Using surveillance selectively
Our firm anticipates these approaches and addresses them proactively, reducing Sun Life’s ability to rely on them to uphold a denial.
Step 8: Prepare a Comprehensive and Structured Appeal
An appeal must be more than additional documents. It must be a coherent, well-structured submission that addresses Sun Life’s stated reasons for denial directly.
A strong appeal includes:
- A detailed written submission
- Point-by-point responses to denial reasons
- Updated medical and functional evidence
- Vocational analysis where required
- Clear explanations of why work is not sustainable
This is where experienced legal preparation makes a decisive difference. Poorly structured appeals often fail even when disability is genuine.
Step 9: Know When Litigation Must Be Considered
If Sun Life maintains its denial after appeal, legal action may be required. At this stage, strategic decision making is essential.
Our team can help assess:
- Whether the denial was reasonable
- Whether further evidence will strengthen the case
- Litigation risks and timelines
- Settlement versus trial strategy
With over 100 years of collective experience, JEWELL RADIMISIS JORGE LLP understands when to negotiate and when to pursue litigation to protect a client’s financial future.
Frequently Asked Questions About Sun Life LTD Denials
Does Sun Life deny claims often?
Yes. Denials are common, particularly when claims involve chronic pain, fatigue, or mental health conditions.
Can I appeal a Sun Life denial on my own?
You can, but many claimants later discover that early missteps weakened their case. Legal guidance helps avoid this.
What if Sun Life says I can work another job?
This usually relates to the any occupation definition and requires vocational and functional evidence.
Does Sun Life conduct surveillance?
Yes. Surveillance and social media reviews are commonly used.
How long do I have to sue Sun Life?
Limitation periods vary by policy. Legal advice should be obtained as soon as possible.
Why Hiring JEWELL RADIMISIS JORGE LLP Matters After a Sun Life Denial
Sun Life is a large insurer with significant resources. Navigating a denial alone places claimants at a serious disadvantage. Legal representation ensures your evidence is properly framed, deadlines are protected, and insurer tactics are challenged.
At JEWELL RADIMISIS JORGE LLP, we combine over 100 years of collective experience with personalised representation that treats clients like family, not file numbers. We understand how Sun Life evaluates claims and how to push back effectively.
If your Sun Life long-term disability claim has been denied in Toronto or anywhere in Ontario, contact JEWELL RADIMISIS JORGE LLP for a free consultation. We will review your denial, explain your options, and help you take the next step toward the benefits you deserve with clarity and confidence.