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Having Claim Problems? We can help!
Are you the beneficiary of a life insurance or disability insurance contract or an automobile injury claim, and find yourself at a stalemate with an insurance company?
Insurance claims aren't easy. The insurance company has a legal department and an army of lawyers. It's you against a stacked team.
We've decided to even your odds.
Just tell us your story in the comment box below and we'll get you assistance with your problem from the law firm of Landy Marr Kats LLP which has over 30 years experience successfully fighting insurance companies.
Successful litigation of personal injury claims, insurance lawsuits and claims settlement are our specialty.
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Lesa Ong
Keith M. Landy
Jordana Goldlist
Samuel S. Marr
Felicia Zipete
Vadim Kats
Tell us Your Story
Background
At LSM Insurance, we are dedicated to helping life insurance claimants get a fair shake from insurers. We have always offered claim assistance to our own customers and are excited to announce our latest project.
We have teamed up with one of the top legal firms in Canada to help life insurance claimants get a legal opinion on their situation - for free.
Just tell us your story in the box below and we will give you our best advice based on the circumstances. Of course, we can't investigate all the details over the internet, but if you tell us the full story, we can give you a pretty good idea of what your options and what your chances are.
We do sometimes publish our advice as a service to other consumers, but we always remove any personally identifying details from what you send us.
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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.
Thank you for your question. Our firm Landy Marr Kats LLP has experience handling similar cases.
Each case is a little different. It depends on the exact policy wording, on precisely what your pre-departure medical records disclose, as well as careful review of your “story”. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs.
We would really need to meet in person. We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis, which means that we get paid only if and when the case settles, or is won in Court.
Please contact me at the email or phone number below, and I will be pleased to set up a meeting at our office.
Landy Marr Kats LLP
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.
I am sorry to hear that you were injured in a car accident.
To receive compensation for injuries sustained in a car accident you need to establish that you have sustained a permanent and serious injury that is long lasting. We can help you in establishing this once we review the case and determine that your injuries are in fact those for which you can receive compensation.
Please contact us so that we can make a mutually convenient appointment to discuss this further. Please note that you have two years from the date of the accident to commence an action against the at fault party.
Landy Marr Kats LLP
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.
It is important for you to consult with a qualified lawyer. Each case is a little different. It depends on the exact policy wording, as well as a careful review of your story.
Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or a portion of the claim, as well as monies to offset some of your legal costs. While punitive damages are very rare in Canada, if the denial is completely without any legal or factual basis, the Courts do have the power to award damages to punish an insurer. In one famous case a few years ago, an insurer, without evidence, claimed the home owner burnt down his own home.
A large punitive damages judgment was granted to the Plaintiff are time limits in which a lawsuit must be started. A formal proof of loss must be sworn and delivered to the insurer.
We do not charge for initial consultations. If you retain us, we will often agree to be paid on a contingency basis, which means that we only get paid only if and when the case settles, or is won in Court.
Landy Marr Kats LLP
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.
Thanks for the question.
These cases are common and difficult. While it may seem unfair, the onus is on the one applying for insurance to be honest and answer all questions fully and accurately in the application process. Often the insurer does not due a full and proper investigation until after a claim is made.
The legal issue usually is whether there was a “material misrepresentation.” In order to evaluate such a claim we need to see:
1. The application form;
2. The medical files;
3. The denial letter.
At Landy Marr Kats LLP we have successfully handled these types of cases in the past. After gathering all of the information to establish your entitlement to benefits, we approach the insurance company and attempt to resolve the case amicably. If we are retained we would likely do the case on contingency basis which means you don’t pay us until we win or settle your case. Please contact us for a free consultation and we will see if we can help you.
Landy Marr Kats LLP
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.
Thank you for your question. Landy Marr Kats LLP has experience handling many similar cases.
Each case is a little different. Long term disability claims are often very difficult for the insured, because while you are sick you need to gather the evidence proving your sick.
In your case you really need to get your doctor to write a report that is supportive and says you are “disabled” as defined in the policy, provided of course that is the doctor’s medical opinion.
If thereafter the claim is denied we can fight the case for you. The result will depend on the exact policy wording and on the medical evidence. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs. Usually we do not bother appealing denials within the insurers own appeal process. We just sue, because in our experience the appeals are almost always unsuccessful and just waste time.
If your claim is denied we would really need to meet in person. We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis, which means that we get paid only if, and when, the case settles, or is won in Court.
Landy Marr Katz LLP
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.
Hi Cindy,
Unfortunately this is not the type of case we can help with.
I would recommend contacting http://www.fsco.gov.on.ca
Landy Marr Katz LLP
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:
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.
Thanks Alec, I will do that.
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
Thank you for your question.
It depends on the exact policy wording as well as a careful review of your “story”. We would need to see the denial letters and the policy wording. If you have that you could email it to me to take a look at.
As for OHIP you should be making an application to OHIP, they will pay something, unfortunately OHIP rates are low compared to other jurisdictions and likely they will only pay a small fraction of the other bills. As there are deadlines for OHIP and insurance claims you should act immediately.
If the bills are unpaid it will likely effect your credit rating and if sued you may have to consider bankruptcy or making a settlement unless the claim against the insurer can be successfully pursued.
Landy Marr Kats LLP
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.
It is matter of contract between the client and the lawyer. It can vary between lawyers.
Typically the defence will contribute something towards the Plaintiff’s legal costs and disbursements. If the settlement was say $100,000.00 inclusive of interest, claim and costs, a contingency fee would take say 30% of $100,000.00 plus GST plus disbursements, leaving the balance for the client. Sometimes the percentage is exclusive of the defence contribution. Usually, but not always the client is not expected to pay anything for disbursements (except out of the proceeds of settlement). Typically the client owes his lawyer nothing until the Defendant pays money.
However, it is important to remember that claim, on this example was worth less than a $100,000, and some portion of that amount was allocated as the defence contribution to costs. If for example $10,000 was a contribution to costs, the client really is paying $20,000 (plus GST and disbursements) for the fee and the defendant $10,000.00. However, unless the case goes to trial and judge fixes costs, it may often not be so specifically allocated.
However, it is important to remember, that if the case is lost nothing typically will be owed to your own lawyer, in our legal system normally the winning side in a lawsuit must pay costs to the losing side. Therefore, if the case goes to trial and is unsuccessful, the client will have to pay a significant amount for the Defendant’s lawyer’s costs, even if he pays nothing for his or her own lawyer.
Landy Marr Kats LLP
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
Thank you for your question. Landy Marr Kats LLP has experience handling many similar cases.
Each case is a little different. Disability claims are often very difficult for the insured, because while you are sick you need to gather the evidence proving your sick.
Each company is different. Is short-term disability (“STD”) covered by the employer or an insurer? Sometimes employers hire an insurer to “adjudicate” the claim, while responsibility for paying STD rests with the employer. Other times premiums have been paid and STD benefits are the responsibility of an insurer. If the insurer or employer is acting in bad faith a claim can be made for that, but those claims are difficult (but not impossible) to pursue.
You have waited long enough. If you are an Ontario resident, we could meet with you to discuss commencing a lawsuit. We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis, which means that we get paid only if, and when, the case settles, or is won in Court.
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 ?
Thank you for your question. Landy Marr Kats LLP has experience handling many similar cases.
Each case is a little different.
If the widow is an Ontario resident we can fight the case for you. The result will depend on insurance application and the medical evidence. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs. We will get all the medical evidence required.
We would really need to meet you and the widow in person. We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis, which means that we get paid only if, and when, the case settles, or is won in Court.
Samuel S. Marr
Landy Marr Kats LLP
My mother passed away years ago,, And when I was young she teased me about getting her car if and when the day comes, because she was going to write up her will. So I know she had a will. But we couldn’t find it. I am also pretty sure she had life insurance. But I was young and hurting and in no state to look into the matter, and didn’t know where to start. Now years later, a girlfriend of mine is going through the same type of situation with her family. So my question is, is there somewhere for the general public to call or a lawyer or the executor in order to find if the person that passed away had life insurance? How do you know the company doesnt just cancel the policy because of non payment?
thank you
Hi Steve,
The following steps can help you collect on a missing life insurance policy.
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:
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.
Apparently, I signed up for a Life Insurance Policy one evening while I was slightly “intoxicated.” I wasn’t drunk enough not to remember, but I was definitely persuaded to buy it when I wasn’t at my best.
How can I get my money back? I don’t want or need this policy.
Thank you
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
I work for a major Bank which provides short term D/I. I have been off on stress leave with a Doctors note. Manulife claims that they do not pay for stress leave. Can you help? Please answer by email. Thanks
Thank you for you question. If you live in Ontario, we could help you. You can contact me at the email address below.
Typically Banks (because they have more money than most insurers) self insure. This means they do not purchase group insurance for their employees. Instead they create a “Plan” and have an insurer like Manulife “adjudicate” the claims.
We need to see the Plan to see what is covered or not, but I doubt “psychological claims are excluded”. That may be a breach of the Human Rights code.
Sam Marr
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.
Thank you for your question.
My firm Landy Marr Kats LLP has experience handling similar cases.
Each case is a little different. It depends on the exact policy wording, on precisely what your pre-departure medical records disclose, as well as careful review of your “story”. These cases are common and difficult. While it may seem unfair, the onus is on the one applying for insurance to be honest and answer all questions fully and accurately in the application process. Often the insurer does not due a full and proper investigation until after a claim is made.
The legal issue usually is whether there was a “material misrepresentation.” In order to evaluate such a claim we need to see:
1. The application form;
2. The medical files;
3. The denial letter.
At Landy Marr Kats LLP we have successfully handled these types of cases in the past. After gathering all of the information to establish your entitlement to benefits, we approach the insurance company and attempt to resolve the case amicably. If we are retained we would likely do the case on contingency basis which means you don’t pay us until we win or settle your case. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs.
If you are an Ontario resident, we can probably help you. We would really need to meet in person. We do not charge for initial consultations.
Please contact me at the email or phone number below, and I will be pleased to set up a meeting at our office.
Samuel S. Marr*
Landy Marr Kats LLP
In Jan. me and my family were traveling along Hwy 10 stop at a red light @ square one Drive when we were rear ended by a Honda Accord no series injuries at the seen. The next day I contact my insurance company to put in a claim and they said my insurance was canceled 2 months ago duo to 1 missed payment and we were notified by registered mail but I did not get a letter from my insurance company now I am stuck with the damages and I want to get his insurance company to cover my damages.
Thank You!
Grant
Thank you for your question. Missing insurance premiums can result in the termination of the policy. You should however ask to see proof that it was sent by registered mail (was it sent to the correct address).
Samuel S. Marr*
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?
Thank you for your question.
It really depends on the policy language. If the equipment was separately insured then that commercial policy would also be available.
The auto policy may have monetary limit on coverage.
Also the auto policy probably limits your claims to fair market value (but it depends on the policy wording). There is usually some “negotiation room with the insurer”. A lawyer would need to review the policy and denial letter to see if the insurer is correct.
When you buy the insurance it is very important to discuss these issues. A good insurance broker/salesman can make sure your are buying the insurance you need.
Sam Marr
My common-law husband was killed in a single car accident in September. Because it was an accidental death his insurance company was to pay double. The insurance company paid off the basic life amount but has denied double indemity because he had an alcohol blood level of 0.25. Denial was because of intoxication. My husband drank alcohol on a daily basis for the 30 years that I have known him and has a high tolerance to alcohol. Is there any recourse that can be taken to substantiate payment of claim?
Rita
Thank you for your question. My firm Landy Marr Kats LLP has experience handling similar cases.
Each case is a little different. It depends on the exact policy wording. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs.
If you are an Ontario resident, we may be able to help you. We would really need to meet in person. We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis, which means that we get paid only if and when the case settles, or is won in Court.
Please contact me at the email or phone number below, and I will be pleased to set up a meeting at our office.
Sam Marr
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 question. My firm Landy Marr Kats LLP has experience handling similar cases. The insurance company owes you a duty of good faith. Potentially you have a case for breach of that duty.
We would really need to meet in person. We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis, which means that we get paid only if and when the case settles, or is won in Court.
Please contact me at the email or phone number below, and I will be pleased to set up a meeting at our office with either myself or one of the other lawyers in our firm.
Sam Marr
I want to file a lawsuit on insurance company as soon as possible please give me a call at 416 509 3453
Thank you for your inquiry. We will be in touch with you soon. Regards … Lorne
Hello,
My Claim with my insurance company to pay out the balance of a Line of Credit has recently been denied. This Claim was based on the indication in the policy
that a “Stroke” could be grounds for the claim. The claim is based on the policy’s “Life / Health Crisis” requirements.
I suffered a Cerebral Hemorage resulting from a Bleed at an Anuerism. The fact that this is a Stroke has not been denied.
The Insurer has stated that based on the conversation with the Doctor..They have denied my clain as there is no detectable neurological deficit which is a requirement for a claim.
My grounds for appeal are #1: The Policy in my opinion reads that a deficit must be measurable for a minmum of 30 consecutive days. I doubt there would be any denial that this is/was the case. the insurer is Claiming the Policy reads 30 consecutive days and concidered permanent.
#2: In my opinion I do have permanent impairment from the stroke that may not be measurable. IE: Short, sudden sharp headaches.
Ringing in ears
loss of sense of Smell and Taste.
My wife Claims some Memory Loss (Retention)
With also claim personality Change
(Short temper)
In a Nutshell…Based on short version of events as noted above…Do I have “Valid” reasoning to persue an Appeal.
Thankyou for your response,
Thank you for your question. Landy Marr Kats LLP has experience handling many similar cases.
If you are Ontario resident I think we can help you.
Each case is a little different. It depends on the exact policy wording and the medical evidence.
Often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs. Usually we do not bother appealing denials within the insurers own appeal process. We just sue, because in our experience the appeals are almost always unsuccessful and just waste time.
We would need to meet in person. We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis, which means that we get paid only if, and when, the case settles, or is won in Court. Contact me to set up an appointment.
Samuel S. Marr
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.
Thank you for your question. Landy Marr Kats LLP has experience handling many similar cases. If your friend is an Ontario resident I am confident we can help.
Each case is a little different. Long term disability claims are often very difficult for the insured, because while you are sick you need to gather the evidence proving your sick.
We can fight the case for your friend. The result will depend on the exact policy wording and on the medical evidence. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs. Usually we do not bother appealing denials within the insurers own appeal process. We just sue, because in our experience the appeals are almost always unsuccessful and just waste time.
We would need to meet in person. We do not charge for initial consultations. If we are retained, often we will do these cases on a contingency basis, which means that we get paid only if, and when, the case settles, or is won in Court.
Please contact me to set up an appointment.
Sam Marr
416 221 9343
I had purchased a critical illness and life insurance policy with SunLife Insurance in 2005. In April 2008 Iwas diagnosed with prostste cancer and had my prostate removed.I then put in a claim for my critical ilness insurance. Shortly after I put in the claim they denied me because of a minor procedure my father had over 20, years ago which I had no knowledge of. I answered all health questions truthfully. About a month later I recieved a letter in the mail stating they cancelled my life insurance policy.I then got some advice from a lawyer they told me to write a letter to thr Superintendant of Insurance staing the company engaged in Post Claim Underwriting which I did, and have not heard back after several calls. I feel that I have been treated unfair and would like to know if I have a case.
Thank you for your question.
Landy Marr Kats LLP has experience handling many similar cases.
Are you an Ontario resident?
Each case is a little different. It depends on the exact policy wording, the medical evidence and the questions and answers on the application for insurance. If you answered the questions truthfully, coverage should be available.
Often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs.
Please contact me to discuss this matter further.
Samuel S. Marr*
Landy Marr Kats LLP
2 Sheppard Ave. East
(Sheppard Centre)
Suite 900
Toronto, Ontario
M2N 5Y7
416-221-9343 Ext 230
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
Hi James,
I’m sorry to hear about your brother. Are you an Ontario resident, if so we could help you.
Samuel S. Marr*
Landy Marr Kats LLP
Hi there, my wife and I took out a life insurance policy in May of 2008. My wife passed away in December 2008. I have submitted all required documentation only to learn that my claim has been denied on the grounds of material misrepresentation. On the initial application that the broker filled out my wife checked yes to the box that contained depression and anxiety however on the supplemental medical form that the nurse from the insurance company filled out she checked no. I am not sure how or why this error was not picked up by my wife or I or even the insurance company.
The insurance company is suggesting that my wife had a psychiatric history and had they known they would not have issued the policy.I should also note that my wife’s death had nothing to do with depression or anxiety.
I realize that there is an obvious discrepancy on the forms but there was no intent to mislead the insurance company. Shouldn’t the insurance underwriter have picked up this error? Do you think I have a valid argument?
Thanks,
Matt
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 Altaf,
Thanks for the note. I hope you feel better soon.
I would definitely call the bank and see if you qualify for a critical illness benefit under your plan.
Best Regards … Lorne
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
Hi,
My mom passed away in Dec. They had life insurance on their car and her claim has been denied because she had a mri 6 months prior to buying the new car. She had a small blood vessel bleed in her head and the mri was to make sure it stoped bleeding which it had.She passed away from a blood clot that moved in her leg 4 years later,the life insurance co. is claiming that it is related to her prior condation,even tho the agent new of her precondation they said it was not life theatning and sold them the policy.now it is denied is there any way to fight this ?,because as far as i am concerned this company is ripping people off.
Thank you!
Thank you for your question Regina
Landy Marr Kats LLP has experience handling many similar cases. If you are Ontario resident I am confident we can help.
We have often successfully taken on banks and insurers in similar cases, so do not give up. We would consider a lawsuit against both the Bank and the disability insurer.
Each case is a little different. Disability claims are often very difficult for the insured, because while you are sick you need with an insurer who makes it difficult to apply for insurance.
We can fight the case for you. The result will depend on the exact policy wording and on the medical evidence. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs. Usually we do not bother appealing denials within the insurers own appeal process. We just sue, because in our experience the appeals are almost always unsuccessful and just waste time.
We would need to meet in person. We have several lawyers who have experience in these types of cases. We do not charge for initial consultations. If we are retained, often we will do these cases on a contingency basis, which means that we get paid only if, and when, the case settles, or is won in Court.
Please contact me to set up an appointment.
Sam Marr
416-221-9343 ext 230
smarr@lmklawyers.com
Thank you for your question Francis. Landy Marr Kats LLP has experience handling many similar cases.
If you are Ontario resident I think we can help you.
Each case is a little different. It depends on the exact questions asked and answered and the medical evidence.
Often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs.
We would need to meet in person. We have several lawyers experienced in handling these types of cases.
We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis, which means that we get paid only if, and when, the case settles, or is won in Court. Please
Contact me to set up an appointment. At that time we would meet on a no obligation basis. You would need to bring photo ID with you and all of documents you have, including the policy, the application and the denial letter(s).
Please contact me to set up an appointment.
Sam Marr
416-221-9343 ext 230
smarr@lmklawyers.com
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
Thank you for your question. Landy Marr Kats LLP has experience handling many similar cases.
If you are Ontario resident I think we can help you.
How much is the policy? Who told you the beneficiary was changed? Did you ever see any documentation in this regard?
It is important to act quickly before the money is paid out to your husband’s ex-wife.
We would need to meet in person with you. We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis, which means that we get paid only if, and when, the case settles, or is won in Court.
Please contact me to set up an appointment. At that time we would meet on a no obligation basis. You mother would need to bring photo ID and all of documents you have, including the policy documents and the denial letter(s).
Samuel S. Marr
I would like to have a lawyer who would work on commission based and at the end he/she will get most of the amount of claim.
My engagement ring was 20 K and lost and now my house insurance had denied the case. I dont mind at this point just get a small portion of this amount like 2K and have the lawyer take the rest.
Please let me know if you know of any lawyers who would do this.
Thanks in advance,
Wilton
Thank you for your question.
My firm Landy Marr Kats LLP has experience handling similar cases.
Each case is a little different. It depends on the exact policy wording and all the facts relating to the loss.
The legal issue usually is whether there was a “material misrepresentation.” In order to evaluate such a claim we need to see:
1. The insurance policy
2. A sworn proof of loss if you filed it;
3. Documents proving the valus (appraisal) and/or purchase documents
4. Police Report;
5. The denial letter and any correspondence;
6. Copies of any statements you gave.
If you are an Ontario resident, we can probably help you. We would really need to meet in person. We do not charge for initial consultations.
Please contact me at the email or phone number below, and I will be pleased to set up a meeting with one of the lawyers in my firm
Samuel S. Marr
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.
Thank you for your question.
Landy Marr Kats LLP has experience handling many similar cases.
If you are Ontario resident I think we can help you.
Each case is a little different. It depends on the exact questions asked and answered.
We would need to meet in person. We have several lawyers experienced in handling these types of cases.
We do not charge for initial consultations. If you retain us, often we will do these cases on a contingency basis.
I think at this point you would be wise to have a lawyer act for you. You need to focus on getting better and let us fight with the insurer. Also if we are involved the insurer will take your claim more seriously.
Contact me to set up an appointment. At that time we would meet on a no obligation basis. You would need to bring photo ID with you and all of documents you have, including the policy, the application and the denial letter(s).
Please contact me to set up an appointment.
Sam Marr
Here is my story: I have had a disability/illness policy for many years that I pay for myself. I was a driver/broker (self employed and incorporated contracting to one company). I have been contracting to the same company for over 20 years but was incorporated in the late 90’s and became an employee of my corporation at that time. My corporation charged the company for services rendered.
Due to the nature of my employment my knees began bothering me more or less 5 to 7 years ago. As time went on I attempted to relieve the discomfort of working with this pain with a store bought knee brace and herbal supplements then sought medical advice to attempt to relieve the pain. My doctor gave me a cortizone shot to see if this would help but also told me that it would not cure anything either.
In the winter of 2008, I fell on the ice while working and injured my shoulder. This injury caused me to not be able to work in my regular position so I was given modified duties per WSIB, working in the office. I didn’t receive any money from WSIB (they did pay for physiotherapy)as the company I was contracting to decided to continue paying me almost my full rate. I did inquire about my disability/ilness insurance at that time, however my agent had passed away (I was told he was retired and in Florida at the time) and nobody at the Insurance Brokers’ company seemed to know who was to take my case or would talk to me about any specifics on my case due to the privacy act according to them. Someone did send me some forms, however I didn’t submit them because I was not aware that I was entitled to a partial benefit, even if I was still working and receiving income. I was informed by someone at the Brokers office almost a year later that I was entitled to this partial benefit so at that time I began my claim.
I remained on modified duties for almost a year, at which time I came to the conclusion that my knees had deteriorated to the point that it would not be beneficial for me to go back into the truck because my knees would only become worse from the physical demands of my position. The company I was working for also informed me that they would not continue paying me my full rate of pay as the injury to my shoulder had mostly healed and WSIB closed the file on this. They offered me a position as a full time dispatcher starting Jan this year but only paying about 50% of my regular income. I gave up my business as a contract driver and became an employee of the company at this time. Prior to this I was an employee of my corporation.
Now my claim with the insurance company has been completed and they have come to the following conclusion: I am claiming for partial disability commencing Jan 2009 due to my knees, there was an expectation for me to return to my regular duties as a contract driver after my shoulder healed and that my regular occupation was dispatching as of winter of 2008, my hours and duties have been unchanged for my disability claim and because of this I do not meet the definition of partial disability.
The insurance company has however sent me a settlement for 50% of my benefit for 6 months. Here is the paragraph exactly as it is written in their letter explaining their position:
Notwithstanding, at this time, we are prepared to issue benefits to you under the Partial Disability provision to the maximum benefit period of 180 days. Your payment for the period of Feb 14, 2009 to Aug 13, 2009 has been sent under seperate cover and your file is closed. This payment is being made on a Without Prejudice basis. This means that this payment cannot be construed as an admission of present or future liability and we reserve our right to enforce any and all provisions of the policy, and to claim repayment of this payment to you.
I take this as a direct threat to me not to pursue this matter any further. Following are the clauses apparently out of my policy that they are quoting and they are basing their decision on:
1) The insured person is engaged in his Regular Occupation or any gainful occupation; and due directly to injury or illness is unable to perform either one or more important duties of his regular occupation or the important duties of his occupation at least one half of the time normally required. Regular occupation is defined as “the occupation or occupations the Insured Person is actively involved in for compensation at the date he becomes disabled.
I am not sure if there is a provision in my policy for long term disability, but i do believe (so does my doctor) that this is a long term disability and I want to be sure that I am not entitled to a permanent benefit before I drop this claim. Please give me your thoughts on this. Thank You.
We can fight the case for you. The result will depend on the exact policy wording and on the medical evidence. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs. Usually we do not bother appealing denials within the insurers own appeal process. We just sue, because in our experience the appeals are almost always unsuccessful and just a waste time.
We would need to meet in person. If we are retained, often we will do these cases on a contingency basis, which means that we get paid only if, and when you get money either because the case settles, or is won in Court.
Please contact me to set up an appointment. If we need we need a copies of the insurance policy (if available) all correspondence with the insurer and all medical reports which you have. You also need to bring with government issued photo ID and your OHIP card.
Sam Marr
416-221-9343 ext 230
I lost my life insurance beneficary policy. My cousin died. How do I find the company.
Thanks for the note - There is no guaranteed way to find the company but the following tips may help:
Try and locate you cousins insurance brokers, lawyers and accountants.
Go through his/her personal effects to see if there has been any record made of contact with insurance companies, brokers or agents.
Check banking records to see if there are any cancelled cheques or entries in statements or pass books indicating premium payments, and to whom payable.
Check safety deposit boxes, strong boxes, and other storage places like the basement and attic.
Contact the personnel/human resources departments of previous employers.
Contact any associations to which the deceased’s occupation indicated that he/she might have belonged.
I hope this information helps. Regards … Lorne
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.
I was driving home from work when another person ran a red light, I managed to avoid collision but hit a curb, the person expressed that they did not want to go through insurance but pay me damages instead. later she was delaying in payment so I called my insurance company to ask what I should do?…they put it through as a claim!… I didn’t want this and have not received any kind of money or lost damages or injury help from them, this was not fair, can I get this claim removed, they say it is an at fault claim because I verbally told them I hit something even though it was a curb.
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
Comment:
I’m not even sure if you can help. My father passed away and left 2 insurance policies with his work. One has his ex girlfriend (from over 10 years ago) as the named beneficiary and the other has my brother as the named beneficiary. My brothers and I want to dispute the policy in my fathers ex girlfriends name and have the funds depostited into our fathers estate account. To date the named beneficiary has not replied to any mail sent or filled out the package sent by the insurance company to claim the money. The money is now sitting in a court waiting to be claimed. The policy with my brother as the named beneficiary has been paid to him but my other brother and I would like to dispute this claim also and have the money depositied into our fathers estate account. Is this worth pursuing?
If the deceased was an Ontario resident we may be able to help.
It depend what the Will says and when the Will was prepared.
Our initial consultation is free.
Sam Marr
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.
My suggestion is to report this to your auto insurance company, as it is covered under comprehensive coverage ( windstorm or flying objects)
Provide your neighbors insurance information to your insurer and leave it up to them to subrogate.
If you have any further, please feel free to call me to discuss.
Cathy S. Ramsundar
Associate Broker
Mitchell Sandham
467 Westney Road, South, Unit 13
Ajax, Ontario
L1S 6V8
905-683-4549 ext 224
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.
Thanks for the note.
If your policy was not issued you definetely qualify for a full refund. I would recommend contacting your broker or Canada Life at 416.697.6981.
Regards … Lorne
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
Thanks for the note. Insurance companies will generally treat bankruptcy and consumer proposal as the same and they will generally postpone issuing coverage until fully discharged.
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.
Thank you for your question. Landy Marr Kats LLP has experience handling many similar cases. If you are an Ontario resident I am confident we can help. The initial consultation is free.
Each case is a little different. Disability claims are often very difficult for the insured, because while you are sick you need to gather the evidence proving your sick.
We can fight the case for you. The result will depend on the exact policy wording and on the medical evidence. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs. Usually we do not bother appealing denials within the insurers own appeal process. We just sue, because in our experience the appeals are almost always unsuccessful and just a waste time.
We would need to meet in person. If we are retained, often we will do these cases on a contingency basis, which means that we get paid only if, and when you get money either because the case settles, or is won in Court.
Please contact me to set up an appointment. If we need we need a copies of the insurance policy (if available) all correspondence with the insurer and all medical reports which you have. You also need to bring with government issued photo ID and your OHIP card.
Sam Marr
416-221-9343 ext 230
smarr@lmklawyers.com
Hi there,
I am a young professional who had a MVA in June during my lunch break at work. This was the first ever accident or claim in my 10 years of driving history.
Currently I am facing several problems when dealing with my insurance company with regards to my ‘Short Term Disability’ Issues.
I continue to be n constant pain; facing occasional numbness feeling of my right leg; shooting pains in my right shoulder, headaches.
I do have all my reports with me, Will you be able to help me with the situation and make the Insurance company pay my entitlements as we depend on them for our survival.
Please advise.
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?
We can help. We can do your case on a contingency basis, i.e. you don’t pay us until we get you the money.
We need to investigate why the company has not paid your past wages. If the company has the money to pay and is simply delaying in paying, then we can commence legal proceedings to ensure that a payment is made to you.
If the company claims that it has no money to pay you, then consideration should be given in imposing personal liability against the Directors of the corporation. Business Corporation’s Act of Ontario (s.131) imposes personal liability upon the Directors of the Ontario Corporation for unpaid wages up to a maximum of 6 months’ salary.
Also, under the Employment Standards Act of Ontario (s.81) directors are personally liable:
1) where the employer is under a court appointed received or bankruptcy;
2) there is an unpaid Order to Pay made by an employment standards officer against the employer;
3) there is an unpaid Order to Pay made by an employment standards officer against the Directors; or
4) the Board has issued a certain decision under s.116.
The wages under the Employment Standards Act does not include termination or severance pay. The maximum liability of the Directors under the Employment Standards Act is for not more than 6 months’ wages, and for vacation pay which accrued for a period of not more than 12 months. Interest is payable on outstanding wages for which the Director is found liable. There are restrictive limitation periods apply, and so you need to act quickly by contacting a lawyer.
Vadim Kats
Landy Marr Kats LLP
www.thetorontolawyers.ca
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
Thank you for your question. Landy Marr Kats LLP has experience handling many similar cases. The initial consultation is free. YOU MAY ONLY HAVE ONE YEAR FROM THE DATE OF DEATH TO SUE SO YOU NEED TO CONTACT A LAWYER IMMEDIATELY.
Likely the INSURER may be considering denying the case for one of two reasons. One reason may be because they are suspicious that whether the “death” occurred. They have an obligation to act in good faith and if there no basis for the denial this would be an outrageous claim for which we can claim damages for bad faith in addition to the amounts due under the policy.
Each case is a little different. It depends on the exact policy wording, and the second reason they may be denying is because of error in the medical information given to the insurer when the policy was written. The outcome may depend on precisely what the prior medical records disclose, as well as careful review of your “story”. The deceased did have an obligation to answer medical questions truthfully.
These cases are common and difficult. While it may seem unfair, the onus is on the one applying for insurance to be honest and answer all questions fully and accurately in the application process. Often the insurer does not due a full and proper investigation until after a claim is made.
The legal issue usually is whether there was a fraud or a “material misrepresentation.” In order to evaluate such a claim we need to see:
1. The application form;
2. The medical files;
3. The denial letter.
At Landy Marr Kats LLP we have successfully handled these types of cases in the past. After gathering all of the information to establish your entitlement to benefits, we approach the insurance company and attempt to resolve the case amicably. If we are retained we would likely do the case on contingency basis which means you don’t pay us until we win or settle your case. Very often the initial denial is overturned, either by the Courts or by way of a settlement in which the insurer agrees to pay all or at a portion of the claim, as well as monies to offset your legal costs.
If you are an Ontario resident, we can probably help you. We would really need to meet in person. We do not charge for initial consultations.
Please contact me to set up an appointment. If we need we need a copies of the insurance policy (if available) all correspondence with the insurer and all medical reports which you have. You also need to bring with government issued photo ID and your OHIP card.
Sam Marr
416-221-9343 ext 230
smarr@lmklawyers.com
I was denied a claim my spouse and i had with …. ….for $.00,000.my spouse died on july 1 and i contacted the insurance company.they took a long time processing the claim and made me sign release forms.after several months of me calling and contiually being given the runaround they said that we had missed a payment and that we ahd to be reinsured.i had no knoledge of this.my spouse said it had been taken care of.they say that the date this happened was the same as the date that my spouse was admitted to the hospital for the first time and they say that she knew at that time she was sick.she did not find out anything until some time latter.i say the dates were coincidence and the insurance company is wrong.they also said we would had to have signed a reinsurance agreement.i don’t recall any document.they did not provide any documentaion to support their decision to denie the claim, just a letter saying claim denied for the reason i mentioned already. I find it difficult to believe that there is nothing i can do targue with these people.my spouses passing left me in some financial difficulties which i’m sure the insurance companies are aware.they dragged out the processing of the claim for months and then sent me a cheque for 3100 which they say is the money we paid back to the date of reinsurance and apearently thats their final decision. please help me.is there not some government agency that protects the woking class from these companies railroading people with their high priced corporate leagal departments.there should be some law against this.