Insurance Claims

Your insurance company is supposed to help you but sometimes that help may be as forthcoming as you would like.  If your insurer has denied your claim, we prepare and advocate your case to a successful conclusion against your insurer.

Disability Claims

Many employed persons in Ontario are covered by disability insurance policies in the event they are injured or become seriously ill and cannot work. An individual may have a claim against their disability carrier if they are unable to work at the employment they were performing at the time of sickness or injury. However, after two years, many policies provide for entitlement to disability benefits only if the claimant suffers from an inability to engage in any occupation for which they are reasonably suited by education, training and experience. This is a more difficult test to meet and a claimant may or may not continue to qualify for benefits depending on the nature of the disability. In every case, the specific disability policy must be reviewed to determine whether there is a viable claim.

Motor Vehicle Accidents

In Ontario, if you have suffered injury in a motor vehicle accident, you should immediately apply for accident benefits through your own insurer. You may qualify for weekly income replacement benefits and may receive funding for rehabilitation services such as physiotherapy, massage therapy and chiropractic treatment from the accident benefits insurer. You may also have a claim for pain and suffering against the driver of the vehicle that is to blame in the motor vehicle accident if you suffer a permanent and serious impairment. You will meet this test if your injuries affect your ability to be employed, substantially interfere with your ability to continue in your pre-accident employment or significantly interfere with your activities of daily living. You may also be able to claim for income loss and claim for family members under the Family Law Act and other incurred expenses.

Fire Loss Claims

Property owners purchase insurance on their own properties to allow for peace of mind in the event they suffer damage to their property as a result of fire loss. In some situations, however, where there has been misrepresentation on the original application, arson, or failure to notify the company of a change in the use of the property, the insurer may deny a claim. The denial of a property insurance claim can result in serious financial losses for the property owner.

Life Insurance Claims

Life Insurance is purchased by individuals in hope that their family will be protected in the event of death. However, in some cases, claims can be denied by an insurance company on the basis that there has been a misrepresentation made in the application. In this situation, the insurance company will take the position that where a medical condition has not been disclosed or any other fact has been misstated, the claim will be denied.

Canada Pension Plan Claims

A claimant is entitled to Canada Pension Plan disability benefits if they have made sufficient contributions to the plan and if their injuries are “severe and prolonged.” Currently, in order to qualify for benefits, you must have contributed to the pension plan for four out of the last six years. Generally, benefits will be awarded where it is established that a claimant has a disability that appears to be permanent and the claimant is not competitively employable.

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Injuries & Accidents
Insurance Claims
Medical Malpractice