For most Canadians, adding additional health care coverage may not be top
of mind. Critical illness insurance or catastrophic illness insurance
provides coverage outside of traditional health insurance plans.
Designated insurance plans are often avoided when it is difficult to justify
the cost even though the premiums are typically low. Critical illness
insurance does not necessarily have clearly defined parameters, which
can lead to incorrect interpretation. Those looking to file a claim should
note that even if you are diagnosed with a qualifying illness, your claim
may be denied. If you or a loved one has been denied coverage, contact
a JEWELL RADIMISIS JORGE LL.P lawyer. With over a combined 75 years of
experience serving the Toronto area and Ontario, our lawyers have the
knowledge you need to fight for the compensation you may be entitled to.
Call our firm at (647) 360-6685 or schedule a free case review using our online formtoday.
Critical illnesses require extensive medical care and attention due to
the patient’s inability to function as they did before the illness.
General health insurance can cover a portion of the necessary costs but,
overall, traditional healthcare policies are often inadequate when it
comes to terminal illnesses.
Critical illness insurance provides coverage for those experiencing one
or more of the following illnesses:
Despite a life-threatening medical diagnosis, critical illness insurance
claims may be denied if the policyholder does not meet specific qualifiers.
These conditions can range from the severity of the stroke or heart attack,
to the persistence of the damage, to a predetermined number of days the
policyholder must be ill, to the duration of survival after the initial
diagnosis.
For critical conditions like cancer, heart attacks, strokes, and those
that require organ transplants, many medical services might not be available
to the patient without critical illness insurance. This policy can often
help cover daily living expenses with a lump sum enabling the patient
to focus on recovery. Transportation costs, usually not covered by traditional
health care plans, are also taken care of and can include transportation
to and from treatment centers, lift installment, and retrofitting vehicles
to accommodate wheelchairs.
In 2020, several insurance companies even adjusted coverage to include
infectious diseases like COVID-19. However, despite adjustments, critical
illness insurance plans with allowances for COVID-19 are only available
based on a narrow set of circumstances that certainly do not include every
degree of infection. You should consult a lawyer to determine if you or
a loved one has coverage for COVID-19.
Have you filed a critical illness claim only to be denied? The specific
qualifications for critical health insurance leave many cases open to
denial. The most crucial step in filing a claim is to ensure that you have a
qualifying condition, and
your plan covers your diagnosis. Those seeking to file a claim should have paperwork detailing their diagnosis
ready to present. Any medical records documenting your condition could
be valuable to your case. Also, be sure to keep copies of all communication
with your insurance company.
If you or a loved one has had a claim denied, you can seek legal counsel.
Qualified critical illness insurance lawyers like ours can help interpret
your denial letter and/or review your policy. Schedule an appointment
with a JEWELL RADIMISIS JORGE LL.P lawyer to determine your rights and,
if you have a case, begin the process of pursuing legal action.
Give us a call at (647) 360-6685.
Claim denial and bad faith cases in Canadian courts have
changed since 2002. In this context, the nature of bad faith claims could be if your insurance
company does not fulfill its contractual obligations or is deceitful in
carrying out the terms. As recently as 2018, there was
a case involving bad faith in handling a disability claim resulting in punitive damages awarded to
the insured. Cases related to critical illness and disability do not always
have standardized award amounts for punitive damage.
If you have been denied a claim, our lawyers at JEWELL RADIMISIS JORGE
LL.P will assess the fairness of the denial letter, review your policy,
and create a strategy to help you get the compensation you may be entitled to.
Filing or appealing a critical illness claim can be tricky. If you believe
you have been wronged in bad faith, you may be able to take legal action.
Are you looking to appeal a critical illness claim in Toronto or anywhere
in Ontario? Choose a legal team with the knowledge and experience to give
you the sound legal advice you need. Contact JEWELL RADIMISIS JORGE LL.P
to find out if you or a loved one can file or appeal a claim.
We look forward to hearing from you. Contact our law firmtoday.
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