Understanding Your LTD Policy: A Plain-Language Guide

Key Terms in Your Policy

Your LTD policy is a contract between your employer's insurance plan and the insurance company. It defines what "disability" means, how long benefits last, what exclusions apply, and what your obligations are as a claimant. Understanding these terms is critical.

Own Occupation vs. Any Occupation

Own occupation: For the first 24 months, you qualify if you can't perform the essential duties of your specific job. Any occupation: After 24 months, the definition changes — now you must prove you can't perform any job you're reasonably suited for by education, training, or experience. This is the most exploited transition in disability insurance.

Exclusions and Limitations

Pre-existing condition exclusion: Most policies exclude conditions that were diagnosed or treated within a specified period (often 12 months) before coverage began. Mental health limitation: Many policies limit mental health benefits to 24 months. Self-reported symptom limitation: Some policies limit benefits for conditions diagnosed primarily by self-reported symptoms.

What Your Policy Actually Says About Benefits

Your policy specifies the benefit amount (usually 60-70% of pre-disability earnings), the elimination period (how long you must wait before benefits begin — typically 90-120 days), the maximum benefit period (often to age 65), and any offsets (other income sources that reduce your LTD payment, such as CPP disability benefits).

Common Traps

Ambiguous language that the insurer interprets in their favour. Obligations you may not know about (like reporting income changes or attending IMEs). Termination triggers buried in fine print. This is why having a lawyer review your policy is so important — we know exactly where the traps are and how to use the policy language in your favour.