What To Do When Your LTD Benefits Are Suddenly Cut Off in Nova Scotia

You have been relying on your long-term disability benefits to pay the mortgage, cover groceries, and hold things together while you deal with a serious health condition. Then one day, a letter arrives from the insurance company. Your benefits are being terminated. No real explanation. No conversation. If this has happened to you in Nova Scotia, you are not alone, and you are not without options.

Why LTD Benefits Get Cut Off in Nova Scotia

Insurance companies do not terminate benefits at random, but their reasons are not always as solid as they make them sound. Here are the most common triggers we see from clients across Nova Scotia.

The Own-Occupation to Any-Occupation Switch

This is the single biggest reason people lose their LTD benefits, and most policyholders do not see it coming. Most LTD policies define disability in two phases. For the first 24 months, you qualify if you cannot perform the duties of your own occupation, the specific job you were doing before you got sick or hurt.

After 24 months, the definition changes. Now you must prove that you cannot perform the duties of any occupation for which you are reasonably suited by education, training, or experience. This is a much harder test. The insurance company may decide that even though you cannot go back to your old job, you could theoretically work in some other capacity.

That "theoretical" job might pay far less, might not exist in Halifax or Truro or wherever you live, and might not account for your real-world limitations. But the insurer uses it as grounds to cut you off. If you are approaching the two-year mark on your disability claim, this is something to prepare for.

The Insurer Says You Can Work

Sometimes the insurance company will rely on a paper review of your medical file, done by a doctor who has never examined you, to conclude that you are able to work. Other times, they will send you for an independent medical exam and use that doctor's opinion to justify termination.

These opinions often conflict with what your own treating physicians say. Your family doctor in Truro, your specialist at the QEII in Halifax, the people who actually know your condition, may firmly believe you cannot work. But the insurer relies on their own hired expert instead.

Surveillance

Insurance companies operating in Nova Scotia regularly hire private investigators to conduct surveillance on claimants. If they capture video of you doing something they believe contradicts your reported limitations, they may use it to justify cutting off your benefits. The problem is that a few minutes of footage on a good day does not reflect what your life actually looks like. You can read about how surveillance evidence works in disability and injury cases.

Missed IME or Non-Compliance

If the insurance company asks you to attend a medical examination or provide updated medical records and you miss the appointment or fail to respond, they may use that as a reason to suspend or terminate benefits. Always respond to these requests, even if you disagree with them. Ignoring them gives the insurer an easy excuse.

Your Rights When Benefits Are Cut Off

Being cut off from LTD benefits does not mean the insurer is right. Courts in Nova Scotia and across Canada have consistently held that insurance companies must act in good faith when assessing disability claims. They cannot cherry-pick medical evidence, ignore your treating doctors, or apply unreasonable interpretations of policy terms.

Nova Scotia courts have been particularly clear on this. The duty of good faith means the insurer must give equal weight to evidence that supports your claim, not just the evidence that supports their decision to terminate. Courts also interpret ambiguous terms in LTD policies in favour of the insured person.

Understanding the common reasons insurers deny LTD claims can help you recognize whether your termination was legitimate or whether the insurer overstepped.

Internal Appeal vs. Going to Court

Most LTD policies have an internal appeal process. You can submit additional medical evidence and ask the insurer to reconsider their decision. Sometimes this works, especially if you have strong new medical documentation that addresses the insurer's specific concerns.

But here is the reality: internal appeals are reviewed by the same company that cut you off. The deck is not exactly stacked in your favour. Many people go through the appeal process and get denied again.

If the internal appeal fails, or if you want to skip it and go straight to legal action, you can sue the insurance company for breach of contract. In Nova Scotia, these lawsuits are typically filed in the Supreme Court of Nova Scotia. The court reviews the medical evidence independently and decides whether you meet the policy definition of disability. Courts are not bound by the insurer's decision.

If you have already been denied once, you can learn more about what to do when your LTD claim is denied.

Gathering the Right Medical Evidence

Whether you are appealing internally or preparing for litigation, the strength of your medical evidence will make or break your case. Here is what you should focus on:

• Updated reports from your treating physicians: Ask your family doctor and any specialists to provide detailed, current reports about your condition, your limitations, and why you cannot work.
• Functional capacity evaluations: These assessments, done by occupational therapists, measure what you can and cannot physically do. They provide objective evidence that is hard for insurers to dismiss.
• Psychological or psychiatric assessments: If your disability involves mental health conditions like depression, anxiety, or PTSD, a report from a psychologist or psychiatrist carries significant weight.
• Treatment records: Keep records of every appointment, every medication, every therapy session. Consistency of treatment shows the court that your condition is real and ongoing.

Time Limits in Nova Scotia

Under Nova Scotia's Limitation of Actions Act, the general limitation period for starting a lawsuit is two years. For LTD claims, this clock may start ticking from the date your benefits were terminated, or it could be calculated differently depending on the specifics of your policy and the circumstances of your case.

Do not wait too long. Two years sounds like plenty of time, but building a strong case takes months. If you are getting close to the deadline, speak with a lawyer immediately to protect your right to take legal action.

LTD and Other Benefits You May Be Entitled To

When your LTD benefits are cut off, it can feel like everything has been pulled out from under you. But there may be other benefits available. If your disability started with a workplace injury, you may have a claim through the Workers' Compensation Board of Nova Scotia. If you are unable to work at all, you may qualify for CPP Disability Benefits through the federal government. These do not replace your LTD, but they can provide some income while you fight the termination.

If your disability arose from a motor vehicle accident, you may also have Section B benefits available under your auto insurance.

How CLG Handles LTD Cases in Nova Scotia

At CLG Injury Law, we see LTD terminations regularly from clients across Nova Scotia. Insurance companies send out these letters knowing that many people will simply accept the decision and move on. Our job is to push back.

We review your policy, your medical records, and the insurer's reasons for cutting you off. We work with your doctors to build the strongest possible case. And if the insurer will not reinstate your benefits, we take them to court.

CLG Injury Law has offices in Halifax and Truro. We offer free case reviews for LTD claims. If your long-term disability benefits have been cut off, reach out. You do not have to face the insurance company alone.