Ottawa mother sues Sun Life over revocation of insurance benefits

“I feel like my body is five times heavier because I’m so depressed, but I have to keep going because of my kids.”

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Amanda Jollymore slipped into a dark place late last year.

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Neurologists said her two-year-old daughter, Mia, would never walk or talk. After many trips to the hospital and a battery of tests, she learned that the little girl needed palliative care.

Jollymore’s depression worsened, her anxiety intensified. The Ottawa woman had been off work since May 2021 as she focused on her daughter and her own deteriorating mental health.

At the end of January, the next blow landed.

Sun Life, which approved Jollymore for long-term disability in August 2021, withdrew its coverage.

“It just made it worse,” Jollymore said tearfully in a recent interview. “I feel like my body is five times heavier because I’m so depressed, but I have to keep going because of my kids.”

Jollymore has now sued the insurance company. She filed a lawsuit in May claiming she was entitled to a long-term disability due to her depression and general anxiety disorder – diagnoses backed by her doctors – which do not allow her to work.

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The insurance company, for its part, denies that Jollymore is entitled to long-term disability.

In its defense, filed last month, Sun Life said Jollymore originally qualified for long-term disability in August 2021, when it approved her claim. The information sent by Jollymore at the time met the definition of being “totally invalid” as required by policy, the defense statement said.

But, after a review of medical reports on file and other information, Sun Life said Jollymore “no longer continues to meet the definition of ‘totally disabled’ or ‘totally disabled’ as defined in the policy” and terminated benefits on Jan. December 31, 2022, states the defense brief.

“We sympathize with Ms. Jollymore and her plight,” Sun Life spokesman Gannon Loftus said. “Our teams are looking into the matter and working with Ms Jollymore and her legal counsel to find a solution.”

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The defense does not specify what caused Jollymore to no longer meet the definition of being totally disabled, and Sun Life did not respond to detailed questions about his case, citing confidentiality.

Jollymore and his attorney, Albert Klein, said they don’t know what led to the revocation of his long-term disability coverage.

“Amanda paid these premiums for years thinking she had a safety net, some peace or mind, and then Sun Life arbitrarily decided on a whim that they weren’t going to cover her. “Klein said.

Jollymore’s daughter was born on March 4, 2020. Doctors noticed physical symptoms suggesting birth defects and referred her to the Children’s Hospital of Eastern Ontario in Ottawa, beginning her health care odyssey. health.

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Doctors examined every part of Mia’s tiny body. They examined his brain, looked at his blood and genetics, and did bone biopsies. Some thought she might have dwarfism, others thought it was a bone marrow problem.

“It was a grueling first few months,” Jollymore said.

At nine months old, Mia had infantile spasms and was diagnosed with a rare form of epilepsy. She contracted urinary tract infections, other times she caught a cold and her oxygen level dropped.

Mia was admitted to hospital 13 times in her first 18 months, Jollymore’s claim states. Doctors diagnosed the baby girl with a hole in her heart, severe farsightedness, low white blood cell count, global developmental delay, brain damage affecting her vision, frequent bouts of pneumonia and lung disease, among others problems. She feeds through a tube in her stomach and burps through a syringe.

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“She’s at the developmental level of a two-month-old baby,” Jollymore said.

Doctors also said Mia had an undiagnosed genetic syndrome.

“Whenever she’s admitted, it’s realistic that she won’t come home,” Jollymore said tearfully.

“Obviously it made my mental health very, very bad.”

Jollymore returned to work as a workforce analyst in March 2021 once her maternity leave ended. She worked remotely from her daughter’s bedside every day. She and her husband also have a 12-year-old son who needed love and attention.

“I wasn’t able to concentrate because I was constantly crying, late for meetings or calls,” Jollymore said. “I was making mistakes.”

She said she was exhausted, but couldn’t sleep, lived with a constant stream of headaches and had tantrums.

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Her doctor told her she was not in the right frame of mind to work, so she told her boss and the company approved her short-term disability leave. A few months later, Sun Life approved his application for long-term disability benefits.

“It was amazing,” Jollymore said. “I could focus on my mental health.”

She diligently followed Sun Life’s monthly requirements, providing medical updates and records, she said. She sought advice, tried various medical treatments and spoke with a support group for families with children with special needs.

But recovery proved difficult.

In January, a social worker told her that an examination had found nothing to support her claim that she was unable to work. His appeal to Sun Life was rejected.

“The decision actually made my mental health worse,” Jollymore said.

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Her husband works long hours in the restaurant industry trying to support the family while she takes care of Mia. They also took out a line of credit to pay the bills.

Jollymore said she tries to focus on the positives when she can.

They celebrate Mia’s “inchstones” – their version of milestones – such as a recent one where she can hold her head up high for three seconds.

Mia’s bright green eyes light up when she hears her dad’s voice and she “absolutely adores her brother.”

“We call her our warrior,” Jollymore said.

The overwhelming sadness that taints each day, however, is difficult to overcome.

“I spend my days cuddling with her and taking it all in because I don’t know how much time we have,” Jollymore said. “I am not good.”

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