LTD Claim File Question


#1

I requested my LTD claim file approx 4 months ago and finally received it several weeks ago. I have several questions:

1.Do they give you all the information on the file FROM the date of the request and back? Or is it up to date until a short period of time before they send it. (meaning I think I am missing approx last 4 months)

2 There was talk of possible surveillance and cyber surveillance in the file. But I do not see anything in there that would indicate they have done this (no reports or pictures,ect) Is it possible they would hold that information back even though it is against the privacy laws of Canada?

Thanks for you time


#2

It is possible you are missing last four months as you indicated. It could be that they sent up to the date of your request or date the person put it together and it sat around before they sent it out.

They are supposed to give you everything and usually do in my experience. If there was surveillance in their file, they should have sent it. It is possible they would hold something back either negligently or intentionally. if you every sue them you will know for sure because their lawyers make sure all docs are provided.


David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.


#3

Thank you David for your reply.

If they did hold something back would not that be a breach of “the privacy act” of Canada. How would they go about defending that situation? It does not seem to me that they would have a leg to stand on in that case. But am no Lawyer that’s why I am asking.

I am approaching COD and would like to know if they have been watching me. Read many bad stories how people doing everyday life things where watched and then the resulting pictures/videos where misconstrued against them.

I thought they HAD to disclose these kind of things, as per the act, long before any litigation was taken.

Thanks


#4

I am not sure what province you are in as some provinces you would file a complaint with that office and not under PIPEDA. https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/02_05_d_15/

My experience with GWL is that they disclosed my spouses claim file within the 30 days (4 months is too long) but when we reviewed the claim file we would have to request pages that were missing. We could identify the missing pages as there would be a reference to an email exchange between his employer or a conversation that was missing. Sometimes it would say page 1 of 7–but we would only receive 3 pages–so they would send when we asked or refuse and claim commercial information.

When you request they are suppose to list any documents that they are refusing to release and the reason why. This did not happen for us.

They are also suppose to give the name of who to file a complaint to. This was not done either.

If you are approaching the COD date they will be reviewing your claim, likely 6-9 months before the COD.
You will be asked to provide your work history and education and typically requested to apply for CPP-D.

Your insurer or case manager likely has done a social media/google search on you but nothing worth documenting.

You will know if you have been or about to be under surveillance if you receive an activity form to fill out.

Just don’t write anything on the pages and keep the envelope it came in.


#5

Yes, they have an obligation to disclose the information, including any surveillance unless there is “contemplation of litigation.” There can only be contemplation of ligation if you are telling them you are getting a lawyer or have hired a lawyer. The privacy and freedom of information acts do have penalties for non-compliance with the act, which include fines up to $5,000. Certainly, there is civil liability beyond that for an insurance company because any intentional hiding of documents would amount to bad faith and could result in civil penalties for bad faith etc in the context of a lawsuit. Outside of a lawsuit, an insurer is probably only liable for penalties under the applicable Statue or Act.

If you fear non compliance with the disclosure you can take it up with the appropriate privacy commission and they have the power to investigate.


David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.