The RBC Life Insurance Company (“RBC Insurance”) is part of the Royal Bank of Canada. It provides both group and individual disability insurance policies in Canada. RBC Life also took over many older disability insurance policies from Unum, Provident, and others.
This article discusses everything you need to know about RBC long-term disability benefits. It provides general information about policies and benefits as well as how to apply and appeal a denial of long-term disability benefits.
This article is part of our Ultimate Guide to Long-Term Disability in Canada.
RBC Long-Term Disability Benefits
RBC provides long-term disability benefits to organizations through group and individual insurance policies.
Employers buy group insurance policies to cover their employees. However, RBC is best known as a provider of individual long-term disability insurance. They provide these plans to self-employed professionals and business owners.
Many dentists, chiropractors, veterinarians, physicians, and business owners have individual long-term disability policies with RBC. But, RBC Insurance also took over many existing policies from other insurance companies, including Unum, Provident, and Paul Revere Insurance. Many self-employed professionals bought these policies, which are now held by RBC Insurance.
Depending on the plan, RBC offers some other perks. For example, they have back-to-work assistance, spousal benefits, and cost of living adjustments.
If you’re an RBC employee, your long-term disability benefits are provided through Manulife Disability. Although, it is possible you may also have a top-up individual disability insurance policy from RBC Insurance.
Short-term Disability Claims
RBC Insurance also provides short-term disability insurance to other businesses through group insurance plans. They offer different short-term disability plans. So, it’s important to get a copy of your employer’s group benefits booklets to understand your benefits.
If RBC Insurance denies your claim, you can do 2-3 internal appeals. If RBC Insurance denies all those appeals, then your final option is to bring a lawsuit against them for payment of short-term disability benefits.
Same with long-term disability, if you work for the RBC, your short-term disability claims will be managed by Manulife Insurance Company. Your application and appeals will be administered by Manulife.
Applying for RBC Disability Benefits
Applying for long-term disability through RBC will generally be the same process as other insurance companies. However, the exact process to apply may differ according to your policy. If you have a group insurance plan, ask your employer for the proper forms and steps to complete.
Before you apply, make sure you meet the requirements. They will be different for every policy, so make sure you check yours.
Some RBC disability plans have a waiting period or elimination period. In other words, after you apply, there might be a period of time that you have to wait before receiving your benefit. Generally, RBC’s waiting periods are between 60 and 90 days.
In most cases, you apply by submitting three forms: a claim form that you fill out, a medical form your doctor fills out, and a form your employer fills out. Generally speaking, you must also include medical documentation along with your application as well.
However, in some cases, you can get “base coverage,” which means you can get benefits without submitting medical evidence. But if you are looking to get full coverage, you must submit further documentation to get approved.
How to check your disability claim status
The best way to determine the status of your RBC disability claim is to contact the representative assigned to your case. If your claims representative does not respond to your inquiries, you can follow RBC’s complaint process. Try to work with the claims representative and use the complaint process as a last resort.
RBC Long-Term Disability Complaints
RBC has an internal complaints process. These are for complaints related to the service you have received. The process is as follows:
You first raise your issue with your claims representative, or you can call 1-800-461-1413 to submit your first complaint. If they do not resolve the issue, you ask them to escalate your concern to the Customer Care Office.
Contact information for the Customer Care Office:
Mailing information: PO Box 213, Station A Mississauga, ON L5A 4N9
Toll-free telephone: 1-888-728-6666 Toll-free fax: 1-888-844-3331 Email: [email protected] rbcinsurance.com
If the Customer Care Office does not resolve your complaint, you can contact RBC’s Ombudsman Office.
Contact information for the Ombudsman Office:
Mailing address: 20 Adelaide St. East, Suite 802
PO Box 29, Toronto, ON M5C 2T6
Toll-free (Quebec): 1-866-582-2088 olhi.ca
RBC Long-Term Disability Denied
In our experience, RBC Insurance can be aggressive in denying claims for professionals. So, you have to take this very seriously. They hire some of the best and most experienced lawyers in Canada. While many insurance companies look to cut costs, RBC Insurance is willing to pay more in legal fees. I believe one reason is that some of their older long-term disability policies pay benefits for life. This is an unusual feature that is in many policies RBC Life took over. Therefore, RBC Life has an unusually high financial incentive to deny these policies with “lifetime” benefits.
RBC Insurance may seek to have your long-term disability insurance policy declared void
Additionally, RBC will not hesitate to challenge the validity of long-term disability insurance policies. They have won the two leading court decisions in Canada on this area of the law. So, you should watch out for this tactic when you have an individual insurance policy from RBC. They won’t do this in all cases, but they will consider it in borderline situations. Borderline situations are those where it is hard to tell if you made an innocent mistake or if you intentionally misrepresented your situation. If you have a borderline situation, then what you say can greatly impact your ability to win benefits. Talk to a disability lawyer as soon as possible if you think you might be in this kind of situation.
RBC will seek to declare the policy void even if you have been paying premiums for many years. When you file a claim, they will get a copy of your historical medical records. Then, they will compare those records with the answers you gave on your original application to purchase the insurance. Their lawyers are good at making innocent mistakes look like deception or fraud. RBC has been successful in having courts declare long-term disability insurance policies void. It doesn’t matter if you meet the other requirements when this happens; they don’t have to pay because the insurance policy is deemed invalid. They will simply pay you back for the premium payments you have made, which is a small fraction of the benefits that would have been owed under the policy.
Why Do I Need a Long-Term Disability Lawyer for My RBC Insurance Claim?
In our experience, RBC Insurance has a greater willingness to take cases to trial as compared to other long-term disability insurance companies. Therefore, it is critical that you build a strong case early on. You must convince RBC that going to trial will not give the best outcome for them.
If you have an individual insurance policy, then you need to get legal advice early on in your claim. Many of these policies involve large sums of money. This means RBC Insurance has a financial incentive to deny or limit payments. If RBC Insurance denies your individual disability insurance claim, then you should seek legal advice immediately. RBC hires some of the best lawyers in the country to fight disability claims. These lawyers will seek to exploit any mistake or weakness in your claim.
It’s critical that you understand all the terms of your policy, including the differences between total disability, residual disability, partial disability, and presumptive disability. You need to know how RBC Insurance will seek to define your “own occupation” or “regular occupation.” It may not be as simple as you think. You also need to understand the difference between your regular occupation and gainful occupation. This is important because RBC may seek to approve your claim under different definitions of disability to limit your payments.
Resolute Legal disability lawyers have represented many people involved in appeals or lawsuits with RBC Insurance. We know their tactics and how to defend against them. Call us at (888) 732-0470 so we can get started on winning back the benefits you deserve.
Learn more by downloading a copy of my book below. Then fill out the form to request a free consultation. Let us review your situation and give you a free claim review. We can explain your policy and make recommendations to maximize your chances of success.