Should I appeal a denied insurance claim in Canada?
Appeal if the expected value — the amount at stake multiplied by your probability of success, less fees and costs — is positive and meaningful. Many denials are overturned because insurers deny on incomplete information. Start with the insurer's internal appeal, then consider the OmbudService (OLHI for life and health) or a lawsuit.
How long do I have to sue over a denied claim in Canada?
Limitation periods are short. In Ontario, the basic limitation period is two years from the date the claim was denied (the date you knew or ought to have known you had a claim). Disability and life policies can have even shorter contractual limitation clauses, so act quickly and get legal advice.
What are my options after an insurance claim denial?
Typically: (1) request the insurer's written reasons and file an internal appeal with new evidence; (2) escalate to the relevant ombudservice (OLHI for life and health, GIO for general insurance); (3) file a lawsuit within the limitation period. A denial letter is not the final word.
Can I recover interest and legal costs on a successful appeal?
Yes. A successful claimant is generally entitled to prejudgment interest on the benefit and, in litigation, a portion of legal costs from the insurer. In cases of bad-faith denial, aggravated and punitive damages may also be available under Whiten v. Pilot.