Table of Contents

Glossary Terms: Overview

Below you will find a comprehensive list of disability lawyers' glossary terms and references. While terms may have short definitions, we encourage you to contact PW Lawyers for a more thorough understanding and educational background.


Terms A-J

Accident

Any event or circumstance resulting to injury or damages to the insured. It is also a term included in an insurance policy describing possible scenarios where coverage can be triggered.


Activities of Daily Living (ADL)

The term generally refers to people’s daily self-care activities such as eating, toileting, dressing, bathing, transferring, and maintaining continence.


Adjuster

A person from the insurance company or an independent adjusting bureau who settles claims. An adjuster conducts the investigation of the claim and determines the maximum coverage for the insured.


Advocate

A person who supports or promotes a cause or policy.


Appeal

A request made to a higher level of authority for review of a decision


Appeal Period

The timeframe in which one can file an appeal.


Bad Faith

A term that describes an obvious unfair or unlawful conduct that exceeds mere negligence.


Beneficiary

An individual designated to receive something, such as financial compensation or rehabilitation services, as a result of a legal claim or insurance policy.


Benefits Claim

Compensation or financial assistance for the loss of the insured provided by the insurer based on the terms of contract in an insurance policy.


Beyond Reasonable Doubt

The degree of proof needed in a proceeding for a claimant to prove a disputed claim.


Brief

A written statement outlining the argument of a case. This document often contains objective and legal arguments, as well as references to any laws or cases that are being relied on to support those arguments.


Caregiver Benefits

Compensation or financial assistance provided to caregivers (the insured) by their insurance company.


Claim

A statement of a legal right. (Ex. Insurance Claims state that you are entitled to a certain support due to injury)


Claim Denial

When a statement of a legal right is denied by the designated governing body. (Ex. An Insurance company denies an insurance claim filed by someone who has been in a car accident, and needs financial and medical support post-injury resulting from the accident)


Compensation

Money claimed by or ordered to be paid to a person as reimbursement for loss or injury


Compensatory Damage

Financial compensation given meant to make amends to the loss or damages sustained.


An agreement or permission granted, voluntarily, by a competent individual, either orally or in writing.


Consultation

The act of deliberating and discussing matters in order to reach a decision.


Contingency Fee

Fees payable to a lawyer only if a case is successful. The contingency fee is proposed before the case is pursued, and usually equals to a percentage of what a client recovers.


Contract

An oral or written agreement between parties in which there is a mutual promise to each other. (Ex. Your Insurance Company has a contract with you, and outlines what each party will do in the event of filing a claim)


Corporation

A term that refers to a company as a whole other person or entity.


Coverage

A set of conditions laid out in an insurance contract to serve as protection to the insured.


CPP Denial

Refers to the denial of a Canada Pension Plan claim.


Damages

Money claimed by, or ordered to be paid to, a person as compensation for loss or injuries


Death Benefits

Financial assistance payable by the insurance company in the event of the death of an insurance policy holder.


Deductible

An amount deducted from a loss before the insurer pays up the insured his total proceeds.


Denied Claim

The event in which a submitted claim has been denied or rejected by the insurer.


Deposition

A pretrial interview with a witness under oath for the purpose of obtaining evidence related to a lawsuit without the presence of a judge or jury.


Disability

A condition that renders a person unable to move or perform his daily living activities normally.


Disability Claim

A request for compensation or financial assistance in the event the insured has a disability or impairment.


Disability Dispute

A disagreement in terms of claim entitlement or coverage due to certain conditions of the disabled insured.


Disfigurement

A condition in which the damage has rendered the original object unrecognizable due to extensive damage.


Duress

Someone being forced to do something through physical, psychological or emotional pressure (Ex. This can involve pressuring an insurance holder to use their own finances and not their entitled insurance benefits to receive proper care/treatment)


Economic Loss

Damages incurred due to unforeseen economic changes.


Expert / Expert Witness

A person who has a developed skill set and knowledge base on a certain subject and is therefore accepted by the court as being able to form opinions on evidence presented during the case, as well as to assist the judge. An expert may also aid in supporting an insurance claim, such as a Doctor, OT, PT, Social Worker, etc.


General Damages

Damages for non-financial losses suffered by a claimant. Examples of such include pain, suffering, and disfigurement.


Health Care Expenses

Expenses incurred for paying hospitalization, medical bills, and caregiver aid.


Impairment

The loss of mental or physical functions, temporary or permanent, due to illness or injury.


Affirmation to be requested by a medical professional from the patient before performing any kind of medical procedure or treatment.


Injured

An individual who has incurred physical or mental damage due to an accident.


Insurance

An agreement between an insurance company and an individual or entity written on paper describing the duty of the company to reimburse the individual for loss or damages with the condition that the individual has provided considerable amount in the form of premiums.


Insurance Benefit Claim

An entitlement to an insured for loss or damage described in the insurance policy.


Insurer Examination

An assessment conducted to determine the soundness of a claim.


Jurisdiction

The official power or legal authority to make legal decisions and judgements.



Terms K-S

Lawyer Fee

Compensation given to a lawyer for legal services.


Liability

The legal responsibility or a financial obligation


Limitation Period

The time limit for filing an insurance claim, appeal etc. Limitation period also is a legal term referring to the required timeframe for commencing or filing a legal proceeding.


Limitations Act

A Canadian law that governs and explains the allowable limitations imposed on an insurance agreement between the insurance company and the individual or entity.


Long Term Disability

A condition determined under specific conditions within a policy to be long-term or lifetime. Most policies consider all diseases or conditions that are determined to result in death long-term.


Long Term Disability Claim

An assistance entitlement to an insured who has lost its ability to care for his/her self.


Long-Term Care

Any medical or physical assistance required by a person with disability or illness who does not have the capacity to car for his/her self.


Lost Wages

Loss of salary due to the insured being unable to work because of a disability or illness.


Material Witness

A person with knowledge or information of a subject matter that has a significant effect to the outcome of a trial.


Mediation

A negotiation or meeting between two parties to come up with an agreement and resolve the outstanding disputes.


Medical Benefits

Financial assistance given to the insured for use on medical expenses.


Mental Illness

A broad term referring to a condition wherein an individual is considered incapable of understanding or thinking within the lines of a normal or sane person.


Mentally Incapable

A condition in which a person loses the capacity to understand relevant information.


Negligence

The failure to take reasonable care and responsibility to prevent foreseeable harm to others.


No-Fault Insurance

This is a type of insurance in which the insured is reimbursed by the insurer regardless of who caused the fault that resulted to the losses. It is similar to a first-party coverage but is a widely used term in Canada, United States and Australia to refer to automobile insurance wherein the insured and its passengers can be reimbursed without proof of fault.


Occupational Therapist

Skilled workers that treat injured, disabled or ill patients through therapeutic methods.


Optional Benefits

Additional benefits an insured can add or remove from his policy to increase or decrease his premiums.


Out-of-Court Settlement

An agreement or solution to a dispute without the intervention of the court or a jury. Most agreements are settled by giving an agreed sum of money to the plaintiff so he/she can sign a legal document waiving the rights to pursue the case.


Pain and Suffering

A general term referring to emotional and physical discomfort, or other non-quantifiable illnesses that a claimant can use to collect compensation from the negligent party.


Party

Any individual referred to as the defendant, plaintiff, cross-complainant, or cross-defendant in lawsuits.


Personal Injury

Refers to any physical or emotional illness that renders the insured incapable of normal daily function.


Physical Therapist (PT)

Trained and highly educated health care professionals who provide assistance to patients with disabilities for the purpose of lessening the pain and restoring mobile functions.


Physiotherapist (PT)

Trained individuals that help people with disability and injury to practice motor and mental skills, as well as help in managing pain and mental stresses.


Plaintiff

A person who brings a case, commences an action, against another in the court of law


Policy Team

The duration in which a policy is in effect or provides the insured cover.


Power of Attorney

An authority to act on behalf of another person in legal or financial matters. Also may refer to legal document that authorizes a person to make, on the grantor’s behalf, decisions concerning the grantor’s property and personal care. Allowance and boundaries of the Attorney’s power would be outlined and contained within the written document itself.


Pre-Claim Examination

An assessment or examination conducted by the insurance company or adjuster before approving or releasing claims.


Proof

Written statements with a standard format that prove the credibility of an insured’s claim.


Psychiatrist

Medical doctors that evaluate a patient’s condition to determine whether it is caused by physical, mental, or a combination of both and not psychiatric.


Psychologist

A professional who evaluates the mental condition and capacity of an individual.


Punitive Damages

Damages awarded to punish a defendant for their “purposely harsh, vindictive, or malicious behavior”. This amount often exceeds simple compensation.


Quality of Life

The general well-being of an individual.


Reasonable Care

A term used to refer to care needs an insured may require that are in line with the limitations outlined in the insurance policy.


Recovery

Also referred to as claim recovery. It is commonly called as subrogation and is a legal term referring to a situation wherein the insurer assumes the insured’s right to pursue a claim against a wrongdoer.


Rehabilitation Benefits

A compensation given to insured workers that have been injured in a work-related accident.


Remedy

Also known as judicial relief is the means in which a court imposes its will in the form of penalty, court order or right enforcement.


Representative

An individual acting as legal substitute with the full knowledge of the insured.


Settlement

An agreed amount by both parties paid to the plaintiff to settle a dispute.


Short Term Disability (STD)

A condition in which the insured cannot perform his duties due to disability or illness for a specified period of time.


Short Term Disability Claim

Compensation given to an insured who cannot perform his duties due to illness or injury and is therefore deemed incapable of earning income for daily life.


Social Worker

A skilled or trained individual that provides assistance to individuals and families to enhance their general well-being.


Special Damages

Damages intended to compensate a plaintiff for aggregated monetary loss. Examples of such include: lost earnings, medical bills, and repair costs.


Statement of Claim

A written legal notice presented to an individual from someone whom they have a disagreement with. These notices are usually written by a lawyer to present whatever claim the complainant has against the individual.


Statutory Accident Benefit

Compensation provided to accident victims as mandated by the laws of the state or the country.


Strict Liability

A person is held liable owing to the fact that an act has occurred. Proof of intent or negligence is required to seek strict liability compensation.


Subpoena

A legal document that compels a person to attend proceedings as a witness in a legal case, in order to give a testimony. Evidence may also be subpoenaed, submitted to a court of law, to help back up a claim made in court.


Summons

A legal notice issued to the plaintiff and defendant to commence a civil action or legal proceeding for the purpose of acquiring jurisdiction over a party.



Terms T-Z

Tort

A private or civil wrong doing resulting to legal liability.


Treatment Plan

A documentation tool detailing the steps provided to a patient for well-rounded health care.


Uninsured

A person with coverage or protection.


Vicarious Liability

The duty or responsibility of the principal resulting from the actions of its subordinates.


Waiting Period

Specific lengths of time that must pass before some or all of one’s health care benefits can begin.


Witness

An individual with first-hand knowledge or a crime or incident related to an investigation or lawsuit.


Workplace Stress

A state of mental and physical disturbance resulting from the loss of control of an individual in meeting the demands of his workplace.


Wrongful Death

A term referring to a situation wherein the death is caused by negligence or intentional harm.


Long Term Disability Lawyers

Our Toronto Disability Lawyers have success in making Long Term Disability Insurance Claims, Disability Benefits & Appeals, Insurance Claims, and Disability Claims. If your employer has cut your benefits, if you have an appeal, or would like to reclaim your health, contact us today. Insurance companies will try to take advantage of your situation as their financial gain. We're here to guide and help you understand what a Long Term Disability Lawyer is.

Disability Claim Lawyer Availability

We're available round-the-clock to offer injury victims a completely free consultation. If you have been seriously injured and would like to speak to an attorney, we will make arrangements to travel to meet you.


Paul Wilkins

Principal Partner

Paul is a member of the Ontario Trial Lawyer’s Association and the Advocates Society. Frequently involved in pursuing his clients’ claims, his areas of focus include statutory accident benefits, short term and long term disability benefits, disability claims and Canada Pension Plan disability benefits.

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