My LTD insurer willfully broke the law for 10 months and I am planning to make this public

Disability Insurance
1

Hello

My name is Alex and I have bee disabled for more than 10 years. During the last 3 years my insurer has started to make my life a living hell: they harassed me, they interfered in my relationship with my doctor, etc… As a result, for the last 3 years, I have not been the same as before: I have been living in stress, despair and helplessness…

However, during the last year I have been able to document a willful and protracted law breaking on the part of my insurer. I am referring to the fact that my insurer has refused to provide me access to my medical file for close to 10 months.

This is not just simple misunderstanding: I have proof of having emailed at least 5 times the director of my LTD Carrier and asking him to provide me access to my medical file. Each and every time I would explain to him that my request is made under PIPEDA, and that, by refusing to provide access to my file he is breaking the law.

Having documented this law breaking, I am planning to go public: I have gathered over 2000 email addresses, belonging to the boards of directors of the top 100 Canadian companies. That is, I have spent close to a month of my life to gather the necessary information in order to be able to contact the executive layer of the wealthiest companies in Canada.

This is a link to the email I am planning to send. This email describes the law breaking, by presenting a summary of my interaction with the director of the LTD department.

This is the link to the documentation supporting my above email: it consists of a collage of my PIPEDA -based requests for access to my medical file.

About a month ago, just after I have put together my list of 2000 executives, I reached out to my insurer.
I told my insurer that I am going to make him face the consequences of his actions. In particular, I contacted the CEO of my insurance company and showed him:

  1. the email I am planning to send to 2000+ executives belonging to Canada’s top companies.
  2. the documentation supporting his Company’s law breaking
  3. the list of 2000 email addresses belonging to the Boards of Director of the wealthiest Canadian Companies

My Question:

I may be naive or unsophisticated, but I am puzzled by the lack of response from my insurer. How would you interpret it?

Does my insurer think that my publicizing of their law-breaking deeds will have no impact on their business? In my opinion that is a moronic thing to assume.

Or, maybe my insurer is so trapped into its own role, into its own vison of itself, that it cannot acknowledge its own law-breaking?

Maybe they are so cunning that they think their lack of a response will make me hesitate.

From my point of view, tough, I cannot wait to make these “people” face the consequences of their actions: I caught them breaking the law and I want to caution the business world in regard to the kind of deeds my insurer is capable of.

What am I missing here? My insurer’s lack of reaction is making me hesitate, but the more I wait the more I think that my insurer is paralyzed by a lack of options.

2

I am sorry to hear about the problems you’ve been having. It’s stress that none of us need.

I couldn’t open the draft email but regardless of what it says, your plan will have no effect on your insurer. It’s very unlikely that any of the emails will reach any of the executives - when their assistant reads far enough to figure out that it’s not about their business they’ll just throw it out.

I would suggest filing a complaint with the privacy regulator instead, if the main problem is their failure to comply with the privacy legislation. There may be some technical requirements of a freedom of information request that you haven’t complied with - I’d start by checking the website of the privacy regulator in your jurisdiction to make sure that you send a formal request.

Note that depending on who your insurer is, they may be governed by a provincial or a federal privacy regulator.

1 Like
3

Hi Caro

Thanks for the reply

Too bad you cannot open the links: I tried and it works for me. I really wanted feedback on the content.

I am pretty sure that the vast majority of those 2000 individuals do not have Executive Assistants: most of those people are Senior Managers and such.

The idea is that it is not the first time that my insurer has broken the law or the contract, however this time, his violation of the law is so clear and so prolonged he cannot deny it.

Now, if you read my previous posts on this forum, you will see a hint of the stress and despair I have been feeling during the last few years, As such, if now I finally have the chance to make these people pay for their illegal actions why not do it.

Do you know why these people were refusing to give me access to my file? Because, as it turns out, they have destroyed a good part of the documentation that my clinic has provided them across the years.

In any case, I am hoping to get feedback on the contents of my email, and on why my insurer acts as if nothing has happened. Yours is a good guess: my insurer might think that they will be no impact upon their business future.

4

Really sorry to hear how much pain your LTD insurer has put you through. Feel for you.

My thoughts are the following:

  1. The Insurance company hasn’t acknowledged you because they just don’t care, or they have taken notice and have opted to come after you with a libel lawsuit the moment you hit send. Most corporations take the “best defense is a strong offense” tactic. Make sure your facts in the email (sorry can’t open your link) are purely accurate facts with no slandering opinion added (no matter how justified your comments are). Also, unless you’ve got a media outlet (CBC, Global, CTV, etc) with you on this, then your crusade will likely land on deaf ears, and possibly get in you tied up in court, regardless of how right you are. If a media outlet isn’t interested in supporting you on this, then I’d say you are just setting yourself up for a world of hurt. Media outlets usually love going after the “big bad insurance companies”…it makes for good news ratings…so if they aren’t interested in what you have to say, then I doubt anyone else will be.

  2. Unless you have some of type of personal relationship with any these 2000 email recipients, it’ll just get sent to their trash folders. As a director myself, that’s exactly what I’ve done with unsolicited emails of this type I’ve gotten frequently in the past. We get them all the time.

  3. I’m assuming your LTD insurer has already cut your monthly benefit payments. If not, prepare yourself to have your payments promplty end the moment you hit send. I can’t imagine any insurance company continuing a contractal arrangement with anyone who is sending emails about “how bad they are”, even if you are 100% correct.

  4. Prepare to defend yourself against a defamation lawsuit (lawyers aren’t cheap) if there is any “weakness” in the accusations you are about to make against them. I’d talk to a lawyer before hitting send. You may think you have a rock solid position, to later find you’ve stepped in a total mine feild with legal precedent going against you.

  5. If your LTD insurer has cut your benefits, you’d be far better off hiring a specialized LTD lawyer (on a contingency basis) to issue a legal claim against the insurance company and take it all the way to court. If you are justified a judge can smack them with HUGE financial punitive damages for acting inappropriately that will definitely hurt their reputation and set a strong precedent.

I’d seriously think again about taking the action you are proposing. Anyways, that’s my 2 cents worth. Lets us know how it turns out.

Buckets

1 Like
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Hi Buckets

Thanks for your reply.

They have not cut my benefits. Not for lack of trying.

Anyway, the point is that I am tired of living in fear.

I really think I am onto something here. My approach to this “going public” is as follows: we have this insurance company, which is actually U.S. -based, and which thinks it can break the laws of Canada at will, going so far so as to deny a PIPEDA based request for 10 months.

In other words, what we have here is the case of a disabled Canadian citizen, living in Canada, reaching out to an audience of Canadian- headquartered Companies, telling then to beware this “Canadian Law”-breaking U.S.-based insurer.

This audience is huge: the combined market cap of the 100+ companies I would reach, amounts to 2 trillion US $. If even one or two companies I will contact turns away from dealing with my insurer, then I feel I reached my goal.

And, in any case, rather than live in fear I would rather take my chance, and worst came to worst, move to Europe, where I have kin.

What’s wrong with my email? I am able to access it at will: it is a pdf uploaded to my OneDrive. It would be great to get some feedback in regard to its content.

6

I doubt there will be any libel suit; I unfortunately also doubt that the letter will have any effect at all. I don’t think it’s capable of providing you with any relief from the fear of losing your benefits which sucks but can’t really be changed. I was responsible for the annual insurance renewal at my employer and like Buckets this type of thing went into the trash.

Also re moving to your relatives in Europe, check your policy to make sure that you can still receive benefits while living outside of Canada, many policies require that you live here in Canada to receive benefits.

7

Hi Caro

I will not receive my benefits while in another country.

As in regard to fear, allow me to clarify: when I say that I am tired of living in fear, I mean I am tired of living in uncertainty, in a constant state of stress.

The income is what keeps me paralyzed, I want to get my disability, and in the process I am bound to these leeches, these heinous human beings.

My hate for these people, for what they have done to my sense of self, and to my mental well-being is so much, that if I knew that, (by publicizing their behavior,) I could hurt them badly, I would do so even if I have to give up my benefits. - I am not talking about exaggerating or distorting their behavior, or maligning them, I am just talking about exposing their law-breaking in an effective manner, with the right words, to the right audience.

When I said I am ready to more to Europe, I meant that I would rather live in abject poverty that keep living in stress and fear of uncertainty.

I also do not think they people should be able to sue me for libel, but who knows? I am just summarizing my emails and presenting the facts.

I just wish people on this forum would check my email and tell me whether it sounds credible.

If I could reach just a fraction of the 2000 executives, it might be enough.

8

Great, if you’re just reproducing emails that they have sent to you, then they really don’t have any solid grounds for a libel suit against you.

If you don’t mind some advice (tell me to go a fly a kite, I’m ok with that) but “living in fear” is really a prison of your own making.

Honestly, if you are 100% ok with not getting any monthly LTD benefits, then start treating your insurance company like they have already cut you off. Be bold, brash, take your sweet time in responding, and be difficult…act like you don’t give a damn about their money. They are banking on the fact that you fear them. TAKE YOUR POWER BACK.

All you have to legally do is the bare minimum that is required by your LTD policy to maintain benefits (which basically usually means just getting reasonable treatment for your health condition, attend one IME, etc)…for everything else just say “Sorry , no I won’t be doing that be doing that.”.

Let them play whatever games they want too, the
more games they play, the better. The more they act in bad faith, the better. Their bad behavior is all stuff you should look forward too and document in great detail (send them a summary email every time they act in bad faith).

Eventually they WILL cut you off thinking their underhanded tactics have worked. Your cut off date should be a day you celebrate, because that’s the point you can now start a legal claim against them. There are many good LTD lawyers out there that will take on your case and not charge you a penny until you win your claim, and will take a percentage of the money owed to you by your insurance company upon judgment. As long as you have your doctor’s support that you are unable to work at any occupation, then you are good!

The legal system is where you can really cause your insruance company the maximim amount of pain. Since you’re “out for blood” blow through the mediation part of the process and take it to court (make sure the lawyers you interview to take your case on know this is your plan). Once before a judge, a good lawyer will mop the floor with any insurance company that has employed bad faith tactics. You’ll win your case and the judge will likely issue significant punatative damages against the insurance company, and this all goes into the public record. Since they cases rarely get to this stage the media will eat it up. The reputational damage caused by LOSING such a case in trial will immense.

Anyways that’s what I’d do, instead of sending out a mass email that likely 100% of the recipients will send to their trash folder.

Buckets

9

This is an update on my plan to go public with my Insurer’s law breaking

1) Premise

My insurer is aware of my accusations, consisting of the fact that it has broken the Law for 10 months straight. In particular, I have emailed my insurer both:
1. my "exposing email", which narrates how, for 10 long months, my insurer willingly and knowingly broke Canadian Law
2. my “supporting documentation”, which backs up the claims I make in my “exposing email”

My insurer is also aware that I have compiled a list of approximatively 2000 email of executives belonging to the top 100 Canadian Businesses, and that it is my INTENT to email these executives my proof that my insurer has violated the Law.

However, up to now, my insurer has said little in regard to my intent of going public, maintaining silence.

As I have said in my first post, I am unclear on why my insurer is silent: I think it may be a combination of:
1. desire not to appear weak
2. (mistaken) belief that very little impact will occur if I was to go ahead and make public its law breaking
3. desire to go to court and sue me for libel

2) News

I just reached out to my insurer’s CEO and wrote him that I cannot pass upon the opportunity of making public his Company’s Law Breaking.

I then invited him and his team to scrutinize both my “exposing email” and my “supporting documentation” for any phrases or wording hinting at libel.

This is what I wrote my insurer:

I need your Department to carefully review both of the documents submitted for your review and check for any statements you consider that are misrepresenting you, and/ or are conveying an unjust unfavorable impression of your actions.

My request applies to any tone, message or request I am making of you or your department. As well, if you feel I should add or delete any statements of characterization, feel free to ask me to do so.

I am even willing to replace the word “unlawful” from paragraph 1 of my “exposing email”, and exchange it for “contradicting the Canadian Law”.

I will consider any requests including any disclaimers you might want to add to my email.

So what do you think?

In the event I still receive no reply from my insurer, would my above request for feedback, which I emailed my insurer, protect me from any libel charges?

10

I was actually able to open your attachments this time and I don’t see anything very damning in there from what I briefly read. I personally think #2 is the reason as to why they have not responded. They really just don’t care that you might go public with this. Your threat of exposure carries little financial risk to them, IMHO.

I’m 100% on your side, and I actually lost interest in your heavily redacted attachments and didn’t fully read them… I still can’t imagine any company who is shopping for group LTD insurance will let your email persuade them one way or another to use this insurer or not…thats if they even read it. Like I said before, unless the email recipients know you, I can gaurentee every single one of them won’t even open your email, and will send it to there trash folder.

Don’t hold your breath on the insurer ever replying to your threat of exposure. They just don’t care. You seem hell bent on sending out the email, so just go ahead. There maybe some expensive consequences if you do, but I get the feeling you’ve already made up your mind to send it.

11

Sorry to hear about your pain. You have mentioned your LTD is from U.S.? We have different rules
in Canada. I recommend you check with labour board first and tell your story they will listen and they will tell you what to do once you report this to labour board (you will have a stronger case) they will take actions about your case, (I could not open or read your case) My sister had a case as in with the U.S company and she first inquire with the labour board and tell her what to do next. I also suggest you do not hire a lawyer since your wordings are appropriate instead if I were you and not sure if you are using the right wordings I would hire a professional proofreader cheaper than a contingency fee arrangement.
A professional proofreader only one time fee (not sure the cost). In my opinion you are ready for a good case yourself you can do it without a lawyer, Its seems to me you are a strong person and know how to fight back,
just do your study and you are ready the way you represent yourself above letter you can do it, just believe in yourself. My sister went to court without a lawyer and at the time her English was not as good but she had a strong belief why I hire a lawyer when I know I can do it myself. Another thing is
who cares if you loose the case, there is always options; you can alway apply for ODSP with good benefits. You can fully have the money for yourself when you win the case don’t let over half of your money go some contingency fee arrangement. Believe in yourself that you can do it on your own. The reason I tell you not to hire a lawyer is because in the court and when you represent yourself without a lawyer
the judge will be on your side 100% why? The nerve!! you step into the court fighting for your right without a lawyer is %100percent case won. My sister is a living proof SHE WON HER BATTLE believe it or not, just don’t over dress, dress as you normally go to dr’s appointment. Hope this helps a bit!! Maybe your opening statement will be Im sorry your honour I have no lawyer I am disable and I cannot afford to hire one so I’m here in front of you to here my side of story…(of course you can choose your opening statement CLOSING statement I understand your honour that I could loose this case for not hiring a lawyer but I gave my best shot not to loose my benefit as I have no other income so I am her to fight for my right but mine is just a sample) Also read about opening and closing statement so you will have idea of a sort of a becoming lawyer for yourself.

12

Why wouldn’t you just sue them if they are breaking the law?
A lawsuit seems to be more pressure.

13

So what did you end up doing?