Disability Insurance Lawyer in Quebec: Challenge a Denial of Benefits With Nothing to Pay Upfront
As your disability insurance lawyer in Quebec, Accident Solution challenges denials, benefit terminations and payment delays. We read your policy, we build the medical evidence, then we negotiate with the insurer or we sue. Our fees are contingency fees: nothing to pay until we obtain your benefits. Free consultation, answer within 24 hours.
The insurer decisions we challenge
We take the contest from the first notice of denial through to judgment. These are the disability benefit decisions our expert lawyers overturn most often.
The initial denial of the claim, on the grounds that the medical evidence is insufficient or that an exclusion in the contract applies.
The termination or interruption of benefits after 24 months, when the insurer switches the definition of disability and refuses to keep paying because you could hold some other job.
The reduction of the payment following an offset against a public plan, a questionable deduction or a miscalculation of your income.
The processing delay that leaves you with no income replacement for months.
The disagreement over the degree of disability, when the insurer recognises a partial disability where your file establishes a total disability.
The denial based on a pre-existing condition, on an alleged non-disclosure or on a supposed misrepresentation at the time of underwriting.
The pressure to return to work, or an imposed career change your health does not allow.
The denial opposed to a self-employed worker covered by an individual policy.
The denial based on the insurer’s own medical assessment, which contradicts your treating physician.
The denial for failure to cooperate, invoked because you turned down an assessment, a rehabilitation program or a request for documents.
A written denial is not a final decision. It is the starting point of your recourse, and the prescription clock begins to run the moment it lands.
Salary, mortgage, group and public disability insurance
Private and group plans
We act on individual private insurance as much as on employer group insurance, in short-term disability (STD) as in long-term disability (LTD).
Mortgage disability insurance follows the same logic: your home loan is what is at stake, and every month of incapacity without coverage is paid for in penalties. Bring your policy to the first call and we will read the clauses with you.
Public plans: QPP, CPP and Employment Insurance
We also prepare and contest your disability pension applications under the Quebec Pension Plan (Régime de rentes du Québec, RRQ) and the Canada Pension Plan (CPP), along with your Employment Insurance sickness benefits, payable for up to 26 weeks. Retraite Québec requires a disability that is both severe and permanent, meaning you are incapable of holding any substantially gainful employment.
An unfavourable decision is contested by filing a request for review within 90 days of the date it was sent, then before the Administrative Tribunal of Québec (Tribunal administratif du Québec, TAQ) within 60 days. These deadlines are short and they cannot be recovered.
How we handle your disability insurance claim
Free consultation and a read of your policy
We go through your insurance contract, the denial letter and your medical reports. You leave with an honest assessment of your chances and with the deadlines that apply to your situation. No commitment, no charge.
Building the medical evidence
Our occupational health and safety (SST) experts and our partner lawyers assemble the medical file the insurer demands, then the counter-expertise that answers its own. One precise medical report, dated and followed over time, carries more weight than ten pages of argument. This is almost always the stage where a disability file is won.
Formal demand letter and negotiation with the insurer
We remind the insurance company in writing of its obligations, including its statutory payment deadline. Many files settle right here, with no trial and no hearing. A formal demand letter (mise en demeure) drafted by a lawyer changes the tone of the exchange, and insurers read it differently.
Court proceedings
If the insurer maintains its denial, we file suit and we represent you at the hearing. You do not have to face the insurance company’s counsel and experts on your own, and we prepare you for the hearing well before the date.
Your file deserves a lawyer’s read before the deadlines run out
Answer within 24 hours, anywhere in Quebec. We travel to your home if your health requires it.
Our contingency fees: you pay only if we win
On disability insurance files, we work on a contingency fee basis. You advance nothing: our fees are due only if we succeed and your disability benefits are paid.
Denying a claim costs an insurer very little. Contesting it should not cost you your cash flow: you keep your money while we carry the risk of the litigation.
For other mandates, we also offer flat fees, percentages and instalment payments. Our blog covers legal costs and insurance disputes in more detail.
Why trust Accident Solution with your file
A Quebec Bar lawyer or an administrative appeals expert
Our hybrid model lets you choose: representation by a lawyer of the Quebec Bar (Barreau du Québec), or by an administrative appeals expert at a lower cost. Few firms in Quebec offer that flexibility. Meet our team of lawyers, led by Me Robert Astell, a member of the Quebec Bar since 1995.
A legal and medical team under one roof
Our expert lawyers work alongside our SST experts, without outsourcing the medical evidence. Thirty years of combined experience in administrative law and in litigation against insurers.
We come to you
Recovery, reduced mobility, a remote region: home visits are part of the service, and your household’s financial security should not depend on your ability to get to an office. The initial consultation stays free and without obligation, and you get an answer within 24 hours.
The deadlines that can extinguish your recourse
A disability file is lost on a date more often than on the merits. These are the clocks running while you wait for an answer from your insurer.
| What is at stake | The deadline | The source |
|---|---|---|
| Suing your insurer in court | 3 years from the day the right of action arises | Civil Code of Québec (Code civil du Québec), article 2925 |
| Reporting the loss to your insurer | As soon as you become aware of it | Civil Code of Québec, article 2470 |
| Receiving payment after your proof of loss | 60 days | Civil Code of Québec, article 2473 |
| Getting a final answer to a complaint against the insurer | 60 days, 90 days in exceptional circumstances | Regulation respecting complaint processing and dispute resolution in the financial sector, section 14 |
| Asking Retraite Québec to review a decision | 90 days | Retraite Québec |
| Contesting the review decision before the TAQ | 60 days | Retraite Québec |
Your policy can also impose its own internal deadlines, which are shorter. That is the first thing we check when we open your file.
Already receiving benefits from a public plan?
An insured person can draw on several sources of compensation at once, and insurers almost always deduct one from another. We coordinate your claims so that the deduction applied is the one the contract allows, not the one the insurer prefers. Your rights do not add themselves up on their own, they have to be coordinated.
One file, several plans
Our other service lines often touch the same file:
- CNESST lawyer for an employment injury handled by the Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST)
- SAAQ lawyer after a road accident
- IVAC lawyer for a victim of a criminal act
If you are in the city, our Montréal disability insurance team receives you at 408 rue McGill.
Disability insurance lawyer in your city
We plead everywhere in Quebec, out of our Montréal and Québec City offices, in person, by phone or at your home. Choose your city to reach the team that serves it.
Frequently asked questions about disability insurance
What is disability insurance?
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It is financial protection that pays you a replacement income when an illness or an injury prevents you from working. It comes from a private insurer, from an employer group plan or from a public plan such as the Quebec Pension Plan, and the benefit is often non-taxable, depending on who paid the premium. The detail of your coverage is set out in your contract.
What is the difference between short-term and long-term disability?
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Short-term disability covers a temporary absence and runs out after a period fixed in the contract. Long-term disability takes over and can continue far longer, depending on the policy. The transition from one to the other is a frequent point of denial.
What is the elimination period?
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It is the waiting period between the onset of your disability and the first benefit payment. Its length is set by your contract and varies from one policy to another. A longer elimination period lowers the premium, but it leaves you without income for longer.
My insurer stopped my benefits after 24 months. Is that legal?
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Many policies change the definition of disability after an initial period: it is no longer about your own occupation, but about any reasonable occupation. That occupation still has to actually exist and match your training, your experience and your previous earnings. A termination based on an abusive reading of that clause can be contested.
How long do I have to contest a denial of benefits?
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Recourse against an insurer is prescribed by three years where the law does not fix another period, under article 2925 of the Civil Code of Québec. Your policy can nevertheless impose a much shorter internal review deadline. Have your denial letter read quickly rather than letting the clock run.
Can the insurer require me to undergo a medical assessment?
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You have to inform the insurer of the circumstances of the loss and provide supporting documents, and most contracts provide for a medical assessment. That does not make its report unchallengeable. We produce a counter-expertise and we attack the methodology when it is incomplete or slanted.
Are depression and burnout covered?
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Yes, subject to the terms of your contract. Insurers often contest depression, burnout and fibromyalgia on the grounds that those diagnoses rest on few objective markers. Well-built medical evidence, longitudinal and documented, is what makes the difference in these files.
Can I file a complaint against my insurer?
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Yes. The insurer must send you a final answer no later than the 60th day after it receives your complaint, or the 90th in exceptional circumstances. You can then ask for your file to be transferred to the Autorité des marchés financiers, which examines it without being able to compensate you in the insurer’s place.
How much does a disability insurance lawyer cost?
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On these files, nothing upfront: our fees are contingency fees and become due only if we obtain your benefits. The initial consultation is free and without obligation.
Have your denial read by an expert disability insurance lawyer
Free consultation, no obligation, answer within 24 hours. You pay nothing until we have obtained your benefits.