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Sun Life Disability Claims Lawyer > Sun Life Disability Claims Lawyer

Experienced Sun Life Disability Claims Attorneys

Sun Life Financial is a diversified international financial services organization focused on providing financial solutions to businesses as well as individuals throughout their lifetimes. Sun Life also offers disability insurance. You bought your Sun Life disability insurance policy with the promise that Sun Life would be there for you and your family on the chance that you became disabled and unable to work. If you are having issues with your Sun Life Disability claim, contact our Sun Life Disability Claims Lawyer, Nancy Cavey, today.

Sun Life’s History

Sun Life Financial, Inc. is a Canada-based financial services company largely known for offering life insurance policies. It got its start in 1865 and now ranks number 277 on the Forbes Global list. It sold its first group life insurance policy in the United States in 1924 and in 2009 began an aggressive marketing campaign in the United States using sun-themed naming rights.  In fact, it purchased the naming rights for the Miami Dolphins stadium in 2010 which expired in 2016.

Group short and long term disability insurance policies are underwritten by Sun Life Assurance Company of Canada based in Wellesley Hills, Massachusetts. All too often, Sun Life rips the financial rug and safety net from under its disability insurance policyholders.

Common Tactics Used by Sun Life:

  • Uses in-house nurses to review medical records and reach medical conclusions about the policyholder’s restrictions and limitations even though those nurses may have no training in or qualifications to render any opinions about the policy holder’s medical conditions,
  • Uses biased medical peer review providers to create medical justifications for a claim’s denial,
  • Uses surveillance to discredit the policyholder’s complaints, and
  • Uses in-house vocational evaluators to misclassify the policy holder’s occupation, perform questionable transferrable skills analysis and misinterpret the wages of and availability of other occupations it will claim the policyholder can do to justify the denial or termination of benefits.

Courts Across the United States Have Criticized How Sun Life Handles Disability Claims

Sun Life is known to make endless and multiple requests for medical, financial, and vocational information before it figures out a way to deny benefits. This delay and denial strategy drains the policy holder’s bank accounts as they try to stay financially afloat.

Sun Life rarely tells a denied policyholder the real reasons the claim was denied. Sun Life uses “liar for hire” doctors who give them the ammunition it needs to justify a claim’s denial or termination. You need an experienced lawyer, like Nancy Cavey, who battles Sun Life daily. Don’t think that Sun Life doesn’t play the claims delay, denial, or termination game with individual disability policies. They absolutely do, and the policy benefits at stake are often much high so there is much more to lose if you aren’t represented by an attorney.

An Experienced Attorney Will Help You with Your Sun Life Claim by:

  • Reviewing your policy,
  • Reviewing your medical records,
  • Creating a pre-claim strategy to get your benefits on the initial application,
  • Appealing a wrongful denial or termination by writing an appeal letter 25 to 60 pages long that is the trial of your case and goes to Sun Life in a box,
  • Protecting you from aggressive claims handling by Sun Life, including the delay game, the, we need more information game, we want to take your statement game or we want to have you under an independent medical examination or FCE,
  • Aggressively litigating your case, if need be.

Don’t Make the Mistake of Facing Sun Life Alone

woman frustrated with claims processOnce the appeals process is exhausted (and that really means you are exhausted by the endless requests for information and battling with Sun Life), the only recourse is to file a lawsuit. If you purchased your insurance through your employer, the policy is most likely governed by the Employee Retirement Security Act or ERISA. Despite its name, the ERISA statute and regulations are NOT friendly to the policyholder.  You CANNOT add anything to the claims file after the last denial so all the Federal judge gets to see is what is in Sun Life’s file which is stuffed with medical and vocational opinions that are favorable to Sun Life. You didn’t know enough to get the claims file when you appealed, didn’t know enough to add medical, vocational, or lay evidence to the file, or didn’t make the right arguments, you have all but destroyed your case.

An appeal of a denied Sun Life claim is the trial of your case. Taking on a tough insurance company like Sun Life is an endeavor for an experienced specialist. A federal judge will give Sun Life the benefit of the doubt because your Sun Life policy requires you to prove they are wrong and not the other way around. You owe it to yourself and your family to have an experienced disability attorney, like me, take on Sun Life. After all, this is about getting the disability benefits you deserve and you paid for. Some policyholders have bought their own disability policy through an agent and that is known as an individual disability insurance policy. The game is the same but the playing field is more level because any claims denial can be challenged in state court which is a friendlier place to be if you have to sue Sun Life.

Don’t think that Sun Life isn’t playing the claims delay, denial, or termination game with individual disability policies. They are, and the policy benefits at stake are high. There is much more to lose if you aren’t represented by a Sun Life individual disability attorney like me. If you are on the fence as to whether or not an attorney can help you with your Sun Life disability claim, the Law Office of Nancy L. Cavey offers free reports about different disability claims. Feel free to request them to answer any questions you may have.

What Types of Disability Policies Are Offered By Sun Life?

Each policy offers different rights and determines whether or not you are on a level playing field.

ERISA Disability Insurance for Groups

Through employers that are governed by ERISA, Sun Life offers disability policies. Sun Life ERISA policies generally have the following:

  • strict definitions of disability and occupation,
  • limitations on how long payment will be made for mental conditions or subjective conditions like  headaches, pain, fibromyalgia or chronic fatigue,
  • “other income” provisions that allow for a dollar for dollar reduction for the receipt of Social Security disability benefits, workers’ compensation benefits, and personal injury settlements, and
  • A “golden handcuff” on a judge that only allows for a claims denial or termination reversal if Sun Life’s decision is “arbitrary and capricious.”

Non-ERISA Disability Insurance for Groups

Group plans offered by a church or by a municipal employer are NOT generally covered by ERISA. The policy terms are much like those of an ERISA plan but there is one CRUCIAL difference: A claim’s denial or termination can be challenged in state court and new evidence can be submitted at trial.

State law courts are a much friendlier place for the policyholder than Federal court. You are entitled to a jury trial in a state law claim and not some Federal judge just making a decision based on Sun Life’s file stuffed full of things that are unfavorable for you!

Disability Insurance for Individuals (ID)

Private individual disability policies known as ID policies are without a doubt, the best, yet most expensive policy. The policy terms and coverage are broader and more generous. However, that means a high monthly premium and a lot of financial exposure that Sun Life has if you become disabled.

It isn’t uncommon for Sun Life to invoke a pre-existing exclusion or a medical condition policy rider right out of the box as a way to justify a denial of the claim from the beginning of the claim. That is just one reason why it is so important for a policyholder to contact me BEFORE they stop working and apply for benefits.

The Eighth Circuit takes an overly broad view of treatment. In Kutten v. Sun Life Assur. Co. of Canada, 759 F.3d 942 (8th Cir. July 21, 2014) the court ruled that taking non-prescription Vitamin A was enough to trigger the pre-existing condition exclusion and it qualified as “medical treatment.” Really? Would a doctor’s advice to take an over the counter supplement to avoid joint pain enough to apply the pre-existing condition clause if the policyholder developed arthritis and claimed an inability to perform their own occupation? Apparently in the Eight Circuit.

Sun Life fights an individual disability claim as hard, if not harder than an ERISA claim and if you are not careful, costly mistakes can be made during the initial application and appeal stages of a case.

Contact Our Sun Life Disability Claims Lawyer Today

As a nationwide disability insurance attorney, Nancy Cavey, often receives calls or inquiries from Sun Life disability policyholders. She is committed to representing policyholders whose disability claims have been delayed, disputed, denied, or terminated. If you are feeling overwhelmed and frustrated with the disability claims process, you don’t have to go it alone. Contact the Law Office of Nancy L. Cavey today to get the legal help you deserve.