Life insurance claims denied: Sivan Tumarkin with The Globe and Mail

Interview Summary

Millions of Canadians partake in life insurance. While it is not common for a life insurance claim to be denied, denials do occur and can have a significant impact on those possibly dealing with financial difficulties. Why would a claim be denied? If facing a denial, can Canadians choose to pursue legal action against the insurance company?

Sivan Tumarkin, an Ontario disability lawyer and Co-founding Partner at Samfiru Tumarkin LLP joined The Globe and Mail to discuss denied life insurance claims and legal options.

Interview Notes

• Incorrect information on an application: Tumarkin explained that the most common reason for claim denials is a misrepresentation of a client’s information. Despite this, misrepresentation cannot be the sole reason for a denial of life insurance. “If the claim is made within two years of purchasing the policy, the insurer needs to demonstrate that the misrepresentation is “material” – significant enough that it would have prevented them from either insuring the client or insuring them at the premium they were given.” Tumarkin went on to reiterate insurers have to prove the truth was deliberately misrepresented. “The legal bar for this is very high,” said Tumarkin.
• Unclear terms in a contract: Courts prefer the individual’s representation of terms outlined in contracts, Tumarkin noted, which can be advantageous for clients.“Sometimes we’re literally fighting over a comma, period or word in a provision, which could mean hundreds of thousands of dollars to our client,” Tumarkin said. “If we can show that the policy is ambiguous, the insurance company will most likely settle the case.”
• Safeguards put in place by the government: Tumarkin offered important insight for those unsure of their applications and missing deadlines. “An insurance company could say that your failure to meet their terms invalidates your policy,” said Tuamrkin, “but the law actually gives you some leeway on this. The courts have said that if you apply a little bit later, it’s not fatal to your case.”

Related Resources

For further insights and discussions related to life insurance claims explore the following resources:

• Ontario Life Insurance lawyers
• Sivan Tumarkin talks life insurance denial with Global News