Insurance Claim Problems? Get a Top Notch Legal Opinion

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 Andrew Suboch B.A., LL.B. 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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PS. This page is for life and health insurance claim advice. We have a separate page for auto and property insurance claim advice.

True Stories

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.

Tell us Your Story




Get the law on your side.

andrew
Andrew Suboch B.A., LL.B.

Andrew Suboch B.A., LL.B.

Barrister-At-Law

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346 Comments

  1. nocatala 12/27/2013 at 2:52 am

    i made a claim on Tuesday about my husband death,they say my money will be available on Friday at 00:00am bt still no notification about my money.

  2. LSM Insurance 12/27/2013 at 9:15 am

    Hi Mike,

    You need to contact BMO directy for your inquiry. By email at [email protected] or by phone at(416) 596-3900.

    Thank you

  3. LSM Insurance 12/27/2013 at 9:17 am

    Hello,

    You need to contact the insurance company directly.

    Thanks

  4. Karry 12/30/2013 at 1:55 pm

    Hi my name is …. , my 17 year old daughter, who was 16 at the time
    was in a car accident with her friend approximately 5 months ago. I
    assumed an accident report was filed and just found out it wasn’t.My
    daughter received 15 stitches to her chin and has permanent scaring not
    to mention she is still having pain and discomfort due to the injury. I
    would like to know if we can sue for personal injury as well as
    negligence as her friends parents didn’t inform the police or insurance
    company of the accident ?

  5. Andy Suboch 12/30/2013 at 1:57 pm

    I am responding to your recent inquiry. I apologize for the delay in responding but have been involved in a trial against the TTC involving a 4 year boy who got hit by a streetcar. His injuries have been deemed to be catastrophic.

    Based on you description below, absent any other information, I believe that your daughter would have a right to sue the person who caused her injuries. She likely would also have a significant claim for what are known as “accident benfits”. Anything recovered through either a tort claim or through accident benefits is non-taxable.

    If you would like a free consultation in regard to your daughter’s possible claims, please call usha at 416-815-1331 x221 to arrange for either a meeting or phone conference.

    Regards,

    Andy Suboch

  6. June 01/15/2014 at 12:12 pm

    My … year old partner was recently hospitalized for strokes in … . As a result, he has not been able to return to work. He earned 2/3
    of our family income. He works for a union and has benefits, however his
    disability claim was denied. The reasoning was that his strokes were
    caused by severe migraines, which were caused by post-concussion
    syndrome as a result of an MVA in Nov. 2011. Symptoms of post-concussion
    syndrome did not develop for several months,he did not seek treatment
    for several more months due to pride.

    He was referred to a neurologist who recently made a diagnosis. The
    hospitalization was the first sign of stroke. After his employer denied
    the claim, we have submitted through his car insurance. They are upset
    since no medical claim was opened at the time of the accident, but no
    medical claim was needed, and no expenses or time off from work was
    needing to be compensated. A claim was opened for the cr. The auto
    insurance is now become abusive. They are demanding health records from
    birth, my parent’s dates of birth and other personal information (they
    were not involved in the accident in any way). How far back can they
    legally request?

    I feel taken advantage of and that the auto insurance is putting the
    burden on us, despite signing release of records authorizations and
    providing the employer’s information to seek coordination of benefits.
    Please advise. Kindly also advise your fees for services, should we
    choose to hire you for this matter. Do not hesitate to contact me if
    more information is required.

  7. Andy Suboch 01/15/2014 at 12:13 pm

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

    It appears to me that your partner should make a claim as against both the disability carrier and the auto insurer. If he/she was not at fault for the mva, then a claim should also be made as against the person or parties who caused or contributed to the accident.

    To request the notes and records all the way back to your partner’s birth and those of his family members seems to me to be grossly excessive, intrusive and a breach of the duty of utmost good faith of the insurer.

    I charge, on a contingency basis, 30% + HST and disbursements.

    If you and / or your partner would like a free consultation, please call Usha of my office at 416-815-1331 x221 to arrange for same.

    Regards,

    Andy Suboch

  8. jordan 01/27/2014 at 3:42 pm

    Hi,In the 1980s i bought a life insurance policy through avco,in fort st john bc,My mom was the benneficary and she has passed away, is there anyway you can help me to find out where this policy is ty very much jerry

  9. LSM Insurance 01/27/2014 at 5:17 pm

    I can across this link. Hopefully it can help link to phonepages.ca. Regards,

  10. Karl 02/21/2014 at 6:11 pm

    Comment:
    Have worked for employer 13 yrs.just recieved f/t in June 2013.Went off on short term disability and have now been denied ltd because I have a pre existing illness and haven’t had benefits for at least a yr.
    Unable to work .What to do?

  11. Andy Suboch 02/21/2014 at 6:12 pm

    If you were on short term disability [STD] and the insurer cut you off/ denied LTD due to a pre-existing issue, that seems to be at odd with most LTD policies. You may have a claim. If you’d like to discuss this further on a without cost basis, please call Jessica 416-815-1331 x221 to arrange for either a phone or person meeting.

    Regards,

    Andy Suboch

  12. jeremy w 03/21/2014 at 7:16 pm

    I have money entitled to me but I don’t know the insurance company’s name ..its been there till I turned 21 and I’m 22 years old. My Mother passed away by accident from the driver going over a cliff in BC and I don’t know how or where to find it

  13. LSM Insurance 03/22/2014 at 12:14 pm

    I am very to sorry to hear that. You could check pass bank statements, pay stubs or her safety deposit box for clues on who she had coverage with. Attached is a list of the different insurance companies in Canada and their contact details link to lsminsurance.ca

  14. Joey 04/24/2014 at 11:10 pm

    I have had a preventable injury at work my neck and shoulder was killing me because the hitch on the mule I was driving was sticking so I wrote it on the safety sheet that I needs to be greased and I told …. I even told super visors on the other shift because the maintenance was not working on midnights I wrote letters and stuck them in all the managements mailboxes just so someone could fix it before my shoulder goes out again but nobody would listen and my neck and shoulder went out It’s a very long story sir but the point is that management did not like the fact that I was injured they tried and tried to get me fired they tried to get me to blow my cool just so they could fire me WSIB knows all about it but they had me down for a neck strain which it is not I have my MRI results and there is pinched nerves and bulging discs in my neck that they say are non-compensating my doctor had me working 3 days a week then on April 13 2014 my work (…. wrote me a letter that says they have made a decision that I fit to go back to work full time and they don’t care what my doctor or any doctors say and if I don’t go to work full time then just go home so I am at home now with no money coming in because I hurt myself at work and now I can’t move my neck I where a full neck brace 6-8 hours a day I don’t drive I don’t do any sports I don’t sleep I lost 45 pounds so now I really don’t know what to do I am hoping that maybe you can help me or at least know someone or something that I should do please let me know thanks for listening Geoff

  15. Andy Suboch 04/25/2014 at 3:27 pm

    I am a lawyer who practises in the area of personal injury. I have done so for more than 20 years.

    Based on what you have set out below, it sounds like you should be making a WSIB claim. I fail to see how the employer can deny that your injury is workplace related. As it appears to be directly related to the work-place, and was sustained while at work, I do not believe your have a legal case to sue for pain and suffering. I encourage you to go to the WSIB.

    Regards,

    Andrew Suboch

  16. Frank 07/07/2014 at 3:13 pm

    My doctor recommend to my employer and I that I work straight days for a period of time to help with my anxiety and depression. While on off shift my condition worsens. It tends to lead to longer breaks leaving early crying and generally breaking down more often. So my employer had told me to go on std cause they can not accommodate straight days. Work did not schedule me since …. even thought I had asked two of my supervisors for hours I was told to take the time and come back when I was better. Now 5 weeks later my work called and said my claim has been denied ??? I’ve called …. 5 times today and left messages but they have not called me back and my work wants me to call them back today to let them know what I plan on doing. I really am at a loss of what to do now

  17. Andy Suboch 07/07/2014 at 4:59 pm

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

    I cannot comment on …. denial other than to advise, in my opinion, if your doctor recommends accommodation at work, and work cannot so accommodate your medical needs, then prima facie, in my opinion, you probably are entitled to STD’s. Without more information I really can’t give you more of an opinion.

    If you’d like to discuss this further, please call Aimie of my offices at 416-815-1331 x221 to schedule an appointment.

    Until I am duly authorized by way of written retainer, I confirm that I am not your lawyer and will take absolutely no steps to protect any of your interests as they might be.

    Regards,

    Andy Suboch

  18. Karen 08/14/2014 at 2:20 am

    Dear Sir,

    My daughter’s father was murdered on his front lawn 3 years in ….. He had taken out a life insurance policy with …… in the event of his death in trust to me for our daughter. I filled out all their forms, sent a copy of the death certificate and they then asked for the coroner’s report. Police told me that I need a lawyer and they are not allowed to ask for that. I read through the policy and it stated “self-inflicted death” (ie suicide) was not covered. His death was ruled a clear cut homicide. The insurance company was aware that he had a criminal record (and obviously a past to go with it) yet they insured him anyways. He always paid his premiums on time and in full. I knew very little about all of this and made the mistake of sending them the original policy and after asking for the coroner’s report, the insurance agent I was dealing with stopped returning correspondence. I think my lack of knowledge on the subject was evident and used against me. I was denied Orphan’s Benefits as my partner had not paid into …. one year. He was the breadwinner and did catering full time and provided for me. I was cut off social assistance for reasons pertaining to my mental health leaving me numb and unmotivated to attend job banks after such a horrific tragedy for my family. The only money I receive to raise my daughter is my Child Tax Benefit. I am fortunate to have family who has taken me in as I am out of options. Not only did I lose my partner, my father hung himself a little over a year later. I am hoping you are able to be of some assistance. I do have a good friend willing and able to perhaps help with legal costs if it is determined that it is worthy and capable of being pursued.

    Best regards,
    Melissa

  19. Andy Suboch 08/14/2014 at 2:15 pm

    I would like to first extend my condolences on what you have set out below. The presence of a criminal record for your father is irrelevant in my opinion. Obviously you have suffered a horrific loss.

    I do not know why The Co-Operators is refusing pay benefits. From what you have set out, it seems as if you have a good case. I can’t really give you any more of an opinion but am concerned by your comment that the murder occurred almost 3 years ago. There may be a limitation period that might serve to bar any claims.

    I strongly urge you to more fully discuss this with a lawyer ASAP. My office do free consultations and we only charge if we take the file and win. If you would like to meet up and discuss the case in more detail, on a without charge basis, please call my reception at 416-815-1331 x221 to make such an appointment.

    Until my offices have been retained by way of written retainer, we will take absolutely no steps to protect your interests or those of your father’s estate.

    Regards,

    Andy Suboch

  20. dawn 09/11/2014 at 10:09 pm

    My father has 3 daughters from his first marriage and 2 daughters from his common law marriage.
    He was common law with a woman who had 2 boys.
    All together there is 7 children between them.
    My father worked for over 30 years for the city of scarborough Ontario as a garbage man.
    He always told us we would be taken care of.
    He died 3 years ago and we never heard a thing about insurance or assets of his.
    I assumed his common law wife received his pension and life insurance.
    Well she has passed now too.
    Do I as her step daughter or his daughter have any rights to anything.
    How do I find out if I was on his life insurance?
    What happens now that she has died 3 years after him.
    Does only her kids get the assets ?

  21. Andy Suboch 09/12/2014 at 1:18 pm

    I am an Ontario lawyer who has been practising in the area of personal injury and insurance law for more than 20 years. I have been asked to respond to your inquiry below.

    The first place to start would be with the will, if any, of your father. If there is no will then the succession rules/ regulations under Ontario’s Family law Act would likely apply.

    Without any knowledge as to whether there is or isn’t a will, I really can give you any valid opinion or provide advice as to what I believe you should or shouldn’t do.

    Regards,

    Andrew Suboch

  22. Ewan 09/15/2014 at 2:14 pm

    Hello, me and my husband had bought a house more than a year ago and obtained a life insurance which covers our mortgage in case if one of us gets hurt. After 5 months my husband had to go through surgery and is unable to work. We submitted all necessary documents and claims right after surgery and had been waiting for the answer from insurance company for 8 months already. But they keep saying that our claim is in process.
    Are there legal deadlines for the company to pay us? How long should we wait before going to the lawyer?

  23. Andy Suboch 09/15/2014 at 3:28 pm

    Based on what you have set out below, I wouldn’t wait any longer. The insurance company is expected to make a decision within a “reasonable time”. What constitutes “reasonable” is not defined but I am of the opinion that waiting for 8 months is far too long. Such wait may be grounds for an award of punitive damages. What appears to be an un-reasonable delay has no doubt greatly contributed to the stress that you and your husband are facing, both psychologically and financially. Insurance of the nature you have described below is often marketed and sold on the basis that it will bring comfort to those who purchase it. The insurer, by causing un-necessary delay, may be increasing the very damage that its product was intended to avoid.

    If you would like to discuss this claim please feel free to contact Eliza 4416-815-1331 x221 for a free consult. I have offices in downtown, east end and on the Toronto Mississauga border. The initial consult is free and if you do retain me and my offices, you don’t pay until money is received.

    Regards,

    Andrew Suboch

  24. Trish 10/02/2014 at 10:41 am

    Hello, my mom recently passed and she has two simple life insurance
    policies: ScotiaLife and BMO. It appears that each will pay out $…. as her death was not accidental.

    My sister and I are the beneficiaries, we are the only children my mom had. She is divorced.

    My complaint is that they are asking for unnecessary documents – … a copy of her Will and …. a copy of her birth certificate. A copy of her death certificate should be all they require, sheesh it was good enough for CRA.

    I do not want to have unnecessary information regarding my mom floating around. What do you advise?

    Thank you,

  25. Andy Suboch 10/02/2014 at 10:42 am

    I am an Ontario lawyer who has been practising in the area of personal injury, wrongful death and insurance law for more than 20 years. I have been asked to respond to the below.

    Generally speaking, an insurer is entitled to a reasonable amount of information including copies of certain documents, when a claim is processed. This is done to ensure compliance with the policy and entitlement to the benefit claimed. Given that this is a life insurance policy, a copy of the will does not seem unreasonable – this is to permit the insurer to ascertain whether there might be other claimants on the policy. Regarding the birth certificate, this too does not seem to be too excessive.

    The insurers are under a legal duty to keep all personal information and/or documentation safe-guarded. Were these documents to be released into the general public, either directly or indirectly, then, in my opinion, you might have a cause of action for breach of privacy. I do not believe that these documents and/or the information therein will be “floating around”. If you were to commence legal action, the court file which likely would contain these documents, would be open to public access.

    You could challenge these requests but in my opinion, given the amounts claimed, I would not recommend such a course of action.

    Yours very truly,

  26. Ray 10/16/2014 at 6:22 am

    My dad passed on in 2007 and there was no claim at old mutual will I b able 2 claim now and get the benefits?

  27. Andy Suboch 10/16/2014 at 10:57 am

    It is very difficult to give an opinion based on the minimal information that you have set out below. Generally, claimants must start legal action to pursue claims within 2 years of the cause-of-action arising. I do not know if or when a claim was made against Old Mutual. I don’t know if or when such claim was denied. I don’t know if there are extenuating circumstances that might permit a claimant [ie. You] to surpass an applicable limitation period through the doctrine of “discoverability” . however, the general rule is a claim must be commenced within 2 years that a cause of action arose. The onus is on the party that is outside the 2 year limitation period to show circumstances that would allow it to be surpassed.

    Regards,

    Andrew suboch

  28. Paula 10/28/2014 at 2:37 am

    I took out a critical illness policy on a …. . I found out I had cancer on July 15, 2014.
    I am fine with the 90 day waiting period from the Jan 23 date. but what concerns me is that my family doctor has in her records that I a polyp was found in Aug. 2013 and that I had irregular bleeding in …. Will the insurance company look at that as a pre-existing condition.
    Every woman and man have all kinds of polyps and possible cancer was never mentioned. Also women in menopause bleed irregularly all the time. I hope they would realize that.??
    Is there any way I could leave my family doctor’s record of that out of the claim? Thank you!

  29. Andy Suboch 10/28/2014 at 10:25 am

    The short answer, in my opinion, to your inquiry, is, ‘No” but the longer answer is that it, again, in my opinion, should not matter. Whether you did or did not have a “polyp” and/or irregular bleeding prior to taking out the policy may be irrelevant depending on what questions were asked and how you answered. Without looking at the actual insurance application I really can’t say more, but usually the questions are very broadly phrased. The insurer may have asked did you have any “pre-existing conditions and/or illnesses” …. from what I see below your answer was “No” because you did not believe the polyp and irregular bleeding was an “illness” or “condition” [or words to that effect].

    I really can’t comment more but if you believed that you answered the questions honestly, and there is any ambiguity in the questions, then you should, in my opinion, be alright to release these records.

    If you would like a free consultation to discuss this further, please call Eliza 1-416-815-1331 x221.

    Regards,
    Andrew Suboch

  30. louis 11/10/2014 at 3:20 pm

    Hi I took out a policy in …
    We fell on difficult times. The policy lapse. We building a complex at the time, so went back and borrow an additional ..to complete the building.

    The insurance company we borrowed the monies from said we needed to take more coverage . We took out a term insurance for …. The 30k, was to apply the mortgage and the difference goes to me as the beneficiary.

    We got the ok to complete the building in august because the policy was approved in august ….. My insurance brought us the contracts in November of …..

    I asked my agent if its been approve from August why did they took so long to send the contracts back. She said that’s how long they took. My husband became ill the late part of January ..
    He had brain tumor he was having headaches the took some test and found out he had tumor. He was treating the headaches as a sinus condition. He passed away in … of … of blood clot in his legs and travel to the heart which caused a heart attack.
    The death certificate has on it cause of the death Pulmonary Embolism.

    The insurer deny my claim and didn’t pay off the balance of the loan which was assigned to them the insurance company my mortgage loan.
    The paid off the first loan of 230k that policy I took out with them in 2010.

  31. Andy Suboch 11/10/2014 at 3:21 pm

    I am sorry to hear of your loss and extend my condolences re your husband’s passing.

    I have been asked to respond to the below.

    I am a lawyer who has been licensed to practice law in the Province of Ontario for more than 20 years. The areas of which I concentrate are personal injury and insurance matters. A case that I argued last year both at trial and on appeal – Bawden v Wawanesa Mutual Insurance Company – has been called one of the year’s most important in terms of coverage matters [we won at both instances].

    From the below it appears that you might have a case as against both the insurer and the broker, if there was one. I really can’t say more without a more thorough review of documents and a meeting with yourself to get additional facts. If you would like to meet, please call Eliza at 416-815-1331 x221 to arrange for a free meeting. I have offices in downtown Toronto, Scarborough and Etobicoke near the airport.

    Generally speaking, you have 2 years to commence action from when you knew, or ought to have known you had a case. If you fail to commence action within this time, your claims may be statute-barred pursuant to what is known as the limitation period.

    Until I have been duly retained in writing, I will not take any measures to protect your interests or the interests of your husband’s estate.

    If you would like to discuss this further, please call Eliza at the number above to arrange for the free consultation.

    Regards,

    Andrew Suboch

  32. Jason K 12/01/2014 at 3:38 pm

    Hello, my fathers annual income was approx. 150,000. Or more a year.
    When he passed his life insurance PD only 40,000 total. We could not locate original policy. How can I see that this is the legit payout? His company is worth approx 1.5 million and the amount seems low. Thank you for any response.

  33. Andy Suboch 12/01/2014 at 3:39 pm

    To find out if the payout is “legit” should be relatively easy – you merely need to get a copy of the “Declarations page” from the insurer. This is a document that shows the policy’s limits, when purchased, when effective and for what risks the insurance was issued. The insurer should provide you with a copy; if they won’t, then you should be very suspicious. If they don’t, go to insurer’s Ombudsman or to the Financial Services Commission of Ontario. The Executor of your Father’s Will and Last Testament should be the person proceeding in such a manner.

    Given your comments about the value of your father’s company and what seems to be a policy of insurance intended to protect his heirs in the event of his death, there MAY be a cause of action as against whoever was advising your father in terms of insurance coverage as there seems, based on what you have set out below, to be a significant difference between what might have been appropriate coverage and what was secured. However, without considerably more information, I really can’t provide any concrete opinion in that regard.

    If you would like to discuss this further, please contact Kaitlin at 416-815-1331 x221 for a free consult.

    I confirm that until I have bene duly retained by way of written retainer, I have not been retained to protect your interests.

    The general limitation period in Ontario is 2 years from when a cause of action arose, or when you ought to have known a cause of action arose. If you commence legal action outside the applicable limitation period, then your claims might be statute-barred.

    Regards.

    Andrew Suboch

  34. Charles 12/29/2014 at 7:20 am

    My deceased partner died from cancer june 2009 but her insurer refuses to honor her policy because she failed to dis-close on her application form that she had diabetes.
    Her doctor states that diabetes did not contribute to her demise and that her diabetes was being managed and was under control at the time of her death Have I any options Thanks

  35. Andy Suboch 12/30/2014 at 1:55 pm

    Sir,

    If the Court finds that your partner intentionally failed to disclose a pre-existing condition then I am of the opinion, even if the pre-existing condition DID NOT materially contribute to her demise, a Court could find that the policy was void ab initio ie. from the beginning. If the insurer is taking that position, then they should return the policy premiums. If they have failed to return the policy premiums and take that position, then their failure to return such premiums make be an estopple to raising the non-disclosure as a defence.

    A bigger problem may be that your partner passed away in 2009. That was 5 years ago. Generally speaking you have 2 years from when the insurer denied the claim to bring an action. I suspect that you may be out of time pursuant to what is known as the limitation period to successfully sue the insurer, EVEN IF the non-disclosure issue could be traversed.

    Regards,

    Andrew Suboch

  36. Andy Suboch 12/30/2014 at 2:06 pm

    Sir,

    If the Court finds that your partner intentionally failed to disclose a pre-existing condition then I am of the opinion, even if the pre-existing condition DID NOT materially contribute to her demise, a Court could find that the policy was void ab initio ie. from the beginning. If the insurer is taking that position, then they should return the policy premiums. If they have failed to return the policy premiums and take that position, then their failure to return such premiums make be an estopple to raising the non-disclosure as a defence.

    A bigger problem may be that your partner passed away in 2009. That was 5 years ago. Generally speaking you have 2 years from when the insurer denied the claim to bring an action. I suspect that you may be out of time pursuant to what is known as the limitation period to successfully sue the insurer, EVEN IF the non-disclosure issue could be traversed.

    Regards,

    Andrew Suboch

  37. Lloyd J 01/27/2015 at 9:27 am

    My dad passed on …. I am the sole beneficiary of the life policy,I checked on the status of the policy and … told me it was all ready to go , but they were holding payout until the executors finalized his income tax.I am not the executor to the estate and have been informed that the benefits have no part in his personal income tax. Are they just holding it to collect the interest , and if so what action can I take.

  38. Andy Suboch 01/27/2015 at 2:30 pm

    I am sorry to hear of your father’s passing and what appears to be un-necessary grief imposed on you by ….. delay.

    Whether the estate does or does not owe income tax, in my opinion, should be of no relevance to whether Great West Life or when Great West Life pays out on your Dad’s insurance policy. I would give them an ultimatum of 10 days and if the monies aren’t advanced, bring an application for and Order that they pay along with interest and costs.

    If you would like a free consultation please feel free to contact Kaitlin at 416-815-1331 x221 or x223 to arrange for such meeting.

    I confirm that as of the date of this email, you have not yet retained my offices. There is a 2 year limitation that might apply so if you don’t start a claim as against … by …. then your claims might be statute-barred.

    Regards,

    Andrew Suboch

  39. Louise 02/26/2015 at 9:22 am

    Good morning,
    My husband and I applied for a life insurance 2 months ago, just before Christmas. Not having heard from them since then, I phoned the gentleman who is trying to sell it to us. He made some inquiries and found out that they have lost my entire medical exams (questionnaire and blood work). I am shocked that something like this could happen and that the company would not make contact with me to inform me of the situation, present apologies and reinsure me that everything would be done to find what happened. I still haven’t heard from them. What can I do at this point on a legal point of view?
    Thank you for your help and advice,

  40. Andy Suboch 02/26/2015 at 3:29 pm

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

    There is legislation in Canada that requires companies etc to safe-guard private and/or personal information. If they have lost such information pertaining to you and your husband you probably could sue the insurer for breach of privacy rights. However, unless you can show where the mis-placed information went, your damages might only be nominal. As an example, if the information is sitting in a box, under a secretary’s desk at the insurance company, and no one is accessing the information, it is difficult to see what damages you have sustained. As an alternative, if this information were to be widely disseminated throughout the insurance industry then your damages would be, in my opinion, quite high. As a plaintiff, you would have the onus to prove your damages or at the very least to show how widespread your loss of privacy was or may have been.

    I wish you best of luck with your future endeavours.

    Regards,

    Andrew Suboch

  41. Kyle 02/28/2015 at 12:52 am

    Hi,
    So I got hurt and my Insurance company said that I waved my disability portion of my insurance policy.
    However I do not at all remember signing a waiver for that.
    What can I do?

  42. Andy Suboch 02/28/2015 at 2:53 pm

    Without further information I really can’t give an opinion. You should ask to see where you explicitly agreed to “waive your disability portion of your insurance policy” [sic] and if there is a document to that effect, get a copy of same.

    If you would like an opportunity to discuss this further, for a free consultation please call Kaitlin at 416-815-1331 x221.

    I confirm that you have not retained me as of date of this email and until I am duly7 retained by way of written retainer I shall not take any steps or measures to protect any of your interests.

  43. Brenda 11/09/2015 at 1:13 am

    My husband died in a single car roll over. His BAC was …. He was diabetic and he had elevTed blood sugar at the time of his death. The coroner’s toxicology test said that confirmation of the etoh could not be performed due to the elevated glucose result. It also said that the etoh result could be invalid due to the high sugar. Can the insurance company still deny his AD & S D coverage? Do I have a case against this?

  44. Andy Suboch 11/09/2015 at 1:24 pm

    I am a lawyer, duly qualified to practice law in the Province of Ontario, with more than 20 years experience in the areas of personal injury, insurance matters and moving to set aside wrongfully-based insurance denials. A relatively recent case that I won both at trial an on appeal, Bawden v Wawanesa, resulted in the parents of a permanently injured daughter getting insurance coverage that had been denied. An insurance industry publication, Canadian Underwriter, called it one of the top 10 coverage decisions. I have been asked to respond to your inquiry below.

    Based on what you have set out below I believe that you have an excellent chance to show that the insurance company was wrong to deny the claims. The onus is on the insurer to demonstrate, on a balance of probabilities, that your husband’s BAC was in excess of legal limits. Given what you have set out below, I am of the opinion that the insurer would not be able to meet their onus.

    If you would like a free consultation, please contact Ashley at 416-815-1331 x221. There is a 2 year limitation from when the insurer denied the AD & D claims. Such limitation is subject to the principle of discoverability but I recommend acting sooner than later so as to avoid the possibility that a limitation defence would succeed. Accordingly, I strongly recommend that you begin legal action within 2 years of your husband’s passing.

  45. Sheila 02/05/2016 at 12:36 pm

    Hi,
    My mother pass away a year ago.Her life insurance claim was denied, she did not disclosed her initial cancer stage when a bank insurance agent offer her insurance without medical disclosure or medical checkup. Are the family entitle to a premium refund?

  46. Andy Suboch 02/05/2016 at 12:37 pm

    I am a duly licensed lawyer in Ontario who practices in the areas of personal injury and insurance law. I have handled many cases such as you describe below. I have been asked to respond to your inquiry.

    An insurance contract is a contract of utmost good faith. Both sides must treat each other fairly and make full and frank disclosure with respect to prior conditions. If a party fails to disclose a pre-existing condition, such failure may vitiate the insurance contract making it void from the beginning (“void ab initio”). However, there may be extenuating circumstances – your mother did not understand the question, she was advised that it did not matter in any event, etc – that might not allow the insurance company to rely on her alleged non-disclosure. If such reliance ultimately is upheld by a Court, the insurer must return the premiums. Without further information and a review of documentation, I cannot give you a useful opinion as to whether there is a cause of action as against the insurance company.

    It sounds like your mother’s Estate might have a good claim against the insurer. If you would like to discuss further, please feel free to contact Ashley of my offices at 416-815-1331 x221. The initial consult is without charge.

    Until you do come in and retain my offices I cannot and will not act for you or the Estate of your mother. There is a general 2 year limitation period that probably begins from her date of death and in my opinion, definitely would run from the date of denial by the insurer. Time is of essence and a failure to commence an action within 2 years of the cause of action arising likely will be fatal to said action.

    Regards,

    Andrew Suboch

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