Life Insurance Claims

In Canada, life insurance serves as a safeguard for individuals and their loved ones, offering financial protection and peace of mind during challenging times. It is typically purchased to cover various expenses such as funeral costs, outstanding debts, mortgage payments, and to provide for the financial well-being of dependents left behind.

Insurance companies have an obligation to honour legitimate life insurance claims, and can’t deny claims without proper justification. Unfortunately, there are instances where insurers wrongfully deny valid claims, causing distress and financial hardship for the claimants.

The personal injury and life insurance lawyers at Samfiru Tumarkin LLP have proven experience handling insurance claim disputes. If your life insurance claim is denied, or you simply have questions about the claim process, our team can provide valuable legal assistance and guidance. Our firm will review the policy, investigate the circumstances surrounding the denial, and ensure that the beneficiaries get the proper compensation they are legally entitled to.

Continue reading below to learn more about life insurance claims and how you can get the help you need if your claim for compensation is denied in Canada.

BASIC INFORMATION

What is life insurance?

Life insurance is a form of financial protection that individuals in Canada can purchase to provide financial support to their surviving family members in the event of their death.

It functions as a contract between the policyholder and an insurance company. Under this agreement, the policyholder pays regular premiums to the insurance company, and in return, the company promises to provide a predetermined sum of money, known as the death benefit, to the designated beneficiaries upon the policyholder’s death.

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What does life insurance cover?

The death benefit provided by the insurance company can be used by the beneficiaries to cover various expenses and financial obligations that may arise after the policyholder’s passing. These expenses often include:

• Funeral and burial costs
• Outstanding debts such as mortgages, loans, or credit card balances
• Everyday living expenses like rent, utilities, and childcare

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What are the different types of life insurance policies?

In Canada, life insurance policies are available in various forms, including term life insurance and permanent life insurance.

• Term life insurance provides coverage for a specific period, typically 10, 20, or 30 years.
• Permanent life insurance offers lifelong protection. This type of policy also accumulates a cash value component that policyholders can access during their lifetime.

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How much does life insurance cost in Canada?

The cost of life insurance in Canada can vary significantly depending on several factors. Here are some key factors that can influence the cost of life insurance:

• Age: The younger you are when you purchase life insurance, the lower the premiums will be. This is because younger individuals are typically considered to be at a lower risk of death.
• Health: Your overall health and medical history play a significant role in determining life insurance premiums. Insurance companies may require a medical examination or request medical records to assess your health condition. Individuals with pre-existing medical conditions or a history of certain illnesses may face higher premiums.
• Lifestyle habits: Certain lifestyle choices, such as smoking, excessive alcohol consumption, or participating in high-risk activities (e.g., skydiving, scuba diving), can increase the cost of life insurance. Insurance companies consider these factors when assessing the level of risk associated with insuring an individual.
• Coverage amount and type: The amount of coverage you seek and the type of policy you choose (term life or permanent life insurance) will affect the cost. Permanent life insurance is often more expensive than term life insurance due to its lifelong coverage and cash value component.
• Gender: On average, women tend to have slightly lower life insurance premiums compared to men. This is because women statistically have a longer life expectancy.

To provide a specific cost estimate, it is essential to consult with insurance providers directly. They will consider these factors and provide personalized quotes based on your circumstances and coverage needs. It’s recommended to shop around and compare quotes from multiple insurance companies to find the most suitable and cost-effective life insurance policy for your situation.

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What you need to know before you file a life insurance claim

Before filing a life insurance claim in Canada, there are several important things that someone should know:

• Review the policy: Carefully review the life insurance policy to understand the coverage and any specific conditions, exclusions, or limitations that may apply. Make note of the required documentation and deadlines for filing a claim.
• Contact the insurance company: Notify the insurance company as soon as possible after the insured person’s death. The company will provide guidance on the claim process, necessary documents, and any additional steps to take.
• Get Documentation: Gather all the necessary documentation to support the claim. This typically includes the death certificate, proof of identification for the claimant, the original policy documents, and any other relevant paperwork.
• Beneficiary information: Have accurate information about the beneficiaries identified in the policy, including their names, contact details, and relationship to the insured person.
• Claim forms: Accurately fill out the claim forms provided by the insurer, along with all requested information, including details about the deceased, the policy, and the beneficiaries.
• Talk to a lawyer: If you encounter challenges or complications with your life insurance claim, contact the insurance lawyers at Samfiru Tumarkin LLP immediately. We can provide guidance, review your claim, and advocate on your behalf.

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Why are life insurance claims denied?

Legitimate life insurance claims are wrongfully denied in Canada for various reasons. While each case is unique, here are some common reasons why life insurance claims may be denied:

• Misrepresentation: If the policyholder provided false or inaccurate information during the application process, such as concealing pre-existing medical conditions or risky lifestyle habits, the insurance company may deny the claim. It is crucial to provide honest information when applying for life insurance.
• Policy exclusions: Life insurance policies often have specific exclusions listed in the policy contract. These exclusions may include certain types of deaths or circumstances in which the death benefit will not be paid. For example, suicides within a specified period after the policy issuance may be excluded from coverage.
• Non-payment of premiums: Failure to pay premiums within the stated timeframe can result in a policy lapse, leading to a claim denial.
• Contestability period: Most life insurance policies have a contestability period, typically within the first two years of the policy’s inception. During this period, the insurance company has the right to investigate the accuracy of the information provided in the application. If material misrepresentations are discovered, the claim may be denied.
• Policy expiration: If the policy term has expired or the insured person passed away after the policy term ended, the claim may be denied.
• Lack of documentation: Insufficient or missing documentation can lead to claim denial. It is essential to provide all required documentation, including the death certificate, policy documents, and any other supporting paperwork specified by the insurance company.
• Disputes over beneficiaries: If there is a dispute regarding the designated beneficiaries or the validity of the beneficiary designation, the claim may be denied until the issue is resolved.
• Fraud or illegal activities: If the insurance company determines that the death of the insured person resulted from illegal activities or fraudulent actions, the claim may be denied.

While your insurance provider may refer to these or other reasons for denying your claim, you should never take their decision at face value. Have a life insurance lawyer at Samfiru Tumarkin LLP review your denial letter so we can understand their decision, explore your legal options, and get you the compensation you deserve.

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My life insurance claim was denied – what should I do?

If your life insurance claim has been denied, it is important that you do not appeal your denial. Instead, reach out to a lawyer at Samfiru Tumarkin LLP as soon as possible, as there may be time limits to respond to your insurer that you are not aware of.

Life insurance policies are highly technical contracts and they require a legal expert to interpret and understand the details of the policy. Our team of experienced lawyers can help you get the compensation you are owed.

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How a lawyer at our firm can help

A lawyer can help you interpret your life insurance policy and understand your rights. These policies are complex and written in confusing ways. We can help you cut through the legal jargon and understand what the best course of action is to ensure you get your benefits.

Don’t give up. That is what the insurance company wants you to do. They may also encourage you to appeal the denial. Do not go through the insurance company’s appeals process! In most cases, your appeal will be unsuccessful, and your insurer will use this tactic to run out the clock on your time limit to file a claim for full compensation.

If your life insurance claim is denied in Canada, you need to contact the experienced lawyers at Samfiru Tumarkin LLP immediately at 1-855-821-5900 for a FREE CONSULTATION.

Our firm has helped many people, like Florence Steele, resolve their life insurance disputes. We will review the facts of your situation, tell you if you have a case, and advocate on your behalf. Don’t let your insurer walk away with the money that they owe you in your time of need.

Get the advice you need, the compensation you deserve.