Hello,

My travel insurance company is denying my claim. I found out I was pregnant on the 15th of sept. I took a blood test and it was confirmed. I was having slight spotting as well as slight cramping. I took another blood test on the 17th to confirm levels were increasing…and they were. The cramping and spotting stopped and I felt great. My levels weren’t doubling as they should of been but know that that is sometimes normal..all women are different.

Found out my grandfather was sick and going to die in Holland, so had to book a trip to Holland for the 20th. Doctor said it was okay. Took one more test on the 19th and levels were still rising…slowly. I had no pain and no spotting or cramping. Bought medical/travel insurance..no questions asked about medical history.

The day after I arrived in holland for the now funeral, I started to feel pain on right side. Went to a doctor and was told that I should go to the hospital. At hospital an internal ultrasound was done and confirmed Ectopic pregancy. Was admitted and treated for 8 days (missing my grandfathers funeral).

Had to push back return flight by one week. Medical insurance has denied my claim saying that I was not in a stable condition before I left for the trip because of the spotting and cramping which could of led to a miscarriage. I know that lots of women experience these things in the first trimester and have healthy pregnancies.

Please let me know if I have a case that could be won.

Hello

I had been hit by an car from behind recently and my car was pushed into a front vehicle. I am already on short term dissability (lower back pain) for last two months and my wife was also sitting in passenger seat.

I had picked up my wife from her work which she started about 10 days back and was going to chiropractor for my treatment. Unfortunately we both were hurt again due to sudden impact. I reported the collision to my insurance and nearest collision centre after we all exchanged the personal info.

Later I left my car at a garrage rections of my insurance company and estimated cost of rebuilding is about $ 6000.00.

My company put me on the 0.00% fault waived my deductible. Now I want to know aboy injury claims. I also visited my family doctor in the meantime and chiropractor for treatment.

To what extent I can claim for the injuries accumalated on us due to this accident? As my wife had her arm and shoulder muscle sprained and is home for more than 10 days after the said accident. And I am already having back pain has not improved further due to this accident.

Please reply in details with all the best options.

My house burned to the ground in 2006, the insurance has not yet paid any monies to me, I hired N.F.A. in October 2007 in frustration and now they are supposed to have an appraisal on November 27th.

The lawyer for the insurance company keeps saying that he will give a check for 100,000.00 as an advance but the check never comes . I need someone to help me with this. The value of the loss is about 3 million dollars.

Now N.F.A. says I will need to have reciepts to prove the value of all my clothes, this is the first time I hear this after 2 years.

We have mortgage disability insurance. In June of this year my 7 year old daughter was diagnosed with Brain cancer. After two surgeries to successfully remove a tumour from the cerebellum she underwent intensive radiation through July and August. Now she is an in patient for the next 4 months receiving chemo which will lead her back to health. I also have two other children ages 9 and 4.

My wife is self employed and I have been off on stress leave from my career since diagnosis in the beginning of June. Once we understood the gravity of the situation I notified the insurance company and they forwarded me claim forms.

I followed all requirements with respect to the documentation and the company kept requesting more information. The policy was in force for less than two years so they felt justified to ask for additional information; I complied in a timely manner. It became apparent to me that they were looking to deny this claim when they requested medical records from my GP in Ontario.

After persistence from myself I finally was able to reach the manager of the claims department. She informed me that they were denying my claim based on non-disclosure during the underwriting process.

When the policy was underwritten the company had sent a paramedical type agent out to collect saliva and fill out a questionnaire. To the best of our knowledge we answered the relevant questions. The policy was issued with my wife and I both having life insurance but she was denied disability insurance since she was under doctor’s care. I was covered for both life and disability.

The company argues that if they had the omitted information they would not have underwritten the policy. Since the pre-existing conditions were not serious in nature my expectation is that the company would have underwritten the policy with riders for the pre-existing conditions.

I feel that the company should show the same diligence in underwriting the policy as they do when the look to deny a legitimate claim. While it is true that I did not remember whether one of the conditions was over 3 years or not and the secondly that I forgot that I had been diagnosed with Bursitis in my hip, there was no malice or intent to deceive the company when the information was given.

If you can help that would be great.

My LTD claim – lady says she wants information from my care provider but wont go directly to him for information. He will not give me the information needed as he wants to contacted by insurance company directly. I am in a catch 22 i think my claim is only approved till next month. Insurance offered me a buyout and i turned them down now i feel they are gonna get me off anyway they can. I have been off approx. 4 years for mental disbility and still am unable to return to work and this is only addding to the stress and anxiety. There is more but i just cant come up with it now.

Hi,

I am not sure if you deal with cases like mine.

Mid Sept./08, I noticed that I was paying for insurance on my bank credit card which I never applied for/approved. I barely look at my statements but what caught my attention this time was that I was making payments with no changes on my balance. When i took a closer look I noticed a premium charge on my account.

I contacted my bank which then referred me to the insurance company in charge. The company told me that I had been paying the insurance for the last 5 years and it was my fault that I didn’t look at my statements. I asked them how it had been authorized and they said I had done it either in writing or over the phone which I am very sure I never did.

So I asked them to send me some proof that I signed up for it and they said they would launch an investigation and get back to me in 3 weeks. It is now coming to end of November and I haven’t heard anything from them. I called them in October after the 3 week period and all they could say was that they can’t go back tracing records of 5 years ago and it’s my fault that i did not look at my statements. I feel like it’s a rip off, these people have been taking my money just because “I do not look at my statements”, does that sound right? It may not be much money to them, but I need that money sent back to my credit card. By the way, they kept transferring the insurance to my new cards whenever the bank renewed without sending me anything to sign or a phone call to confirm that i wanted to continue with the insurance. Can you help me with this?

Thanks.

Hello Cindy,

I’m not LMK but I can help you from my own experience.

Those “balance insurance” charges are indeed highly dubious. I had never approved such insurance on my own credit card. I managed to catch them within the first couple of years (if your card is fully paid off they can’t charge you which is why I didn’t notice early).

In my case, I am an independent business person – the balance insurance does not apply to independent contractors or business people – only to salaried employees. So effectively I was paying for insurance for which I was not eligible.

I made a big enough noise about it that they did refund a few hundred dollars of premiums to me. It helped that I had a very active account.

The sums are not large enough to involve lawyers, but stick to your guns.

Here’s some tips to help you get your money back:

• Complain to the bank, moving up the customer service ladder.
• Take detailed notes.
• Insist on a paper copy of the proof of acceptance – if they don’t have a signed document, then it doesn’t apply unless they still have the audio tapes.
• Question its veracity if appropriate.
• Offer to involve the police for a fraudulent transaction.
• Contact a consumer watchdog organisation.
• Complain to the bank’s ombudsman.

Somewhere in the middle of this list, you will get the insurance premiums refunded. This particular product is almost 100% profit for the bank and insurance company so it costs them almost nothing to give you your money back.

Anyone who is paying for balance protection should go over that policy with a fine tooth comb. It’s riddled with exceptions.

Balance insurance is a simple skimming scam. The bank doesn’t want too much attention drawn to this practice so they’ll give you your money back and keep taking the money of a hundred others.

I really hope that somebody here can refer me to which type of lawyer i should seek and any other advice god willing, i need it.

2 years ago I spent my year in working and traveling in Australia. On my travels on a night when i was intoxicated partying i feel off of a balcony and required brain surgery to relieve internal bleeding. After all was said and done my travel insurance company denied me of any payments leaving me with a 30,000 dollar bill, plus having to stay on rehab. Because of my alcohol level and that I had smoked some pot that night which was a breach of the contract.

I was told to always appeal, I sent an appeal email and was denied again and because of how traumatic everything was at the time and now poor i was, I didn’t bother to respond again.

Now… due to my ignorance is contacting the hospital in Australia I have received notices (just yesterday) from a solicitor’s office in Australia demanding my payment of said money.

questions…

A) do I have a chance of still fighting, this insurance company for money. What type of lawyer would be best for this type of case.

B)What can these Australian lawyers and credit companies do? sue me? affect my credit rating? can i go bankrupt? (of course i want to pay them there money for services, they found my address because of thank you mail we sent, I am just having trouble paying rent let alone foreign bills..)

C) Is there someone in particular in Ontario law, or OHIP that would be good to talk to about this sort of thing.

this event greatly changed my life, and i would like to see the insurance company cover some if not all of the costs.

thank you for your time

Would you please elaborate on “being paid on a contingency basis”. When a case settles is it a % of the settlement that is owing to you? Are disbursements taken from this percentage? Hearing so many different stories on this and want to know more before deciding on representation. Thank you.

Hello,
My physician has declared me unfit for work (stress,anxiety and depression) and I have been waiting for short term disability since the end of september. They say that my claim is under review …………How long can they play the stalling and in bad faith game…..which is causing more health problems and undue stress in my family relationship?

Any information would be greatly appreciated and thank you very much
R. Colt

I am assisting a widow on estate. Husband had credit life insurance with bmo. Claim made in JUly doctor advises the insurance co has everything they need insurance co says doctor not responding.
What are your costs to intervene ?

Hi Steve,

The following steps can help you collect on a missing life insurance policy.

1. Look through the deceased’s personal belongings and see if there are any records of contact with insurance companies, brokers or agents.
2. Check safety deposit boxes and other storage places like the basement and attic.
3. Contact the deceased’s lawyers, accountants and insurance brokers
4. Look at old bank statements or cancelled cheques for entries made to insurance companies
5. Find out if the deceased was a member of any associations or alumni groups. Many of these organizations offer group life insurance policies to their members
6. Contact the human resources departments of any previous employers.
7. If the deceased died while traveling verify if he/she had a travel insurance policy. Many of these policies pay out a lump sum if the insured died while traveling. They may also cover costs related to transporting the body.
8. If you have details on a policy which has lapsed – meaning the insured stopped making premium payments before he died – ask if it’s a Permanent policy. Many permanent life insurance policies have non forfeiture features after the policy lapses. These features often include:
9. • “Extended term”: The insurance company uses the cash value of the policy to buy a term life insurance policy for the same death benefit using the cash value of the policy. The death benefit will continue for the longest period the cash value will purchase.
   • “Reduced paid up”: The insurance company will keep the policy in force permanently, but will reduce the death benefit.

If you are unsuccessful but still believe that life insurance coverage did exist at the time of death, then contact the Canadian Life and Health Insurance Association. Under certain circumstances, the Canadian Life and Health Insurance OmbudService (CLHIO) will undertake a policy search for insurance coverage’s on a deceased’s life among its participating companies. The two basic requirements that must be met are:

• There must be a reasonable basis for a search. Due to the size and scope of each search, there must be basic evidence to support the premise that some unlocated coverage does exist.
• Specific factual data about the deceased is available.

For more information you can visit them at www.clhia.ca. The American equivalent of the CLHIA is the National Insurance Consumer Helpline which can be contacted at 1-800-942-4242.

In addition, MIB, a 106-year-old association that represents nearly 550 U.S. and Canadian insurers, maintains information on individuals who have applied for life insurance. MIB keeps a seven-year archive of application related information of people who have applied for life insurance through their member companies. This archive covers approximately 90 percent of all individual policies written in North America and contains nearly 100 million records. While MIB records do not indicate that an insurer has issued a policy, they do show if an insurer requested a data search, and a data search usually takes place when an individual applies for policy coverage.

Hi Loretta,

Thanks for the email. In Canada life insurance companies offer a 10-day rescission right. In other words, you have a 10-day period following the delivery of a new policy to cancel it and obtain a full refund of your start-up premium.

I would recommend you provide proof of cancellation within the 10-day period by:

Send a registered letter to the company advising them of your decision; also inform the agent/broker.

I hope this helps. Regards … Lorne

Evidently I did not complete the application for travel health insurance properly. My claim has been denied on the grounds that I did not disclose heart problems for which I was diagnosed and prescribed medication. True, but I had seen a cardiologist before signing up for insurance, and he said I did not have a heart problem and did not need the medication I had been prescribed. So I signed up for the insurance premium that said “90 days stability” even though it also said I was not to have had any heart problems in the past 10 years. I hadn’t, and the prescriptions for high cholesterol and high blood pressure were errors or just precautions. Then I had a serious fall and was hospitalized for a week in the US.
The fall had nothing to do with my heart. I fell on my head and it took me a long time to remember much of it. When I came back to Ontario, I again saw a cardiologist who said I did not have a heart problem.

my truck was stolen. i had $25000 eqvipment in it. i bought truk and machineries together for $45000. everything is insuared. but insurance company is going to pay me $21000 for everything. is there anything can be done for this?

Hello,

My 53 foot trailer was stolen in July/2008 and I still haven’t been compensated. I received a call and was told that there was a mix up with the trailer lisence plate and that they were going to pay. During this time my tractor got reposessed in October and I believe the leasing company may have taken the proceeds of the insurance as well. I wanted to sue the insurance company as this caused me to loose my business. I also wanted to sue my broker for doing absolutely nothing to help. I live in Brampton.

Thanks,
Ferdinand

Thank you for your inquiry. We will be in touch with you soon. Regards … Lorne

I have a good friend who is employed and was in a management situation that caused a severe mental breakdown. He was directed by his physician not to return to work until he recovered. Although he diligently submitted regular doctor reports, he was given no direction from his employer, as to benefits he may be eligible for and due to his illness he was not in a frame of mind to pursue or go after support. When I met him, he had depleted all his sick pay and holiday pay. He had depleted any savings he had and was now borrowing money to live. I encouraged him to look into eligible benefits and he asked for and filled out an application for LTD with his insurance comapny. When he hadn’t heard back for 3 months, I encouraged him to call them. They said they hadn’t received a report from his employer and couldn’t proceed without the employer’s report. It has been an unbelievable ‘back and forth’ process that would weigh down a strong mind….it’s not much wonder he didn’t feel up to pursuing this. Even though his doctor clearly described his illness and the reason he could not work, this claim has been denied twice and I’ve encouraged my friend to appeal again. He is back to work now, but I feel he has been treated very unfairly by his company and the insurance company. He received awards and recognition for exemplary performance during seven years at his company and paid a lot of premium for benefits, both EI and Medical Benefits and he received ablsolutely no income for a period of ten months. He finds it very difficult to fight for his rights because it brings back unwanted memories of a difficult period in his life, so has asked me if I would help. He sent a letter to his insurance company and employer specifying that he wanted me to act on his behalf. Neither of these institutions were receptive to this. I have correspondence that I feel proves negligence on his employer’s part, causing a roadblock to my friend being eligible for benefits. It’s a long story and much more to it, but wonder if this brief outline tells enough for you to determine if this is a case you can help with.

My brother got killed in December 2008, I had insurance on him since 1991. It has been 3 months as of yesterday of his death. I send in the death claim form and also the death certificate all that was required of me the beneficiary. I still have not recieved the death claim benefit she said the death is being investigated because of homocide. How long do I have to wait before they will have to release the death benefits. Thank you

I am working in a pest control company. I had a heart attack last week.doctor asked me for complete rest for at least one month.My job is a kind of physical work involving driving through out the day in GTA. I have a critical illness insurance plan with my bank. I need to ask if I should apply for Governmend EI assistance or claim for my insurance company.I need money for my daily house hold expences only. what should I do.
thank you.

Hi we had a line of credit with the bank and had paid disability and life insurance premiums for years and years. I became ill in Jan of 2007, but did not receive a diagnosis until Sept of 2007. The bank deal with same insurance company I am still trying to get work disability pmnts from. Because I was having such a problem with the insurance company on my personal claim, I got the papers from the bank to claim for disability in July of 2007 but I thought it best to wait for a diagnosis prior to proceeding with the claim. Once a diagnosis of Fibromyalgia had been given to me I contacted the bank to inform them of such. I was unable to make my line of credit pmt the 1st of Oct 2007. I received a letter dated Oct 11th, stating our line of credit was blocked due to missed pmt, and then CIBC said I had no disability insurance. In Dec of 2007 the bank made a deposit into my blocked account for premiums they had taken over the last 5 years,( averaged out by them) and they stated they should not have been withdrawn as I did not have disability insurance on the account. Most people I talk to said to let it go because you cannot fight the bank, as they will bury you in paperwork, and in some instances tell you that if you lose, you will be required to pay their legal fees, Just want an input as to whether this is ethical and legal process by a bank.
Thank you

My husband dead in an accident. He does not has a will. He has a group life insurance from his company. I had been told he change the beneficiary to me in 2005 but I do not have a copy of that change. I recieved a letter from the insurance company one month before my husband dead. It says
“you are receiving a duplicate copy of this letter because you are listed in our records as an interested party for this policy/ contract. When I try to claim this policy after my husband dead. They said I am not the beneficiary of this policy. He never change to my name. His ex-wife’s name on the quarterly statement as primary beneficiary.

Please help me with what I should do.

Sincerely,

Lisa

I have a critical illness insurance and I am diagnosed with a ovarian cancer. I am currently on chemo therapy. I have made a claim and it has been dragging over 3 months. Because I mentioned to my doctors that my 3 sisters had cancer who lived in the Phillipines. However I did not realized that they had cancer when I bought the CI insurance. Now the insurance company requested my sisters medical history, when they were diagnozed. Should I provide this information? Will this affect my claim as I did not mentioned in the application in time when I purchased the policy. I did not know that they had cancer. Please advice. Thanks. Analiza.

I lost my life insurance beneficary policy. My cousin died. How do I find the company.

My father passed away March 20, 2009 and up to the day before he died he believed his Visa Credit Card was covered by life insurance he had taken with them. I was notified not long after his death that the balance was covered by life insurance. Two weeks later I was advised that there was no coverage as they had cancelled the policy in June of 2008. I then called them back and said that they had been taking payments monthly through his Visa Card up to the date of his death and even into the next month. They reviewed the situation and have now come back denying coverage as my father was in his 66th year and apparently the policy is good only to age 65.

I know my father had arranged for coverage over the phone and I am certain that the age requirement was not mentioned. I have not found a letter of cancellation in all of his belongings.

My father paid his premiums in good faith and I feel that they should honor his claim of $3600.00.

Please help.

Thanks for the question.

Unfortunately this is coded as an at fault claim, because you hit something.

Do you have a broker? If so your broker should have advised you to not put through the claim. If not and you are with a direct writer, once you call them it is recorded on your file.

If you have any further questions, please do not hesitate to call me.

Thank you

Cathy S. Ramsundar
Associate Broker
Mitchell Sandham
467 Westney Road, South, Unit 13
Ajax, Ontario
L1S 6V8

905-683-4549 ext 224

My story. My neighbor had a car shelter that in high winds travelled over the top of two houses,, and came down crashing into the side of my truck,,, he asked for 3 estimates for repair which I furnished him with,, He claims to have house insurance that is going to pay for it,, but,, that was a month ago,,, there is between 3 to 5 thousand dollars damage to my truck,,,, not sure if going to court is what I should do.

I applied for disability/critical illness insurance back in February with Canada Life. At the time the insurance broker said I’d receive a discount if I paid the full year’s cost in advance. It’s taken four months for them to get back to me and, in fact, I was turned down for insurance, which is baffling to me as I just had a complete check-up and am in perfect health. I was not refunded the complete amount – I paid $2,289.07 and received a cheque in the amount of $1,718.01. Being charged $600 for nothing is a blatant rip-off and I’m absolutely furious. Is this common practice to not fully refund someone who is turned down for insurance coverage but has paid for the policy in advance?

Thank you for your advice.

when I husband bought his life insurance policy there was a question which asked if he has filed for bankruptcy & we had said no. But at that time we were on a consumer proposal.

In the eyes of the insurance company is bankrurptcy & consumer proposal one & the same & will they say that it was a non disclosure

Kindly advice

thank you

I am a divorced mother that has 3 kids and i was working at a collection agency for 6 years. Due to the high stress of my work and the bad situation at home i had a nervous breakdown and my doctor recommended to go on a sick leave from work. Unfortunately my situation was not getting better so i was prevented from going to work for almost 2 years. The group insurance policy at work was with …… and they kept paying me for 2 years. In the meantime my health deteriorated and i had severe pains due to an ovarian cyst. Three months before my compensation plan was due (January 2009) i was rushed with an ambulance to the Hospital Emergency room where i was kept for 3 days and after all the tests it was decided that i needed to be operated for the cyst removal.So i had a laparoscopic surgery on November 20 2008 . This surgery was a disaster and because of complications it gave me a huge hernea and a hematoma on my left side which was diagnosed again in December 2008 and it was scheduled to be fixed with another surgery (classic surgery this time). Early this year the insurance company decides to stop my compensation on the terms that i wasnt taking my medication for my depression (which is true cause i couldnt afford it since they had cut my medical health benefits from july 2008 because of a late payment).On the group policy though it states clear and they had inform me that my situation would be reevaluated since i was not able to do ANY kind of work because of the hernea and the hematoma.My correction surgery was scheduled for …… but it never happened due to heavy load at the hospital … To cut the story short the surgery was postponed 3 times and in all that period i was having hernea at the size of a head of a baby and extreme pains on my side.The correction surgery was finally done on June 4th 2009 and i got a 2 months reccuperation period from the surgeon that operated me. From the beginning of this year until now i havent received a penny from them and on July 2 they compensated me for a month only due to the correction surgery. For the 6 month period they are playing a cat and mouse game avoiding a direct decision on my case cause of lack of information concerning my dissability. Of course me and my doctors AND the hospital have provided them with ALL the documentation of my case including the surgery cancelation notes , the emergency room visits, the first surgery complications and in general a more than 200 pages volume of medical records from 2008 till now.

As i said before i am single mother that wasn’t able to work for all that period and i had only my kids allowance to survive and pay rent , food and all my expenses . I had to cancel my TV and Internet Subscriptions , make a installment plan with my Electricity company and owe money to relatives so as to be able to survive.
The insurance company is not even paying me the two months reccuperation period of my last surgery (they paid me just one month) and after a phone conversation with my case manager with them i was told I shouldn’t stay at home after my surgery and the letter that my surgeon gave me is NOT GOOD EVIDENCE for me staying home and not working !!!!
I’m in a tragic situation right now and i dont know what to do . I would apreciate an advice from you. Thank you for all the time you dedicated reading my problem.

I worked for a company for the last two years, until the end of May, and have not received any remuneration for the past 14 months. They have provided me with an accrual statement of wages but not a cent in back wages yet. They also provided me with a significant number of shares which they claim I am not able to trade until the end of this month. Do I have any recourse? Would you be willing to look at this on a contingency basis?

My wife died last year in December suddenly while we were on holidays in India. I had mortgage insurance and still I am waiting for the settlement. I brought back a death certificate. I have been paying payments for mortgage and insurance premiums and also lost my dear wife. It’s going to be one year in Dec and they keep on telling me a couple more months. What should I do what can I do? Please reply.

Regards

I have a situation where the person had a company business that had shareholder insurance.The partners were splitting up and the partner that was staying on insisted that he can change his beneificary on the company insurance to his wife. The policy was term and in existence for more than 2 years. The partners seperated, insurance bebeficarey changed. Almost 3 months after they seperated, the company put themselves into bankruptcy and subsequent this guy comitteed suicide (5 months after declaration of bankcruptcy)
The issue when the partners seperated the company had dbt and the partner who contineued the businees warranted in contract that he would assume all bank loans.The issue is he is now dead and his family received all insurance proceeds. What right does the ex partner has to ensure that the debts are paid off.

I work …. as a ….. operator, i have … yrs seniority,and have been of work since …. .i was off work for … months in 20… while being diagnosed and treated for major depresion,anxiety and a eating disorder. It took ….. insurance over 4 months to pay me after i went off.
Presently i am under the care of my Psyciastrist he filled out the …. claim forms along with clinical notes. I thought that would be plenty. After the insurance company recieved the completed forms they called me asked me some questions which I answered truthfully. They said they would have an answer the next day. That day never came so after speaking with my employers h.r.dept.they were told by the insurance company they did not have enough info to make a decision. So my employer sent me to 2 independent doctors and both doctors concur with my Pysciastrist – still no response i am on medication for depression and anxiety. I am married with 2 young boys and have not been able to pay my bills my wife is very supportive but this is causing a strain on our relationship. I try to appear strong for my children but I am a wreck of stress inside. I have done everything I have been asked to do, 4 doctors agree (including my family doctor)t hat a am obviously not well. I am fed up with …. contributing to my illness twice now in 3yrs. The last thing I need to think about right now is do I have enough money to feed my family. Please help …. needs to pay for what they have done to me.
p.s i have all my doctors clinical notes and the independent review reports.

Kelly

RE: Life Insurance Beneficiary
Can a primary beneficiary disclaim or request part of the claim be given to the contingent beneficiary listed on the life insurance policy?

My mother passed away in June. The month before, my sister was taking care of her while she was on hospice. She and my mother got in an argument and she left her in my care. My mother decide to give me durable and medical power of attorney and to be beneficiary on her life insurance. She wrote a letter saying that. My mom passed away and we received the paperwork that said my sister was beneficiary. I contacted the life insurance company and they investigated it and tried to settle out of court but my sister would not. She wants to go to court. My sister filed an entitlement in court and the life insurance company said we need to file a response to entitlement to life insurance in court, immediately. I wanted to know how to do that. Please will you advise me. Thanks.

On my life insurance policy I had told to the agent that I took pills for high blood pressure for 5-6 months and gave her the name of my doctor but she put in the application no to the questions relating to the high blood pressure and wrote I had no doctor. The policy I took in october 2006. I just found this on my policy on friday 11th march,2011. What can I do or in case of a claim what will happen. My phone is 6477077538 thanks

Posting this for clients of mine. I am a mortgage broker.

We were sold mortgage insurance from a bank and a finance company, and feel that the insurance purchased was not fully explained to us. Especially from the finance company.

When acquiring our mortgage we bought a disability insurance policy. The employees of the lender did not explain that the policy only would last 24 months and then payments would have to resume regardless of whether we were still disabled or not. It took several months for the lender to provide us proof of the policy limitations. During that time, not being able to afford the mortgage payments we nearly lost our home.

After visiting many former and still current employees of this lending institution, including the former branch manager, all of them made it clear to us that they were unaware of the details regarding the insurance policies they were selling.

What they did tell us is that the company pushed them to sell the insurance, but provided very little in the way of training for the insurance products.

At this time, we are not at liberty to name the lending institution(s), as we are considering taking legal action against them, and possibly other lending institutions that practice similar methods when selling their insurance products.

This litigation would probably need to be a “CLASS ACTION LAWSUIT”, as this is most likely the only way to sue a large corporation and win. We know from talking to people in our own small neighborhood that this has happened to many other people.

These companies need to stop taking advantage of people, and be taken to task for the hardships they cause due of their questionable business practices.

I bought two participting insurance a few years ago from Canada Life.one is mine, I had paid $2591*3yrs=$7773, policy day is on January. Other is for my son, I had paid $1340*2yrs=$2680, policy day is on Septemper. Right now I am cancelling my two insurances on May30,2011.I dont know how much money I can get back,but I know I will lose a lot of money,I lost my job,I cant afford it any more,it is really hurting me.could you help me how to cancle my insurance could be better? Thanks a lot!

Respecfully

L

My mom’s insurance company did an investigation and came to the conclusion that out of the ….. dollar policy my mom took out, they would only pay out ….. due to her having chronic kidney disease and hypertension. They did not inform us this until they sent the check and I want to know what are my legal parameters?

Please note I am duly licensed to practice law in the Province of Ontario.

Based on your description of events as set out above, I believe you have a strong case against possibly both carriers for LTD benefits. I can’t really give a valid opinion as to which should respond without reviewing the file/ particular policy. What I would recommend is that you retain a lawyer who should issue a demand letter seeking a positive response within short time period [7 business days] and when the response is not sent, quickly issue a statement of claim against both carriers. Then possibly a motion for interim relief, Basically we want the Court to find that either of the carriers is going to pay you LTD benefits but that one should pay until they decide then the other can indemnify you for any benefits paid. This case seems to me to turn on whether your doctor will state that you had a recurrence of the old symptoms or not.

I could assist you with such representation and work on a contingency basis. If you would like to meet with me to review your case please feel free to call Sarah at my offices to schedule a meeting. If either of my offices’ location does not work, we can discuss by way of phone conversation. Sarah can be reached at 416-815-1331 x221.

Regards,

Andrew Suboch B.A., LL.B.
Barrister-At-Law
Tel: (416) 815-1331
Fax: (416) 815-1257
E-mail: aps@subochlaw.com

About … years ago I was in a car accident, injuryed back, shoulders. Our … insurance wanted me to go back to work which I did. There was the threat of being cut off if I didn’t go back to work. My doctor treated the pain with cortizone, which deteriated my hip bones. Both hips where replaced. I was put on disability and paid by Sunlife, about one year ago I was put on permanent disability by the insurance company. They paid me 65% of my salary and … topped up the rest. Now the insurance company has sent me a new contract which states they are entitled to all income from other sources which would be …. payment. If I don’t sign this contract my payments will be discontinued. To me this is like backmail, is this legal? I worked for …. ….. and paid insurance premiums. Your advise wouild be appreciated.

I am a person duly locensed to practice law in Ontario. I am guessing that you are located in Saskatchewan.

If you obtained LTD benefits a while ago, and continued on with such benefits, in Ontario at least, and I suspect in Saskatchewan which also is a common-law jurisdiction, it would be improper for Sunlife to try to unilaterally impose a new contractual term on the LTD contract. However, if there was a pre-existing term in the LTD contract that there was to be a set-off from what Sunlife was to pay and any SGI payments then Sunlife would probably be in its rights to deduct from their LTD payments to you, any amounts you received from SGI. Until I actually look at the Sunlife AND SGI policies, I could not give you a more definitive answer.

Regards,

Andy Suboch

On …… While working at the …. ….. In whitby ON I trip at the funeral home while transferring furniture fom one room to another I trip and fell breaking my left femur bone, shattering my knee cap and broke my right elbow. I was taken to …… …where DR. M saw me and did the operations.My daughter flew in from Manitoba to help my wife with decisions to be made. She contacted the workmen compensation about a claim for my injuries. The workmen compensation decline the claim because ….. l had not paid into it. Received the letter from WSIB on ….. stating ” your employer has not submitted an application to cover his worker ; therefore there was no coverage under the Act in effect at the time of injury. As a result, you are not eligible to any benefits from the Workplace safety and Insurance Board ” I Spent 16 days at ……. and then transferred to …….. and discharged on ….. ,2010 . At the time of the fall my employer ….. paid my wages at a reduced amount of 250.00 a week plus benefits.I just received notice that my services are no longer needed and my Benefits from …….. will not be honored as the end of July.2011. Leaving my spouse with no benefits what so ever .

Hello,
I am working in one of the big company,In Apr 2010 I carried the heavy box and got pain in my shoulder and arm at that tim I ignore to see the Dr and I get that box each month and split/sort almost 4000 parper in less then 20 hours. I use tablet for my upper back pain, shoulder and neck and two times I reported to my manager I can carry this box but she ignore it and told “ommm this is your report and you have to handel it” I manage the pain up to last week and after very bad pain I got two week note from my Dr and I am work with PT two times during a week but my insurance company doesn’t accept more then that, waht should I do because this is a work injoury and I will leave this company at all after 3y work.

Dear Sir and Madam,

I am a lawyer duly authorized to practice law in the Province of Ontario. I have been asked to respond to your enquiry below.

It sounds like you have decided to proceed on to an Arbitration as against your insurance company. I am not sure if that is what you are referring to below. There are provisions in the Insurance Act and/or under some policies whereby disputes between an insurer and its insured are to be brought before a “neutral” “umpire”. This process is somewhat different than arbitration but the effect is the same – the rules of evidence are relaxed and each party makes out its case.

I am not sure as to what “NFA” is or does. It sounds like a claims service that is supposed to represent your interests. From what you have written below, NFA seems to be failing short in that regard but such comment is based on your description below of what they / it [NFA] has/ has not been doing.

I would be pleased to meet with you on a gratis basis to review your file so as to give you my opinion whether you might be better served by having a lawyer represent your interests. I would not charge for such a meeting. If you did decide to retain my firm, I would be paid at the end of the litigation.

If you would like to meet, please call Sarah at 416-815-1331 x221 to arrange for such a meeting.

Best wishes,

Andrew Suboch

You seem to have an arguable case in regards to the non-payment of your claims.

I would be pleased to meet with you on a gratis basis to get more back-ground information before fully giving you an opinion as to your likelihood of success at trial. If you are interested in meeting, please contact Sarah 416-815-1131 x221 of my offices to arrange for such a meeting. If you decide to retain me after a meeting, I would defer payment of my office’s fees and disbursements UNTIL there is an actual recovery on your behalf.

Regards,

Andrew Suboch

I am a lawyer duly authorized to practice law in the Province of Ontario who has been asked to respond to the below.

When an insurer decides to cancel a policy, it must strictly conform to various criteria set by the government before it can validly cancel such a policy. I cannot state with any certainty, reviewing the below, whether the insurer complied with such criteria to validly cancel the policy. I suspect that they did not.

There is the further consideration whereby if the insurer knew what was ailing your husband, could they have proceeded in the face of what appears to be mental incapacity? I believe a Court would find that they could not.

Finally, there may have been a fiduciary duty at some time established between the insurer and your husband and possibly yourself as a beneficiary to the policy. If they breached such a fiduciary duty, there could be serious financial consequences.

If you would like to meet with me on a without costs basis, to review your potential claims, I would be pleased to do so so that I might get more information and advise you as to how I believe you should proceed. If you are interested in such a meeting, please call Sarah, to whom this is copied, at 416-815-1331 x221 and she will arrange for such a meeting.

Yours very truly,

Andy Suboch

I have been on long-term disability through … ….. continuous years. Before this I was also on their disability plan and attempted to go back to work on two occasions. Obviously it didn’t work out. My doctor retired last year, and I live in Sault ste. Marie, where there is a doctor shortage. I talked on a regular basis to my worker through …. . I considered him a friend. Over the last … months myself and him thought that it might be good for me to get out of the house and go back to work part-time. He told me to go down to our walk in clinic and get a return to work form. I did this, the doctor I saw just gave me the return to work form, no questions asked. My worker contacted my previous employer, and was told my position was long gone. I have … years of paper trails that say I am unfit to work, including documentation from the doctors ….. sent me to. I received a letter from …. .days ago, that says I am cut off from benifits. Something which I thought might help me, has now turned into a disaster. I have no income and two children to support. I am at a lost as to what to do. I need help! I cannot afford a lawyer, but I do qualify for legal aid. Please help me!

I have fibromyalgia and take oxycontin for pain. Two life insurance companies have turned me down. Is this legal???

Mom passed away … years ago this month and I just found a “paid-up” certificate of insurance from the company she retired from. They are no longer in business so I contacted the insurance company directly, got the person’s name and extension who handles older policies, have left 4 messages since ….. .. and no response at all. I gave her my Mom’s name, year it was effective, policy number, my Dad’s name as he was probably the beneficiary who has also passed away. I want to find out if there was an alternative beneficiary and, if not, according to the certificate of insurance, the funds go to her living children. What is your advise as I think it is ridiculous to be forced to hire an attorney for something that has been put in black and white. Thanks for any help,

My husband became ill ….. He was off work for the waiting period and applied for LTD through his employer. He is treated for ongoing chronic pain which is the reason for his absensce from work. The forms the doctor had to fill out stated what he is being treated for and chronic pain was one because that is what he has been treated for since … but it has not kept him from work. what is keeping him from work now is Panic attacks, opiate dependancy, anxiety and major depression disorder. The letter that the insurance company sent us states that he was treated for chronic pain in the past and the pre-exisitng clause MAY apply to this claim. They want him to sign a declaration but th eway it is worded is not right as the chronic pain should not apply to this claim it has not kept him for work, the mental illness has kept him from work which he has never been treated for in the past ever. I am trying to send them a letter but we may need some advice do we have to
wait to seek advice until after the claim is denied if they deny it. To me it sounds as though they are trying to deny but I cant see how they can when chronic pain is no tthe reason for being off. Panic, anxiety and depression disorder has kept him off and he is seeing a psychiatrists as well as a addicitoons counsellor on an on going basis. would you know why they would be focusing on the chronic pain when this is not his reason for being off??? he should be entiltle as he is seeking treatment for mental illness and will get better eventually.
Hope you can help and I hope I made sense.

hi , im writting in deepest concern to my mother’s benefactor pertaining to the life insurance she has for herself. Im asking where do i stand as far as it goes for going aganist my mother’s husband whom is a chronic aclolohic and is her beneficiary. Im deathly afraid that he will not have any good intentions for this ins. money and she has recently passed.My family is struggling to even have a simple family grave side service and small family gathering afterword and than to have to deal with the remaining funeral expense> where can i get some type of assistance and or maybe lead me in the right direction to make sure my mother and myself are at peace please help..thanks

I was sideswiped by a tractor trailer in heavy, fast-moving traffic on the 401. He took off after the accident, so I could not get his licence plate or insurance info.

I reported the accident to the police and my insurer right away because I thought that was what I was supposed to do. I have never had an accident in almost 40 years of driving, so am not familiar with this.

My insurer made me go to a preferred repair shop the next morning, and they quoted a shocking $3800 to repair a few scratches and a dent on my car’s side back panel. I thought this was really high, and went to my own mechanic, who quoted me just $750 for the same work. In the meantime, the insurer did some pretty sketchy internet “research” and found just 1 person on Kijijii selling a similar make/model car for just $2200.

They did this based on this one classified ad, without ever seeing my car, the mint condition it’s in, how well it runs, and all the substantial improvements I’ve made to it. (It’s a special edition car, carefully maintained and renewed, fully loaded, and very few were made originally, so it’s kind of unique. It easily has at least another 10 years of life to it, according to my mechanic. People constantly compliment me on how nice it is.) Despite all this, the insurer arbitrarily set my car’s value at just $2200 too.

Then, using the inflated figures from their repair shop and the lowball value they set for the car, they immediately concluded that the car is a total write-off. They are offering me next to nothing and are ready to seize my car. This all happened in less than 24 hrs.

I am stunned and extremely upset. I can’t believe the people who were supposed to be my safety net just turned into my biggest threat. There is no way I will be able to buy a new or even a used car with the paltry amount they are offering as a “settlement”. I just want to fix the scratches and save my car. I even suggested they forget I ever mentioned the scratches and to close the file, that I will pay the $750 out of my own pocket. They said No, and are now threatening me that if I don’t take their settlement and hand over my car, they will not re-insure me and will brand the vehicle as a write-off so no other insurer will either.

If I had known they would do this to me, I never would have even told them it got scratched. Everybody has told me it’s not that big a deal to fix the car, even the cops who did the report. I just don’t understand how they can force me to become permanently carless over something so small. I will be unable to work if I lose my car, so this affects my livelihood too.

I feel totally abused and bullied in this process. I have been with this insurance co for … years now, and have paid them at least $..,.. in premiums over the years for car insurance that I have never used and that is also letting me down now the very first time something happened.

Any advice?

Hi my father was killed in a car crush on the alaska hiway in …. …. . a tractor trailer rear end him i have no info on the cliam or any thing will help thanks this happend on ….

I am a … year old who is currently on Long term disability through an insurance carrier that I have with work. I took leave …. used up my savings and rrsp and started usung my home equity line at the bank to pay my mortgage and bills etc… I did get sick benefits from E.I. and disiabilty kicked in after that. My family doctor has been following up with me in regards to meds and referring me to psychiatrists for depression and anxiety. The problem I have now is the insurance carrier is on my case about going back to work and she is actually telling me that I am not sick. And a few times had refuse to pay me even though I had done all that she has asked me to do in regards to updating her with doctor notes etc… once again its the end of the month and shes doing it again. I phone her asking whats going on and she wont answer my calls and she wont phone me back. I have bills to pay. I dont know where to go from here. I dont know what my rights are? Can you help me?
Thank you for your time

Please be advised that I am a lawyer duly authorized to practice law in Ontario. I practice primarily in the area of personal injury/ insurance law but also have a substantial employment law practice. I have been asked to respond to your enquiry below on a without cost basis with respect to this correspondence.

I do not necessarily agree with the comment that ” when a union is involved that it is out of a lawyers jurisdiction”. While that is generally true in regards to employment matters [hiring, firing, discipline where there is a valid collective agreement] I do not believe it is true when a claim is made for Long Term Disability benefits which is what I believe your mother was claiming.

Given her unfortunate death, her claim will be restricted to what she might have been entitled to from when she applied to her date of passing.

I cannot really comment more but given that you have been advised that a decision is still pending, I do not believe that the limitation clock has run out of time.

If you would like to meet, again on a without fees basis, please contact Sarah of my offices at 416-815-1131 x221.

Regards,

Andy Suboch

This is further to your enquiry below. Please be advised that I am an individual duly licensed to practice law in the Province of Ontario. I have been practicing in the area of personal injury/ insurance matters for more than 18 years. I have been asked to respond to the below questions.

I would like to first find out more information as to where and when your husband fell. If there is any way that this matter could be moved away from the clutches of the WSIB,I n my opinion, both he and you would be well served to do so. Until I get more facts, I can’t advise you in that regard. If you could find a party that could be successfully sued for your husband’s injuries as opposed to claiming WSIB benefits, then I believe both you and your husband would recover much more than what is available until the WSIB régime.

In any event, it seems that ….. ought to be paying your husband for what I assume are Long Term Disability benefits [LTD’s] and/or accidental sickness and accident benefits. Until I review the relevant insurance poly or policies I can’t comment further in that regard.

I would be pleased to review your husband’s situation on a without fee basis to better get a handle on your particular situation. If you would like to meet with me, please call Sarah at my office 416-815-1331 x221. This meeting would be free. I have 2 offices – both wheelchair accessible – Bay and Queen or Sheppard Ave East and Kennedy in Scarborough.

Regards,

Andy Suboch

Please be advised that I am an individual duly licensed to practice law in Ontario. I understand that you moved to Prince George BC. I can give you some general advice but pleased be aware that I am resident in Ontario.

The insurance contract is one of utmost good faith. From what you have described below, it seems to me that ….. IS NOT dealing with you and your claims in good faith. There would appear to be good medical evidence – see the neurologist who diagnosed Chronic Fatigue and your [sic] “Dr agrees with the diagnosis”. That in my opinion should be enough.

If you were to want to proceed with your case, I’d get a BC based lawyer, assuming that you are in BC still, meet with him/her and review the file. If you were in Ontario, I could act for you and would, based on what you have set out below, begin legal action as against Manulife. If you need the name / phone of a BC lawyer who does insurance law, please feel free to contact me directly.

Regards,

Andy Suboch
416-815-1331 x221

Dear Sir,

This is further to your enquiry below.

I am an individual duly licensed to practice law in Ontario who has been asked to comment.

Based on what you have set out below, I believe that you have good grounds to sue the insurance company to recover the benefit under your wife’s policy of insurance [assuming you are the beneficiary and that it was a policy of life insurance].

I would need to meet with you and review the policy before I give you more advice.

If you would like to come in for a free consultation, please contact Sarah 416-815-1113 x221. I have offices in downtown Toronto and in Scarborough. Alternate sites for meeting can be arranged.

Regards,

Andrew Suboch

i need to sue a doctor in vgh i need some help regarding it i have a note from the hospital that states that a doctor in vgh talk rudely to me and write a false note on my file

I am a person duly licensed to practice law in Ontario. My practice largely consists of dealing with insurance companies on behalf of injured and/or sick individuals. I have been asked to respond to your enquiry below.

I am somewhat at a loss to respond as I am uncertain as to what you are complaining about. It seems that you are unhappy with a doctor’s “rudeness” and/or believe that he/she may have inaccurately recorded something on your chart. Either issue would not seem to warrant legal action UNLESS you can demonstrate some form of damage and/or harm flowed from such actions, acts and/or omissions. Without more information, I really can’t advise you as to what remedies you might have.

I can’t really say more without meeting you and reviewing relevant documents.

If you would like to book a free meeting to discuss your situation, please call Sarah 416-815-1331 x221 at my offices.

Regards,

I am a person duly licensed to practice law in Ontario. My practice largely consists of dealing with insurance companies on behalf of injured and/or sick individuals and/or beneficiaries to insurance contracts. I have been asked to respond to your enquiry below.

I am surprised that a life insurance policy bought for $2,000.00 in the 1940′s today is only worth $7,000.00. I would like to see the policy as that does not correspond to what would seem to be the “norm” today. However, without more information, I really can’t advise you as to what remedies you might have or whether the insurance company’s answer is legally correct. There are many types of life insurance policies and it is possible that the policy purchased was a defined benefit that did not increase over time. You did indicate that it had increased from a $2,000.00 face value when bought to a $7,000.00 value today which suggests to me that this policy is worth much, much more.

As a beneficiary to the estate, you have the right to inspect the particular insurance policy.

I can’t really say more without meeting you and reviewing relevant documents.

If you would like to book a free meeting to discuss your situation, please call Sarah 416-815-1331 x221 at my offices.

Regards,

Andrew Suboch

I am an individual duly licensed to practice law in the Province of Ontario who has been asked to comment on the below.

Without reviewing the policy terms and making enquiries at your brother’s place of work, I cannot give you a valid opinion as to what your options might be. Most employment benefits cease in regards to life insurance once the person stops working or a short time thereafter. If your brother had not paid premiums for 3 years post cessation of employment, I am of the opinion that it is likely that the policy of life insurance was terminated.

If you would like to discuss this further, please contact Sarah of my offices at 416-815-1331 x221 to arrange for a meeting.

Regards,

Andrew Suboch

I am an individual dually licensed to practice law in the Province of Ontario and have been asked to respond to your below enquiry.

The value of your potential claim comes within the $25,000.00 limits of Ontario’s Small Claims Court jurisdiction. This means that you can have your witnesses give their evidence by way of letters [assuming such letters are dated and come on letterhead] thereby avoiding the cost of necessitating and actual appearance of such witnesses [which in the case of doctors can be quite expensive]. From what you have described below, it sounds like you have reasonable grounds to start an action as against the travel insurance provider.

ALL insurance contracts are contracts of utmost good faith. This mandates that the insurers deal with your claims on an honest and open basis and not make pre-determined decisions. A failure to act with utmost good faith COULD lead to punitive, exemplary and/or aggravated damages.

If you would like to discuss this further, please contact Sarah 416-815-1331 x221 to arrange for a free consultation meeting.

Regards,

Andy Suboch

I am an individual dually licensed to practice law in the Province of Ontario and have been asked to respond to your below enquiry.

Based on what you have described below, you may have 3 avenues of recovery – against the person who caused the mva [assuming that wasn't you]; against your own motor vehicle insurer [for what are commonly referred to as Accident Benefits - AB's - or first party claims] and possibly as against your Long Term Disability [LTD] carrier. Until I know which insurer is denying your claim it is impossible to explain what you might do and the timeline to do it. If your company fires you, they would likely be in breach of their duty to reasonably accommodate your injuries contrary to the Canadian Charter of Rights and Freedoms and the prohibition against discrimination based on disability contained therein. I would strongly recommend that you meet with a lawyer in Ontario to further discuss your possible claims.

If you would like to discuss this further, please contact Sarah 416-815-1331 x221 to arrange for a free consultation meeting.

Regards,

Andy Suboch

I am an individual who is licensed to practice law in Ontario. I practice primarily in the areas of personal injury, insurance law, disability law and wrongful dismissal. I have been practicing law for 18 years.

I have reviewed your comments below. Based on what you have described it does not seem that the termination of your LTD claims was proper. I would recommend starting legal action as against the LTD insurer. If you are in dire financial straits, I would STRONGLY recommend not only bringing such an action but perhaps bringing a motion to the Court for interim injunctive relief seeking a temporary resumption of payments as the insurer has effectively hand-cuffed you. Based on the equities of the situation, a Court might order the LTD insurer to re-commence such payments.

If I were you, I would retain a lawyer as I do not believe the insurer will reinstate your LTD benefits unless ordered to do so.

If you would like a free consultation, please call Sarah at my office 416-815-1331 x221 to arrange for same. I would act much sooner than later

Best wishes,

Andrew Suboch

Dear Madam,

I’m an individual duly licensed to practice law on Ontario and have done so for more than 18 years. My areas of practice are insurance, disability and personal injury. I have been asked to respond to the below enquiry.

Based on what you have described below, I strongly believe you should sue the insurance company. What you describe may not only ground a case for breach of (insurance) contract but support a claim for bad faith.

If necessary there are companies that can provide bridge loans to people whose LTD insurers have improperly denied their claims. I can provide you with their names, contact info and a reference if necessary.

I would need more information to give a definitive opinion. If you would like a free meeting please call Sarah 416-815-1331 x221 to arrange same.

Regards

Andrew Suboch

Dear Madam,

Please be advised that I am an individual duly licensed to practice law in the Province of Ontario who has been asked to comment on the below.

It appears to me that your LTD carrier is employing a technique that is relatively common in the LTD -insurance industry. It seems that they are using a “medical consultant” who is often a senior MD who no longer has admitting privileges at a hospital and who is largely captive to the LTD insurer for work. This person gives his professional opinion as to why your claim should be denied. It is my experience that the Courts often [probably properly] give much more weight to the actual evidence of your treating physicians.

It appears that your LTD insurer has improperly disregarded the evidence of your treating medical practitioners. They may be acting in a manner that could ground an award of punitive damages.

If you would like a free consult so that we might further discuss this by phone please call Sarah of my office 416-815-1331 x221.

Regards,

Andy Suboch

I am an Ontario lawyer who practises largely in the area of insurance law.

Your insurance company should cover the cost of repairs. If there is delay due to contractor’s negligence, your insurance company should such additional costs and seek to recover same against the contractor.

If you would like a free consultation please call Sarah at 416-815-1331 x221 to arrange for same.

Regards,

Andrew Suboch

First let me pass on my condolences on your loss.

I am an Ontario lawyer who practises mainly in the area of personal injury which would include negligence causing death. I have been a member of the Ontario Bar for more than 17 years. I have been asked to respond to the below.

Based on what you have out-lined below you have a strong case against the apartment owner. If you would like to meet for a without charge consultation please call Sarah at 416-815-1331 x221. I will be back in town next week from Tuesday onwards and would be pleased to meet with you then.

Regards and I again extend my condolences.

Andrew Suboch

I am an Ontario lawyer who has been asked to respond to your enquiries below.

Based on what you have set out below it sounds like you are entitled to the pay for the period when you were off work. To force the company to pay you, you’d probably have to start legal action which would likely have negative implications for your career at that company. You might want to make a complaint to the Ministry of Labour, Employment Standards Branch. You may have a direct cause of action as against the STD insurer. I would need more information before I could comment further in that regard.

If you would like a free consultation, please call Sarah at 416-815-1331 x221 to arrange same.

Regards,

Andy Suboch

Dear Sir,

I am an Ontario lawyer who practices mainly in the areas of personal injury, wrongful death and insurance matters. I have been practicing in these areas for more than 18 years. I have been asked to respond to your enquiry below.

It seems that you have a valid claim as against the insurance company. A policy of insurance is also a contract of “Uberrima fides” which is Latin for “utmost good faith”. I have no idea why the insurer is taking so long to respond to your claims. They may be breaching their duty of utmost good faith owed to you thereby potentially exposing themselves to an award of bad faith or punitive damages.

If you would like to call to discuss this claim on a pro bono basis please contact Sarah at 416-815-1331 x221.

Regards,
Andy Suboch

Dear Sir,

I am an Ontario lawyer who has been asked to respond to the below.

If your Mom had life insurance policies, and you have provided the insurers with all the necessary documents, if they do not pay promptly then they could be liable to a claim for punitive damages.

If you would like to discuss by phone, please call Sarah 416-815-1331 x221 to make a time for a phone discussion.

Regards,

Andy Suboch

Dear Madam,

I am an Ontarian lawyer who has been asked to respond to the below.

If the policy was in force and premiums paid for 2 years, the insurer cannot now state that they would not have insured your Mom. I believe you are entitled to the benefits of the life insurance policies.

If you would like a free consultation, please call Sarah at 416-815-1331×221.

I am a person duly licensed to practice law in Ontario who has been asked to respond to your below enquiry.

The short answer is “no”. If you are accepted for LTD coverage, in my opinion, you will have exhausted your rights as against the employer for damages. At the very least, I believe that there would be a set-off from what you recover from the LTD carrier as against any damages for pain and suffering that you might obtain. If that is correct, then your actual recovery in my opinion would be negligible, there by eliminating any benefit to you from proceeding with legal action.

We don’t pay very much for pain and suffering [as a distinct type of damages, opposed to say, damages for loss of income] in Canada. In a worst case scenario, think for instance of a case where someone is rendered a quadriplegic, they would only be entitled today, to approx $341,000.00.

If you are not allowed back on LTD, then please give my offices a call for a free consult. The number is 416-815-1331 x221 – Sarah will set up the meeting/ appointment.

Regards,

Andrew Suboch

Dear Madam,

I have been asked to respond to your email below. I am a lawyer who practices insurance and personal injury law in Ontario. I have been practicing in these areas of law for more than 17 years.

The law has been changed but based on what you have described below, I believe that your injuries are of a “Catastrophic nature” and as such you should be able to access the “old limits” of $1,000,000.00 for medical/rehabilitation benefits. You might also be entitled to a possible $1,000,000.00 more for what is known as “Attendant Care”. Also, there should be other amounts payable for House-keeping/ home maintenance. Have all of these benefits been discussed/ explained to you? Just so you should know, rehab has NEVER been cut from $1,000,000.00 to $50,000.00.

If you would like a free phone call with my offices please call Sarah 416-815-1331 x221 to arrange. I strongly believe that you are getting very bad advice from your insurance company.

Regards,

Andrew Suboch

Dear Madam,

I am a lawyer who has been asked to respond to the below. Your issue raises matters of Estae Law that is outside the area that I practice.

If you need a referral to a lawyer practicing in the area of Estate Law, call Hull & Hull (416) 369-7858.

Regards,

Andrew Suboch

I am a lawyer who practices in the areas of personal injury and insurance law. I have been asked to comment on the below enquiry.

Claims for property damage to vehicles arising from motor vehicle collisions generally are resolved in Ontario by what is known as the “Fault Determination Rules”. The general rule is that if you are stopped and the other person who hit you saw you or had a reasonable opportunity to see you and avoid the collision, then they will likely be found to be at fault. That being said, there is some caselaw to suggest that if the matter is pushed, you might be found to be partially at fault.

You can report to your insurance company and they might assess you as not being at fault in which case the other party should also pay your deductible. IF the other party reports the mva, your insurance co will find out in any event.

Regards,

Andy Suboch

Dear Sir or Madam,

I am a lawyer who has been asked to comment on the below.

There is no way to force an insurer to commute weekly/monthly payments. Once they have started, the insurer is required to handle your claims with diligence and utmost good faith. You cannot force them to “lump sum” you out ie. make one “big” payment. However, many insurers are open to that option so you could contact the insurer and see if they are willing to discuss such a lump-sum, onetime payment to resolve your claims.

Regards,

Andrew Suboch
416-815-1331 x221

I am a lawyer who has been asked to respond to the below.

It sounds like you have an excellent case against both … and possibly the person who caused the mva [assuming it wasn't you]. Both claims should be pursued together as the law provides for various set-offs. Based on what you have described, I’d strongly consider starting legal action as against …. as soon as possible.

If you want to have a free consultation, please call Sarah 416-815-1331 x221 to discuss.

Regards,

Andy Suboch

I am a lawyer who has been asked to comment on your enquiry below.

I am uncertain as to what the “stat date” is. There are limitation periods that may have come into play but generally you have 2 years from the date when you knew or ought to have known that the cause of action arose. This is a factual determination that involves consideration of a multitude of factors and ultimately the Court decides when the limitation period began or has run. If you are more than 2 years after the date that you discovered the damage to your floors you may have a problem but there may be a “discoverability” factor whereby a Court MIGHT find that the limitation period only began once the insurance company advised you it would not pay for the entire claim.

If you would like to discuss this with me or a lawyer at my office please call Sarah, 416-815-1331 x221 to arrange for either meeting.

Regards,

Andy Suboch

Dear Sir,

I am a lawyer who has been asked to respond to your enquiry below.

Based on what you have described, you MAY have an action as against your employer for bad faith/ breach of fiduciary duty. That being said, I am not certain whether you would want to proceed as against the employer as the actual damages that, in my opinion, are likely to be awarded as against your employer if a case of bad faith is made out to the Court, would be small and not enough to justify legal action. A court would, in my opinion, voice is displeasure over how the employer behaved but unlikely to award enough in damages to make the case worthwhile to pursue.

Regards,

Andy Suboch

Dear Sir,

I am a lawyer in Ontario who practices in the area of personal injury and insurance law. I have been asked to respond to the below.

Based on what you have described, I believe that you have a good case as against the LTD carrier. If you would like to discuss this, either in person or by phone, please call Sarah 416-815-1331 x221 to arrange for a time and/or place to discuss same.

Regards,

Andy Suboch

I am a lawyer who has been asked to respond to the below.

I am uncertain as to why there is any reference to a “deductible”. Deductibles apply to claims made by and insured under its own policy, not to claims made by a third party which you would be in this case. If there is a deductible, the condo corporation should pay it and give you that amount. If they refuse to do so, subject to any agreement in the rules of the condo corporation, then you could probably successfully sue them in small claims court – monetary jurisdiction of $25,000 for damages.

Regards,

Andy Suboch

I am a lawyer who has practiced in the areas of personal injury/ insurance law for the past 19+ years. I have been asked to respond to the below.

I am surprised that the insurance company has advised the depression is a component of …. Depression and … are two distinct and different medical diagnoses. I believe that your partner, based on what you have set out below, has good grounds to apply for and get LTD benefits.

If you would like free consultation to discuss, please call Sarah, 416-815-1331 x221 to arrange for either a person-to-person meeting or a phone consultation.

Regards,

Andy Suboch

Dear Madam,

I am a lawyer who has been asked to respond to the below. I have been practicing in the area of personal injury/ insurance law for more than 20 years.

Based on what you have set out it seems very strange that the STD carrier is denying your claim, particularly if you have a fractured shoulder. If that is the case, it is possible that the STD carrier and/or your employer [which might also be the STD carrier or pay for STD benefits] may have breached a duty of “utmost good faith” in which case it/they could be liable for punitive damages.

If you would like to discuss further, please contact Sarah at my office, 416-815-1331 x221, for a free consultation.

Regards,

Andy Suboch

I am a lawyer who has been asked to respond to the below email.

I am not certain why you have waited almost 7 years to try and make a claim. The applicable limitation period MAY be 2 years. It seems that you have made a WSIB claim. To me that strongly suggests that you do not have a claim against the person / party that caused/ contributed to the slip and fall. Without more information – where you feel, why you fell, what you were doing when you fell – I cannot give you an opinion as to whether you have a claim in tort – for pain and suffering inter alia.

In regards to your claims as against Sunlife, I do not necessarily believe that they are barred by the limitation period. Disability claims are generally thought to be covered by what is known as a rolling limitation period. You have 2 years from each payment or foregone payment to start a legal action. Therefore, if you are entitled to payments, then you would be able to claim, in my opinion, from 2 years ago today onwards. For this reason, you should speak to a lawyer as soon as possible about your Sunlife claims.

If you want to discuss this with me, please call Sarah 416-815-1331 x221 to arrange for a free consultation.

Regards,

Andrew Suboch

Hi,

We live in Ontario. My parents were traveling in …… visiting my siblings and nephews last summer and my Mother got sick and was admitted to the local hospital. Her sodium levels were drastically low and they suspected that my mother may have contracted pneumonia, so they had her stay overnight to run tests. Of course what they thought was pneumonia just happened to be bronchitis but to come to this confirmation, she had stayed in the hospital for 3 days. We made a claim with our travel health insurance and due to a delay from receiving information from our family physician we found out today that they may be denying our claim (though unconfirmed at the moment). When I asked them why they told me that upon receiving the medical information from our family doctor, they discovered that my mother is on Lipitor which is for cholesterol. Apparently, when my Dad filled out the questionaire for my Mom, he made a mistake where it asked if prior to their trip if my Mom was under treatment for high-cholesterol and marked down no, not realizing that the Lipitor my Mom was taking was for cholesterol. My mom insists that when talking to the agent verbally she told them what medications she was taking but they are going by what is listed in the questionaire. My parents are both seniors and my Dad occasionally misses thing and gets confused frequently when it comes to technical forms and analysis. What can we do in this situation and what advice can you offer us to prepare for that denial letter?

has just refused my claim again (short term benifit),they say they need more documentation, but they will not say what kind. I do not know what my Doctor should do. Or if I sould see another kind of doctor. ……. left a letter on my door step saying I must return to work Mar 19th or they will terminate my job for abandonment. About 6 months ago I was on disability for the same injury and they withheld my benifit paid until I was back at work for two weeks.(8 weeks no money I had to return I needed Insulin) I am …. and have chronic Respitory Sarcoidosis. These are my monthly needs for meds. Resently I herniated two discs in my back after sitting on a damaged chair at work. (no hydralics bang straight down to the floor)the pain was very dibilitating I could not stand up straight and could only sit sideways on my left cheek. I was sent back to work after 6 weeks with pain meds.

The 2nd time I was off work due to my back and exhaustion. I fell and crushed my left knee the swelling is still an issue. My pain in the leg is constant a 9, my back naggs me at 7. I also suffer from incontinence(I cannot tell when I must pee, it just comes out) which wakes me every hour if I lay down to sleep. My left leg is so painful sleeping lasts for max 3 hrs and causes violant nightmares.(I pulled a spindel from my head board to defend myself from one such night mare.) The MRI say replace knee joint due to sever rapid acting Arthritis no cartillage, resulting from injury. Uterine biopsy says sarcoidosis interuterine is causeing pain and spotting (long after menopause) and ultra sound says ovarian cyst present advised to get both surgically removed then bladder complication can be fixed at the same time.(no more pain) My mind is crazy with pain and lack of sleep. The meds Im on help take the edge off thats all (I used to cry everyday)I try and move around as much as possible, my blood sugar levels depends on activity. I really need help with the insurance guys for some kind of settelment. Ive worked for ADT 15 years as an exemplery employee. Now because I am Infirm because of so much pain and the meds I belive they are rushing me as a way to take advantage of the situation to terminate me and take away my pension. Please do you think you can help me or advise me where to get help. Very Sincerely Lonny

This is further to your email below. I am a lawyer who has practised in the areas of personal injury and insurance law for almost 20 years.

If there was an inaccuracy on the application, it might be grounds to deny the claim. The Court would have to determine whether the mis-representation, if any, was material. The travel agent might have exposure if he/she helped to complete what might have been an inaccurate application. I believe that you should consider the amount at stake before considering whether to commence legal action.

For a free consultation, call 416-815-1331 x221 and speak to Sarah.

Regards

Andrew Suboch

I am a lawyer who has been asked to respond to your enquiry below.

You could apply for a declaration from the Court that you are entitled to coverage for cancer-related claims. However, I do not believe that a Court would necessarily grant such relief. To bring such an application would likely cost you $40-50 thousand in legals. In my opinion, the benefit is not worth the potential cost.

Regards,

Andy Suboch.

I am an individual who has practiced personal injury and insurance law for almost 20 years. I have been asked to comment on the below.

MOST disability plans have a period [often 2 years] where the test as to entitlement changes from an inability to perform the essential tasks of one’s employment to an inability to perform any employment for which the claimant is reasonably suited for due to their training, education and/or experience. Obviously the second test is higher and can result in a more legitimate denial of a person’s claim for disability benefits.

Based on what you have described below, assuming that the policy has similar wording, I do not understand why your insurer has terminated your benefits. Since you have un-successfully appealed, the next step would be a court action.

I would be pleased to discuss your claims. Please call Sarah 416-815-1331 x221 to arrange for a teleconference.

Regards,

Andrew Suboch

The onus would be on you to establish:
1. Your wife’s salary at time of death;
2. The mandatory nature of the program;
3. The automatic registration of all employees

Once you have established, on a balance of probabilities, which I would not anticipate being difficult to do, then Canada Pot would have to show, also on a balance of probabilities that she opted out. They probably would need a document with an original signature to do that in my opinion.

If you would like a free consultation to discuss this further. Please call Sarah 416-815-1331 x221 to arrange for same.

I again express my condolences on your loss.

Regards,

Andy Suboch

Dear Sir,

I am a lawyer who has been asked to respond to the below.

Without more information it is very difficult to respond. However, on the assumption your claim is valid, I’d bring an Application to the Superior Court of Justice for an Order that … pay your claim.

Regards,

Andy Suboch

Dear Sir,

I am an Ontario lawyer who has been asked to respond to your enquiry below.

From what you have described, it seems that the insurance company should not deny the policy based on the 2 years’ incontestability clause. At the very least they should return the premiums accepted but before accepting same, you want to consider the policy’s value to determine if it is worth fighting the insurer.

If you would like to discuss on a pro bono basis, please call my office 416-815-1331 x221 and speak to Sarah to arrange for a phone conference.

Regards,

Andy Suboch

Dear Madam,

I am a lawyer who practices in Ontario. I have been asked to respond to the below.
Without looking at the relevant policy of insurance I cannot give you a valid opinion as to what your options are. If you would like to discuss this matter further please call Sarah at 416-815-1331 x221 for a free consultation.

Regards,

Andy Suboch

I am a lawyer who has been asked to respond to the below enquiry

Any law-suits are subject to what is known as the “discoverability” principle. Effectively, until a person discovers or ought to have discovered – and when this determination ought to have occured is a question of fact for a judge to determine – that his injuries meet the “threshold” as set out in Ontario’s Insurance Act, then the limitation period begins to run. In my opinion, based on what you said below, your son would meet threshold but did not find this out until he met the Sick kids’ doctor.

Furthermore, given he is a minor, the limitation period would not run in any event until 18 + 2 years AT THE EARLIEST.

I believe your son has a good chance to succeed in a lawsuit if a doctor can connect the scoliosis to the mva.

If you would like a free consultation please call Sarah at 416-815-1331 x221.

Regards,

Andy Suboch

Dear Madam,

I am a person duly qualified to practice law in the Province of Ontario.

What you need is someone qualified in …. law re obtaining a death certificate from ….. However, if, after 7 years this gentleman has not returned to Canada and has not been seen publically, there is a presumption of death. You probably do not want to wait that long. I’d obtain whatever documents/ obituaries/ death notices etc. that in any way or form confirms his death and present true copies of same to the insurance company. If they refuse your claim, then I’d bring an Application against the insurer, and perhaps his family, for, inter alia, declaratory relief that he is dead and accordingly, as his beneficiary, your are entitled to insurance proceeds. Depending on the amounts involved, I’d consider hiring a lawyer. At the very least, you should put the insurer on notice that as his beneficiary you are entitled to the life insurance policy’s proceeds. I am assuming that the policy requires a death certificate. If there is alternate wording then you might not have to do all of the above.

If you would like to discuss this further, please call Sarah 416-815-1331 x221 to arrange for a free consultation.

Regards,

Andy Suboch

Dear Madam,

I am a lawyer who has been asked to comment on the below.

If your husband was on LTD benefits, I do not understand how the employer could terminate his employment. This would seem to be contrary to the provisions of the Human Rights Act of Ontario, the Charter of Rights and Freedoms and common law. I believe that your husband would stand a reasonable chance if he brought Court action as against his former employer for an order that it pay for his ongoing collateral benefits, especially as they relate to drug benefits.

If you would like to arrange for a consultation, please call Sarah 416-815-1331 x221 to arrange for same.

Regards,

Andy Suboch

Please be advised that I am a litigation lawyer who acts for individuals on a variety of cases, but most of them involve some dispute with an insurance company. I have practicing in this area of law for the past 20 years. I currently am in trial on a case involving a claim for critical illness that was denied by the insurer. I have been asked to respond to the below. I am not surprised that an insurer is denying a claim while another has paid the claim under the same circumstances. Often it is a case of differing policy language. Just as often it is a case of one company’s approach to claims handling – be reasonable and try to resolve – versus a diametrically opposed approach – deny and let the plaintiff take his chances. Based on what you have set out below – and this is without the benefit of reviewing the actual language of the relevant insurance policies – I believe that your brother has a good case against SSQ [I do not recognize that insurer - is it Ontario based?]. I would recommend that you give them a deadline to make a decision then if they do not respond appropriately, bring an action in the Ontario Superior Court of Justice. There may be grounds for an award of punitive damages. I you would like to schedule a free consultation to further discuss your options, please call Dominique at 416-815-1331 x221. Regards, Andy Suboch

Dear Sir,

I am an individual licensed to practice law in Ontario who has been asked to respond to the below.

If the insurance was in place when the diagnosis was conveyed to the insurer, I am of the opinion that the Critical Illness policy should respond and it should NOT have been terminated. This could change depending on the actual definitions contained in the relevant policy.

If you would like a free consultation call Sarah at 416-815-1331 x221 to arrange for same.

Regards, Andy Suboch

I am an individual duly licensed to practice law in the Province of Ontario who has been asked to respond to the below.

Where you reside and where the mva occurred can have a material impact on any further response to your enquiries. You may have a very reasonable chance at recovery but I need to know where you lived when the mva occurred and need to also know where the mva occurred.

Regards,

Andy Suboch

I have been asked to respond to the below. I am a lawyer duly practiced law in the Province of Ontario.

You should contact the insurer that issued your Dad’s accidental life insurance policy and ask for an application to obtain benefits. Fill out the forms and submit. If they deny, contact a lawyer and sue. Based on what you have advised below, and my opinion could change with new or other information, it appears that you have a good case to recover the proceeds of the accidental life insurance policy.

If you would like to discuss further, please contact my offices 416-815-1331 x221

Regards,

Andy Suboch

Dear Sir,

I am a lawyer duly authorized to practice law in the province of Ontario who has been asked to respond to the below.

I do not believe that the actions of the insurer in using the earlier authorization, signed by you in respect of the 1st claim, to access info for the 2nd claim is proper. It may even be fraudulent. I believe that they cannot use that information to assess the second claim and I believe that they may have opened themselves to a claim for breach of privacy. Recent case law suggests that damages for such breach could total $20-25,000.00 plus costs and interest.

Based on what you have described below, it appears that by substituting your duly signed 2nd page of the 1st Authorization, for that of the un-signed 2nd Authorization, the insurer is giving the false impression that you consented via the 2nd Authorization. That, in my opinion, is grossly improper and actionable.

If you would like to discuss what further action might be necessary to protect your interests, please call Fran at 416-815-1331 x221 for a free consultation.

Regards,

Andrew Suboch

Dear Madam,

I am a lawyer who has been asked to respond to your enquiry below.

TIME IS OF UTMOST ESSENCE!!!!! You should retain a lawyer much sooner than later. If you wish to commence a lawsuit for pain and suffering, assuming you WERE NOT the at fault party, you must do so within 2 years of the date of the mva. If you wish to dispute the denial of your claims for accident benefits, you MUST do so WITHIN 2 YEARS OF THE INSURER’S DENIAL OF YOUR CLIAMS. A failure to abide by these time limits could be fatal to any hope you might have of further recovery.

If you would like to further discuss your case, please contact Fran of my offices to arrange for a free consultation. Her number is 416-815-1331 x221. I have copied Fran with this email. You need to talk to a lawyer immediately. If you do call Fran, tell her I have advised that getting you an appointment is to be a priority. We can discuss your claims over the phone.

Regards,

Andy Suboch

I am a solicitor duly authorized to practice law in the Province of Ontario who has been asked to respond to your inquiry below. I have been involved in the area of insurance law for more than 20 years.

Why ….. won’t pay until “this is settled” ie. the claims under the Succession Law Reform Act is beyond me. A will like an insurance policy is a contract. The insurance contract stipulates who gets the money, that is the beneficiaries of the insurance contract. Unless there is some issue as to undue influence causing a person to erroneously include someone as a beneficiary, and the onus is on the person claiming undue influence and it is a VERY HIGH standard to prove, then ….. should pay out as per the beneficiary clause in the insurance contract. In my opinion, based on what you have set out below, you should sue …… In my opinion, the Succession Law Reform Act is completely irrelevant to a policy of life insurance completed / filled out in good faith in a sound state of mind.

If you would like a free consultation, please contact Sarah 416-815-1331 x234 of my offices to discuss this matter.

Regards,

Andy Suboch

My wife had a minor collision. I am sure she is not at fault. I reported
to my insurance company and after … … they asked me do the estimation
of damage. Now, she is asking me to do appraisal of my vehicle. I am
sure that they will ask me to scrap the vehicle because its …. …. but still running very good. I asked them to get it repaired
but they denied. Is it not possible that I repair my car by myself and
drive. Who will decide who is at fault ?

I am an Ontario lawyer who practices in the areas of personal injury/ insurance/disability law who has been asked to respond to your enquiry below.

Without looking at the actual insurance contract I really cannot comment further. It seems to me that what really is in dispute is the definition of “unable to work” as contained in the Boss Plus insurance from Great West Life. Many disability insurance policies refer to either a “own occupation” or “any occupation” definition when determining whether an insured is entitled to claim under the policy. I do not know if your Boss Plus insurance from Great West Life contains either of these definitions.

Generally speaking, an “own occupation” defninition requires a much lesser degree of injury and/or impairment than an “any occupation” definition when determining whether an insured is entitled to claim under a policy. However, there could be further nuances within the policy that might further complicate an assessment as to entitlement. Without actually reviewing the entire policy, it is very difficult if not impossible to further discuss your [potential] claims.

Based on what you have set out below, I definitely think that you should consult a lawyer to discuss this matter further.

If you would like a free consultation, please free to contact Stephanie at my offices, 416-815-1331 x221.

Regards,

Andy Suboch

Thanks for the kind words

Based on what you have told me (albeit without the benefit of reviewing the policy and terms/conditions therein), it appears that not only might you have a very good claim as against Sunlife, you might also have a basis for a bad faith claim so as to justify an award of punitive damages.

If you would like to discuss further, please call Stephanie at my offices to arrange for a free consultation. She can reached at 416-815-1331 x221.

Regards,

Andy Suboch

Dear Madam,

Please be advised that I am a person with over 20 years of experience in the personal injury/ insurance area of law who has been asked to respond to the below.

Without reviewing the relevant LTD policy, I cannot give a strong opinion as to what you are or are not entitled to. However, based on the below, I strongly suspect that you have valid grounds to pursue your claims as against .. I do not understand, on a general basis, how they can ignore what seems to be good and unbiased medical opinions that you are disabled. I would strongly recommend you review this matter in more detail with a lawyer, such as myself, who practices in this area of law.

If you would like to meet and/or discuss this matter further, please contact Stephanie at my office to arrange for a free consultation with me. Her number is 416-815-1331 x221.

Regards,

Andy Suboch

Dear Ms Cater,

I am a person duly licensed to practice law in the Province of Ontario who has been asked to respond to your enquiry below. I have practiced in the areas of personal injury and insurance law for more than 20 years.

In my opinion, you seem to have a valid claim that is subject to what might be described as a priority dispute between insurers. Their coverage issues, based on what is set out below, in my opinion, ought not to impact on the fact that you seem to have a valid claim. They seem to be engaged in a game of “passing the buck” to your detriment. Quite simply, I’d recommend starting legal action in a federal superior court for, inter alia, a declaration that you are an insured under a policy of LTD insurance and that you are entitled to benefits under said policy. I’d sue both insurers and let them convince the Court why they shouldn’t pay and the other insurer should pay. That really should not be your issue.

Without looking at medical evidence, it is difficult to determine whether your condition is a “re-occurrence” in which case the first LTD carrier probably should pay, or a “new occurrence” in which the second LTD carrier should pay. What is considered to be a “re-occurrence” or a “new occurrence” could depend on the policy wording which I have not seen.

It is likely that there is AT MOST a 2 year limitation period that would apply from date of denial so time is somewhat of essence.

If you would like a free consultation to discuss this further, please contact Stephanie at my office 416-815-1331 x221.

Regards,

Andy Suboch

Please be advised that I am a person duly licensed to practice law in the Province of Ontario who has been asked to respond to the below.

The Official Coroner’s office should be able to get you a death certificate re your ex-husband’s death. Are there others who are listed on the insurance policy as beneficiaries? Did he re-marry? You can prove death through other means – newspaper clippings, etc. generally speaking there is a 2 year limitation period with respect to claims under insurance policies but some policies have much shorter limitation periods eg. 1 year. Without looking at the policy, it is impossible to know what is applicable. If you issue outside the limitation period, your claims likely would be statute barred. Time therefore, is of essence. I believe that generally the limitation period is calculated from when a claim was made and/or denied but some policies might calculate the limitation period from date of death.

If you would like to discuss further, please contact Stephanie Yu 416-815-1331 x221 for a free consultation with me.

Regards,

Andy Suboch

Dear Sir,

I am a lawyer who has practiced in the area of bodily injury and/or insurance law for more than 20 years. I have been asked to respond to the below.

I cannot give you any real opinion without getting additional facts. I do not know if there was mortgage protection insurance, if it was offered to your Mom, if it was offered and she declined. If there was mortgage protection insurance in place prior to her illness and then death, I suspect that it should respond and cover the mortgage but can’t really say more than that without additional information and/or investigation.

If you would like a free consultation to discuss this further, please call Stephanie Yu at 416-815-1331 x221.

Regards,

Andy Suboch

I am an individual who has practiced in the area of personal injury/ insurance law for more than 20 years. I have been asked to respond to the below.

Beneficiaries in insurance policies can be changed. What really is of concern is if there was a separation/ divorce agreement which addressed the issue of who was to be the beneficiary of a life insurance policy. I do not practice family law so you or your daughter would best be served discussing the issue below with a person who practices in that area of law. Beneficiaries can be changed but it is my understanding that if a separation and/or divorce proceeding stipulated that your daughter was to be the beneficiary of her ex-husband’s policy of life insurance and that term of the separation/divorce agreement was breached, then a Court might order that she be made the beneficiary of / entitled to the life insurance proceeds.

I again urge you and/or your daughter to discuss the below with a person who practices in the area of family law.

Yours very truly,

Andy Suboch

I am an individual duly licensed to practice law in the province of Ontario. I have practised in the area of personal injury and/or insurance law for more than 20 years.

Based on what you have described below, I do not believe that you husband has any ability to claim for pain and suffering through WSIB. He may be entitled to a claim for ‘Non-Economic Loss” (NEL) from the WSIB. However, I do not practice in the area of WSIB issues which is relatively specialized. You/ he should consult a lawyer who practices in that area of law.

I wish you best of luck with your future endeavors.

Regards,

Andy Suboch

This email is further to your inquiry below. I am a lawyer duly authorized to practice law in the Province of Ontario who has been asked to respond to the below.

Your father’s per-existing condition would only be relevant if he was asked about same and concealed it from the insurance company. From what you have set out, this does not seem to be the case so I cannot see why it would permit the insurer to deny the claims of the his Estate as against the insurer. It is my experience however that insurance companies often try to find a reason to “hang their hats on” when denying claims.

If the insurance company denies the claim, please feel free to contact my office at 416-815-1331 x221 – Stephanie – to arrange for a free consultation so that we could discuss this further.

Regards,

Andy Suboc

Sorry to hear that. Yes it is worth it – the policy may have a graded / partial death benefit.

These deferred policies also generally have a return of premium feature if the insured dies within the deferral period.

Dear Sir,

Further to yours below, please be advised that I am a duly licensed lawyer who practices in Ontario.

Based on what you have set out below, it appears that the insurance company has improperly denied your wife’s claims. Based on what you set out below, I believe that your wife has a good case against the insurance company and such case could possibly include claims for punitive damages. You and your wife should talk to a lawyer. If you would like a free consult the please call Stephanie at 416-815-1331 x221 to arrange for same.

If different facts emerge then my opinion could change.

Regards,

Andy Suboch

I’m sorry to hear that. You would have to contact the insurance company directly to start the claims process. The attached directory may be helpful link to lsminsurance.ca

I am a lawyer in ontario who has been asked to respond to the below. I practise primarily in the area of personal injury and insurance law.

I do not believe your (I assume Long Term Disability) insurer has the right to force you to undergo an operation. If the condition exists as described below, I see no reason for the insurer to cut you off benefits. This is why the insurer probably wants to negotiate a lump sum settlement.

When negotiating a lump sum you should be aware of the possible tax implications of same and should consider the present value of your benefits.

I’d retain a lawyer who, such as myself, practises in the area of personal injury law when negotiating a settlement.

If you would like a free consultation to discuss your case, please call Stephanie 416-815-1331 x221 to arrange for same.

Regards.

Andy Suboch

You may have a claim for STD and /or LTd benefits but given that you are retiring at the end of July, it is not economical for you to hire me to make a claim on your behalf. I would try giving a paralegal a call regarding same.

Regards,

Andy Suboch

You could ask for a copy of the policies and also check with the insurance company

With paucity of information listed below I really can’t give you any meaningful response. If you would like a more detailed response, please give more details as to the issues. Eg type of insurance. When bought. What is basis of claim. What is basis of denial. Etc.

Regards,

Andy Suboch

Sorry to hear about that Elizabeth. You could contact BMO Insurance directly at 1-800-387-9855 regarding the statsu of your claim and or sending you another set of claimant forms. If you are still having challenges you could contact Andy Suboch.