If your insurance claim was denied, delayed, or underpaid, an insurance claim lawyer can help you understand your rights and challenge the insurer’s decision.
At Samfiru Tumarkin LLP, our disability and insurance lawyers help Canadians with denied life insurance claims, critical illness insurance claims, mortgage insurance claims, accidental death claims, and long-term disability claims.
Insurance companies often rely on policy wording, exclusions, medical records, application answers, or alleged misrepresentation to deny claims. A denial does not always mean the insurer is right.
➡️ Denied insurance claim? Contact Samfiru Tumarkin LLP for a free consultation with an insurance claim lawyer.
What Does An Insurance Claim Lawyer Do?
An insurance claim lawyer helps policyholders, beneficiaries, and families dispute unfair insurance denials.
A lawyer can review the policy, examine the denial letter, identify weaknesses in the insurer’s position, gather supporting evidence, and take legal action if the insurance company refuses to pay.
An insurance claim lawyer can help with:
- Denied life insurance claims
- Denied critical illness insurance claims
- Denied mortgage insurance claims
- Denied mortgage life insurance claims
- Denied mortgage disability insurance claims
- Accidental death insurance claims
- Long-term disability claim denials
- Insurance appeals and internal reviews
- Claims involving misrepresentation or non-disclosure
- Disputes over policy exclusions or benefit amounts
⚠️ Insurance deadlines can be strict. If your claim was denied, delayed, or stopped, get advice before assuming you are out of options.
When Should You Contact An Insurance Claim Lawyer?
You should contact an insurance claim lawyer as soon as your claim is denied, delayed, questioned, or put under review.
You should also get advice if the insurance company asks for more information, accuses you of misrepresentation, or says the claim does not meet the policy definition.
Speak with a lawyer if:
- Your insurance claim was denied
- The insurer says the policy does not cover the claim
- The insurer says the policy lapsed or premiums were not paid
- The insurer says there was misrepresentation or non-disclosure
- The insurer is delaying payment without a clear reason
- The insurer is asking for medical records or more documents
- There is a dispute over who should receive the benefit
- A bank-sold or mortgage insurance claim was denied after death, illness, or disability
- You are worried about missing an appeal or lawsuit deadline
Do not rely only on the insurer’s explanation. A lawyer can review whether the denial is legally justified.
Types Of Insurance Claims We Handle
Our insurance claim lawyers focus on disputes involving disability, life, critical illness, mortgage, and related insurance benefits.
Life insurance claims
Life insurance is meant to provide financial support to beneficiaries after the insured person dies. When an insurer refuses to pay, families can be left without the benefit they were counting on.
Life insurance claims may be denied because of alleged misrepresentation, non-disclosure, policy exclusions, beneficiary disputes, missed premiums, or issues during the contestability period.
? Learn more about working with a life insurance lawyer or what to do if your life insurance claim was denied.
Critical illness insurance claims
Critical illness insurance usually pays a lump sum if the insured person is diagnosed with a covered illness and meets the policy terms.
These claims are often denied because the insurer says the illness does not meet the exact policy definition, the survival period was not met, the condition was excluded, or medical information was missing from the application.
? Learn more about working with a critical illness insurance lawyer or what to do if your critical illness insurance claim was denied.
Mortgage insurance claims
Mortgage insurance, creditor insurance, mortgage life insurance, and mortgage disability insurance are often sold through banks or lenders. These policies may be meant to pay off or reduce a mortgage if the borrower dies, becomes disabled, or suffers a covered illness.
Mortgage insurance claims may be denied because of post-claim underwriting, medical misrepresentation, policy exclusions, eligibility issues, or disputes over whether the claim meets the certificate or policy terms.
? Learn more about what to do if your mortgage insurance claim was denied.
Accidental death insurance claims
Accidental death insurance may pay a benefit if death results from an accident covered by the policy.
Insurers may deny accidental death claims by arguing that the death was not accidental, that an exclusion applies, or that another medical condition caused or contributed to the death.
Long-term disability claims
Long-term disability insurance provides income replacement when a person can’t work because of a serious injury, illness, or medical condition.
Insurers often deny LTD claims by saying the person is not totally disabled, does not have enough medical evidence, can return to work, or does not meet the policy’s definition of disability.
? For long-term disability claims, see our disability law services.
Why Insurance Claims Are Denied
Insurance companies deny claims for many reasons. Some denials are valid, but many can be challenged.
Common reasons insurance claims are denied include:
- The insurer says the condition or death is not covered
- The insurer says the policyholder made a mistake on the application
- The insurer says important medical information was not disclosed
- The insurer says the policy lapsed
- The insurer relies on an exclusion
- The insurer says the claim was filed too late
- The insurer says there is not enough medical evidence
- The insurer says the illness does not meet the policy definition
- The insurer disputes the cause of death or disability
- There is a dispute over the beneficiary
The denial letter should explain the insurer’s position. However, the reason given in the letter is not always the final answer.
⚠️ Do not accept a denied insurance claim at face value. The insurer may be relying on an incomplete file, a narrow reading of the policy, or a disputed interpretation of the facts.
Insurance Claim Denied For Misrepresentation Or Non-Disclosure
Misrepresentation and non-disclosure are common reasons insurance companies deny life insurance, critical illness insurance, mortgage insurance, and disability insurance claims.
This usually means the insurer believes the insured person gave incorrect, incomplete, or misleading information when applying for coverage.
The insurer may point to answers about:
- Medical history
- Smoking or alcohol use
- Previous tests or investigations
- Medications
- Mental health history
- Family medical history
- Income or employment information
- Dangerous activities or travel
A misrepresentation allegation does not automatically mean the insurer can deny the claim. The policy, application, medical records, timing, and wording of the questions all matter.
If your claim was denied for misrepresentation, speak with a lawyer before accepting the insurer’s decision.
Insurance Claim Denied During The Contestability Period
Many life insurance claims are reviewed more closely if the insured person dies within the policy’s contestability period.
During this period, the insurer may review the original application, medical history, and other information to decide whether the policy should pay.
A denial during the contestability period often involves alleged misrepresentation, non-disclosure, or incomplete application answers.
Families should not assume the insurer is right just because the death happened soon after the policy was issued. A lawyer can review whether the denial is supported by the policy and the evidence.
? Contestability issues often come down to what the application asked, what the insured person knew, what was disclosed, and whether the insurer had a legal basis to deny the claim.
Insurance Claim Delays
Not every insurance dispute starts with a denial. Some claims are delayed for weeks or months while the insurer asks for more documents, medical records, forms, or explanations.
Some delay is normal, especially if the claim is complex. However, an unreasonable delay can put families and disabled claimants under serious financial pressure.
If the insurer keeps asking for new information without making a decision, or if the claim appears to be stalled, an insurance claim lawyer can help push for answers.
Keep copies of every form, email, letter, medical record, and document you send to the insurer.
What To Do If Your Insurance Claim Is Denied
If your insurance claim is denied, take these steps before giving up:
- Read the denial letter carefully. Identify the exact reasons the insurer gave for refusing the claim.
- Find the policy or certificate of insurance. The policy wording controls what is covered, excluded, and required.
- Keep all documents. Save application forms, medical records, claim forms, emails, letters, and notes from phone calls.
- Do not sign anything final. Avoid signing a release or accepting a reduced payment without legal advice.
- Watch the deadlines. Internal appeal deadlines and legal limitation periods can be short.
- Get legal advice. A lawyer can assess whether the denial can be challenged.
⚠️ An internal appeal is not be your only option. In some cases, going back and forth with the insurer can waste time and put legal deadlines at risk.
Should You Appeal A Denied Insurance Claim?
Some insurance companies offer an internal appeal or complaint process after a denial. That process may be useful in some cases, but it is not always enough.
The right next step depends on the type of insurance, the policy wording, the reason for denial, the available evidence, and the deadline to start a legal claim.
Before filing an appeal, you should understand:
- Why the insurer denied the claim
- What evidence is missing
- Whether the insurer misread the policy
- Whether more medical evidence would help
- Whether there is a legal deadline approaching
- Whether a lawsuit may be more appropriate than another internal review
A lawyer can help you decide whether to appeal, negotiate, complain, or start legal action.
Insurance Claim Lawyers Across Canada
Samfiru Tumarkin LLP helps people across Canada with denied insurance claims.
Our insurance claim lawyers assist clients in major cities and communities, including:
- Toronto
- Ottawa
- Mississauga
- Brampton
- Oakville
- Burlington
- Hamilton
- Vancouver
- Calgary
- Edmonton
- Winnipeg
- Regina
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Whether you searched for an insurance claim lawyer in Toronto, an insurance lawyer in Calgary, an insurance lawyer in Edmonton, or an insurance lawyer in Vancouver, our team can review your denied claim and explain your options.
➡️ Denied insurance claim? Contact Samfiru Tumarkin LLP for a free consultation.
How An Insurance Claim Lawyer Can Help
An insurance claim lawyer can help level the playing field between you and the insurance company.
Our team can:
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- Review your denial letter
- Analyze the insurance policy or certificate
- Identify whether the insurer’s position is supported
- Gather medical, financial, and application evidence
- Respond to allegations of misrepresentation
- Deal directly with the insurance company
- Negotiate payment of the claim
- Start legal action if the insurer refuses to pay
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Insurance companies have teams working to protect their interests. You should understand your rights before accepting a denial.
Insurance Companies We Deal With
Our lawyers deal with insurance companies and financial institutions across Canada in life, disability, critical illness, mortgage, and creditor insurance disputes.
Claims may involve major insurers, banks, credit unions, employers, group benefits providers, or mortgage lenders.
The name of the insurer is less important than the reason for the denial, the wording of the policy, and the evidence available to challenge the decision.
? You can also review our pages on life insurance companies in Canada, critical illness insurance companies in Canada, and mortgage insurance companies in Canada.
Frequently Asked Questions About Insurance Claim Lawyers
What is an insurance claim lawyer?
An insurance claim lawyer helps people challenge denied, delayed, or underpaid insurance claims. This can include life insurance, critical illness insurance, mortgage insurance, accidental death insurance, and long-term disability claims.
When should I hire an insurance claim lawyer?
You should speak with a lawyer as soon as your claim is denied, delayed, questioned, or put under review. You should also get advice if the insurer accuses you of misrepresentation or says your claim is excluded.
Can an insurance company deny a life insurance claim?
Yes. A life insurance company may deny a claim because of alleged misrepresentation, non-disclosure, policy exclusions, missed premiums, beneficiary disputes, or issues during the contestability period. A denial can often be challenged.
Can a critical illness insurance claim be denied?
Yes. Critical illness claims may be denied if the insurer says the illness does not meet the policy definition, the survival period was not met, the condition is excluded, or medical information was missing or inaccurate.
Can mortgage insurance be denied after death or disability?
Yes. Mortgage insurance claims can be denied after death, disability, or critical illness. Denials often involve eligibility issues, medical disclosure, post-claim underwriting, exclusions, or disputes over the policy terms.
Should I appeal a denied insurance claim myself?
You can, but it is important to understand the risks. Internal appeals may not stop legal deadlines from running, and sending the same information again may not fix the problem. Speak with a lawyer before deciding your next step.
What if the insurance company says I lied on my application?
Do not assume the insurer is right. Misrepresentation and non-disclosure allegations depend on the policy wording, application questions, medical evidence, timing, and whether the information was material to the risk.
Can a lawyer help if the insurance company is delaying my claim?
Yes. A lawyer can review the delay, deal with the insurer, request a clear decision, and help determine whether legal action is needed.
Do insurance claim lawyers help across Canada?
Yes. Samfiru Tumarkin LLP helps clients across Canada with denied insurance claims, including life insurance, critical illness insurance, mortgage insurance, accidental death, and disability insurance disputes.
Speak With An Insurance Claim Lawyer
If your insurance claim was denied, delayed, or underpaid, speak with an insurance claim lawyer at Samfiru Tumarkin LLP.
Our team can review your denial letter, explain your options, and help you challenge the insurance company’s decision.
➡️ Denied insurance claim? Contact Samfiru Tumarkin LLP for a free consultation with an insurance claim lawyer.