What does insurance dispute mean?
An insurance dispute means that a person who has a valid policy of insurance is in dispute with the insurer for benefits that are available under the policy of insurance.
This could be the payment of an Income Replacement Benefit, Short Term Disability Benefit, or a Long Term Disability Benefit for the person not being able to return to work or the job that the person was performing at the time of the loss.
This could refer to a dispute on the cost of replacement coverage for a building or contents following a fire loss or loss of a business.
An insurance dispute could also refer to the Insurer refusing to provide a duty to defend or indemnify the Insured due to an alleged violation of the policy of insurance.
What types of insurance claims does your firm dispute?
Our firm represents individuals and businesses that are involved in disputes arising from insurance claims. We cover the following insurance claims:
- Short Term Disability (STD) or Long Term Disability (LTD)
- Home Insurance Claims
- Business Insurance Claims
- Motor Vehicle Insurance Claims
Will an insurance dispute lawyer help me file my claim?
Yes. An Insurance dispute Lawyer would be able to gather up the important facts to your Claim. A review and read-over of the policy of insurance with the facts provided allow for our team at CRB Law to provide you with an up-front assessment of whether or not you have a legal basis to proceed with a Claim to dispute the denial from your Insurer.
Can I sue the insurance company myself?
There are a number of timelines, forms, Proof of Loss, and time limitations to follow in order to avoid having your Claim dismissed for delay or improper filing.
Our Lawyers at CRB Law have extensive experience with dealing with insurance companies and what documentation and timelines are required to make sure that any lawsuit against the Insurance Company is timely and that you are in the best position to maximize your outcome as against the Insurance Company.
Why should I hire an insurance claim lawyer?
An Insurance Claim Lawyer would be able to meet with you in person and provide a no-fee overview assessment of whether or not you have a valid claim. There are many expenses involved if you sue yourself and if you are not successful then the Insurer may go after you for recovery of costs.
An up-front and detailed analysis as to whether or not your Insurance Claim has merit and is one to proceed with is advisable to avoid any hidden risks or costs that you may face after a Court Proceeding.
What are my legal options if my claim is denied?
Your legal option if your Claim is denied is to consult a Lawyer at CRB Law so we can determine whether or not the denial was justified and the likelihood of your success if a Claim is disputed.
One option may be to negotiate a settlement of your denied claim without the need to start a lawsuit by litigation.
Another option may be to start the Court process through the filing of a Statement of Claim to seek a Declaration of Coverage and for recovery of the benefits that have been denied.
Insurance Claims Basics
Claims against your own insurer may be advanced where you hold a valid policy of insurance for your business, home or motor vehicle.
Types of Insurance Claims in Sarnia, Ontario
Short Term Disability (STD) and Long Term Disability (LTD) Claims
For individuals in Sarnia, this includes a claim from work interruption insurance that is allowable in the benefits through Short Term Disability (STD) or Long Term Disability (LTD). This is a policy of insurance as between the employee and the employer’s Group Insurer for being paid if not able to return to work.
Home Insurance Claims
A claim against your own Insurer as a result of damages to your home or rental may arise from incidents such as:
As a landlord or homeowner in Sarnia, you have paid insurance premiums and may have benefits available to you in case of a loss. Consult with an experienced lawyer from our firm to discuss your legal rights.
Business Insurance Claims
A claim against your own Insurer as a result of damages caused to your business may arise from incidents such as:
- Water damage
Your business will have paid for insurance benefits that may be available. A denial of a claim advanced through your Proof of Loss may result in the need to consult with a lawyer to discuss possible options.
Motor Vehicle Insurance Claims
A claim against your own Insurer as a result of personal injuries or property damage to your motor vehicle may arise from a collision in which you or the other driver is at fault.
Individuals in a motor vehicle accident may have a Claim as against their own Automobile Insurer for recovery of Income Replacement Benefits ( IRB) if not able to return to work or the payment of Medical Rehabilitation Benefits ( Med Rehab) if in the need for therapy, medications, devices, and other support for treatment arising from the injuries in the accident.
You may be required to look to your own insurer for claims involving personal injuries where the other vehicle did not carry valid insurance. Simply being hit by someone that did not have insurance does not mean you have no legal rights.
An experienced lawyer in the field of insurance claims in Sarnia can take you through your rights under your policy of insurance and determine if you have a valid legal claim.
The maximum deadline for a time limit for disputing claims of insurance in Sarnia would be up to 2 years from the date of the denial.
Common Causes for Insurance Claim Denials
Violation of a condition of coverage
The most common reason an Insurance Company denies a Claim for an individual with regard to payment of employment loss benefits is that the position of the Insurer is that the person is capable of a return to work and does not meet the disability definition that is in the wording of the policy of insurance.
Exclusion in the policy
On some claims, a denial may be due to an exclusion clause if there is illegal activity being performed at the time of the incident.
All cases and all facts are different. It is important to consider what the reason for the denial is and whether or not the facts of each case support this as a justified reason.
Insurance Litigation Process
There is a set timeline to start a lawsuit against your own Insurer in Sarnia. Our Team at CRB Law would be able to assist you in making sure that your Claim is timely and within a required statutory limitation period.
The usual process is the following:
- Review the insurance policy
- Review the damage that warrants the payment
- Build the case on your behalf
There is an arbitration or hearing process for some claims for denial of insurance benefits. There is an option for the commencement of a Statement of Claim to be issued for another denial of insurance benefits that would commence the litigation process.