Long Term Disability cases are unique in the world of personal injury law. For starters, they are contract cases (the policy of insurance). Every other case in the world of personal injury law is built on tort law. A dog bite, a slip and fall, a car accident case, an assault case, a product liability case. None of these cases are built on contracts. They are built on tort law. Yet, long term disability cases are predicated on the existence of a policy of insurance, and the wording contained therein.
The wording of those long term disability contracts isn’t written by your personal injury lawyer. Nor is it written by the claimant.
Rather, the wording contained in those long term disability policies is prepared by the long term disability companies themselves.
You would be naive to think that they are worded in such a way as to favour the long term disability claimant, as oppose to the long term disability insurer. Quite the contrary. Every word contained in those policies is there for a reason. The words are there to limit the insurer’s exposure and to maximize their recovery. The policies are drafted in such a way as to offer the least amount of money by way of benefits; while recovering the most amount in premiums.
That makes business sense. If you were running a long term disability insurance company, you would want to maximize your returns as well. A mantra of take in more than what you payout in claims leads to profits, which sits at the core to the existence of any for profit business. Insurance companies are in the business of making money. They are not charities.