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


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 Suboch B.A., LL.B.

Andrew Suboch B.A., LL.B.


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  1. Sarah 10/28/2008 at 8:02 pm


    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 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.

  2. LMK 10/28/2008 at 8:59 pm

    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

  3. Sharon 11/01/2008 at 1:30 pm


    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.

  4. LMK 11/01/2008 at 1:46 pm

    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

  5. Jason 11/02/2008 at 7:42 pm

    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.

  6. LMK 11/02/2008 at 7:45 pm

    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

  7. Joyce 11/05/2008 at 5:37 pm

    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.

  8. LMK 11/05/2008 at 5:39 pm

    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

  9. Francis 11/10/2008 at 3:59 pm

    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.

  10. LMK 11/10/2008 at 4:19 pm

    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

  11. Cindy 11/20/2008 at 12:53 pm


    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?


  12. LMK 11/20/2008 at 4:21 pm

    Hi Cindy,

    Unfortunately this is not the type of case we can help with.

    I would recommend contacting

    Landy Marr Katz LLP

  13. alec 11/20/2008 at 4:32 pm

    Hello Cindy,

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

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

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

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

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

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

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

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

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

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

  14. Cindy 11/20/2008 at 4:53 pm

    Thanks Alec, I will do that.

  15. Nolan 11/28/2008 at 12:57 pm

    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.


    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

  16. LMK 11/28/2008 at 11:46 pm

    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

  17. Cliff 11/30/2008 at 10:27 am

    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.

  18. LMK 11/30/2008 at 8:53 pm

    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

  19. Cal 12/02/2008 at 12:33 pm

    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

  20. LMK 12/03/2008 at 6:11 pm

    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.

  21. Mitchell 12/07/2008 at 10:51 am

    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 ?

  22. Steve 12/19/2008 at 6:11 pm

    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

  23. LSM Insurance 12/19/2008 at 7:29 pm

    Hi Steve,

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

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

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

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

    For more information you can visit them at 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.

  24. Loretta 01/17/2009 at 7:53 pm

    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

  25. LSM Insurance 01/18/2009 at 11:21 am

    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

  26. Geoff 01/19/2009 at 6:26 pm

    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

  27. Dawn 01/23/2009 at 12:14 pm

    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.

  28. Grant 01/26/2009 at 12:48 pm

    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!

  29. Linda 02/02/2009 at 2:28 am

    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?

  30. Rita 02/10/2009 at 11:24 pm

    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?


  31. Ferdinand 02/12/2009 at 11:00 am


    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.


  32. Shojaei 02/16/2009 at 12:12 am

    I want to file a lawsuit on insurance company as soon as possible please give me a call at 416 509 3453

  33. LMK 02/17/2009 at 4:26 pm

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

  34. Ted 02/25/2009 at 7:11 am

    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,

  35. Louise 03/06/2009 at 9:56 am

    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'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.

  36. Richard 03/08/2009 at 7:38 pm

    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.

  37. James 03/24/2009 at 11:09 am

    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

  38. Frank 04/01/2009 at 12:24 pm

    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?


  39. Altaf Hussain 04/16/2009 at 9:29 am

    I am working in a pest control company. I had a heart attack last 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.

  40. LSM Insurance 04/16/2009 at 11:09 am

    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

  41. Regina 04/20/2009 at 4:38 pm

    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

  42. Francis 04/21/2009 at 12:28 pm


    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 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!

  43. Lisa 04/29/2009 at 12:14 pm

    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.



  44. Wilton 05/08/2009 at 10:54 am

    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,


  45. Rachel 05/11/2009 at 5:01 pm

    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.

  46. Morley 05/20/2009 at 3:22 pm

    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.

  47. Thomas 05/28/2009 at 11:35 am

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

  48. LSM Insurance 05/28/2009 at 3:07 pm

    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

  49. Lynn Fitzgerald 05/29/2009 at 6:07 pm

    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.

  50. Robin 06/02/2009 at 5:59 pm

    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.

  51. Cathy 06/03/2009 at 11:44 am

    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

  52. Robin 06/07/2009 at 8:40 am

    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?

  53. Frank 06/09/2009 at 9:33 pm

    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.

  54. Cathy 06/10/2009 at 2:01 pm

    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

  55. Lily 06/17/2009 at 7:15 pm

    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.

  56. LSM Insurance 06/17/2009 at 7:25 pm

    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

  57. vidya 08/13/2009 at 10:45 pm

    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

  58. LSM Insurance 08/14/2009 at 2:05 pm

    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.

  59. Lynda 08/20/2009 at 11:06 am

    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.

  60. Nolan 08/28/2009 at 11:34 am

    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.

  61. Tom 09/10/2009 at 7:06 pm

    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?

  62. LMK 09/15/2009 at 9:31 am

    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

  63. Henry 11/17/2009 at 5:41 pm

    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.


  64. Ted 01/18/2010 at 10:48 am

    I was denied a claim my spouse and i had with .... ....for $.00, 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 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 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 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.

  65. Louis 03/22/2010 at 12:36 pm

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

  66. Fran 04/15/2010 at 2:23 pm

    Hi! My husband passed away ... .... ... He has a life insurance but i recieved a letter dated 8 days before his death that it was cancelled. He had a payment for his monthly premium which covers ..... .... .... . Can i make a claim even if it was cancelled before his death but maid premium that covers the date of his death? Thank you!

  67. Kelly 04/30/2010 at 1:09 pm

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


  68. Varissa 05/15/2010 at 6:34 am

    My Father refinanced the house with a new mortgage to consolidate debts and pay off the existing mortgage. The mortgage was a done deal and life insured. The first mortgage payment and life insurance payment was preauthorized payment for August 1st. My Father passed away suddenly in July of a heart attack. The insurance company is renegging. They sent 2 month insurance payments back to us and denied the claim because he died before Aug. 1st. Any help and information would be greatly appreciated. Thank you.

  69. Rick 07/07/2010 at 8:07 pm

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

  70. LSM Insurance 07/08/2010 at 8:58 am

    Thanks for the note. Once the primary beneficiary receives his / her funds the money belongs to them and they can dispurse it how the wish from there.

  71. Holly 11/13/2010 at 8:44 pm

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

  72. Lena 01/24/2011 at 1:10 pm

    Hi, My father passed away 3 yrs ago Nov. 2010. (luekemia) My mother has been fighting the bank and the life insurance company for payment since his death. The ins, co termainated my dads policy we belive when they found out he was terminal. We had autopay set up thru dads donation acct. We had a donation acct set up for my dad thru bank of the west that my sister and my name was on, my sister also had a personal acct. she overdrew her acct and they closed the donation acct when the funds from donation acct were transferred to personal acct to pay these fees. now when donation acct was opened l was told that in no way was there to be anything charged or payed from this acct, unless it was directley connected to my dad as this acct could be audited and trouble would be had if this were to be proven to have happened. The lif ins. co then sent us a letter saying acct need to be payed as funds not available. So l called the ins. co. and spoke with an agent to set up direct pay from another acct. Recieved a conformation from co. that acct was setup and we were in good standing. only to be told month later that the policy was terminated before that confirmation letter was even sent. The dates for the termination and other letteres do not fit as several different facts just dont line up. Im most concerned for my mom who has faced much hardship due to this as well as going thru medical difficultys herself (thyroid cancer) and im trying to figure out what can be done. I thank you for your time and consideration in this matter,

  73. Louis H 03/13/2011 at 1:57 am

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

  74. Lindsay 03/23/2011 at 12:59 am

    My mom is 82 years old and she is being cheated out of her life insurance policy by ..... . I got involved with this case last year, when my mom asked me to look in to why her insurance company was trying to make her pay them over $500.00 for outstanding loan interest to keep her policy from lapsing. My mother had kept all the statements and yearly summaries’ received from .... . I went over the statement and I explain to my mom that more than $500.00 payment that they were demanding was for the interest on an outstanding loan that was borrowed from you surrender value of . My mom said had borrowed money in the early 90s and she had paid it back before it was all due, but she did not get a second loan. She told me that someone form ... had contacted her about a loan in 2005 (she did not remember his name) and the man saw where she had borrowed the money in the early 90s and paid it back, but that is all. At that point I called .... and spoke to someone in customer service to let them know that my mom said that she did not borrow the new amount. They said that she had in fact borrowed the money so I ask for a copy of the canceled check. They sent me a very lousy copy a 32 page document via e-mail. The check was one of the checks you get in the mail for whatever amount stamped nonnegotiable. When I call back and ask for a copy of the canceled check that you say my mom cashed they said that their retention period was seven years and to take this mater any further that I would need to write their legal department. At that point I contacted our family Lawyer and he has been very disappointing. I need someone who can help me turn up the heat on this comppany

  75. stan 04/05/2011 at 9:48 am

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

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

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

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

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

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

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

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

  76. Liela 04/30/2011 at 1:44 am

    Hi My name is Sheri. My ex passed away a little over a year ago. I was the beneficiary on his life insurance policy even though we were seperated and eventually divorced (7 months prior to his death). He didn't disclose different medications he was on for depression and anxiety when he filled out the application. I didn't know this until I tried to collect on it after his death. He passed away within the 2 years of the policy so of course, gave them the right to do an investigation. They have denied paying out because of not disclosing medication he was on and I am looking to fight it. It was a 2 million dollar policy and for that size of a policy; shouldn't it be the legal obligation for their under writers to collect data and investigate things before even offering us the policy with that size of a policy??? They've been doing all this investigation for over a year now. I would have thought with that size of a policy, they would have done there investigation BEFORE they extended the policy, not after the fact. It seems to me they work backwards! The bank wouldn't lend one money (especially 2 million dollars!) just filling out an application of the amount needing to be lent and just taking ones "word" for it that they would indeed be payed back. The banks do A LOT of research before lending out money, especially if it were 2 million. The only reason the insurance company doesn't feel that same obligation, is because THEY'RE the ONES holding on to MY premiums I pay out every quarter and they know they have my money already in their pocket and they have they're loop holes ( like if a person dies within 2 years, they have a right to investigate). Why don't they do that TO BEGIN WITH with larger policies????? if some thing happen's , just like it has with my late ex husband; they know they can get their big dog attorneys to fight it for them and they have all their fancy loopholes. I understand that insurance company's have to protect themselves too and their are people out there that don't always disclose information (such as my ex) but what about the innocent spouse and children left behind that thought their financial future was secure if any thing were to ever happen to the sole breadwinner??? Isn't there ANY kind of protection for the innocent family members? Where had the insurance company's under writers REALLY did their job of investigating larger policies, we could at the very least, have the possible option to pay a higher premium or look for another insurance company that would accept us. We wouldn't be totally destitute like we are now. I have 6 children. Found out I had cancer 2 months after my ex's death and have been under going treatments and have not been able to work because of being so sick, talk about luck!! Some thing is REALLY wrong with the way the insurance company is set up to protect themselves!! Please tell me if this situation is a "loss cause". I need help asap.

  77. Lynette 06/04/2011 at 4:57 pm

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



  78. LSM Insurance 06/04/2011 at 6:03 pm

    Thanks for the note but I'm not sure how we can help. I would contact Canada Life or your broker to verify the policies cash surrender value.

    You may also be able to reduce the coverage to better suit your budget.

  79. Jenny 06/05/2011 at 3:31 pm

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

  80. Yolanda 06/15/2011 at 8:37 am

    I had a mental breakdown in 2008 where I was diagnosed with panic disorder, anxiety, depression and OCD. I was off work until 2010 receiving LTD benefits when I began a return to work plan. I successfully completed my return to work plan and began working my original shifts. Approximately 1 month into my return I was injured at work. The CT scan I had to have showed an area of my brain had something on it but it was unrelated to the injury. Throughout the next two months I continued to work with perfect attendance while I had an MRI and saw a neurologist and 2 neurosurgeons. Gradually I began to have recurring symptoms of my previous mental health issues. My doctor put me off work on medical leave once again. I was advised to apply for EI sick benefits which was successfully approved and was also advised to contact the insurance company that I received LTD from as my illness had recurred within 6 months of my initial return to work I would be eligible for benefits. While I was off previously my company changed insurance carriers but I was automatically grandfathered back to the old carrier. I was declined benefits as the old carrier believes it is not a recurrence and told to apply to my new carrier which I did. My new carrier also declined benefits stating they felt it was a recurrence and it was the responsibility of my old carrier. In the meantime they forwarded all their info to the old carrier to review again. I have yet to receive another decision from that carrier. It has been approximately 6 months from my initial filing with my old insurance carrier. It's been about 2.5 months since filing with my new carrier. My EI sick benefits ran out 2 months ago, I was told a decision would be made 2 weeks ago and in speaking with the old carrier today I was informed there is still no decision made and my file may not even be looked at for some time still. I am now on welfare as I've exhausted all of my other options, without this I would not be able to support my children. We are barely scraping by with the 920 dollars a month we are given. Though I must say I am entirely grateful for that little bit of help. I am at a loss for what my next step should be. Any advice is appreciated. Thanks in advance.

  81. Andy Suboch 06/15/2011 at 8:39 am

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

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

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


    Andrew Suboch B.A., LL.B.
    Tel: (416) 815-1331
    Fax: (416) 815-1257
    E-mail: [email protected]

  82. Loretta 06/22/2011 at 3:06 pm

    My insurance company has denied my claim. What can I do - there was lot of fine print in the policy - I can't understand it it and my brokers been no help.

  83. Henry 06/23/2011 at 11:27 pm

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

  84. Andy Suboch 06/25/2011 at 12:01 pm

    Unfortunately, I do not have enough information to be able to give you any kind of meaningful response.

    What kind of claim was it? When were you injured and/or when did the damage occur? What was the basis of the insurer's refusal of your claim?

    If you would like to discuss your case without charge, please call my office to make an appointment.

    Andy Suboch
    416-815-1331 x221

  85. Andy Suboch 06/25/2011 at 12:02 pm

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

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


    Andy Suboch

  86. Kenneth 07/03/2011 at 11:08 pm

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


  87. Tom H 07/07/2011 at 12:49 pm

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

  88. LSM Insurance 07/11/2011 at 3:31 pm

    I am surprised to say the least that the WSIB has denied your claim, notwithstanding “your employer has not submitted an application to cover his worker ; therefore there was no coverage under the Act in effect at the time of injury. As a result, you are not eligible to any benefits from the Workplace safety and Insurance Board”. It is my experience that whenever an at-work claim is submitted, even if the employer has not submitted a application, the benefits are granted and the employer is charged the applicable premiums PLUS a penalty for not complying with the provisions of the Act.

    If you were considered an independent contractor, then you would have the ability to sue the employer if there was an unsafe working condition which caused you injury. If another party through its neglect [eg. Perhaps a cleaning company] caused and/or contributed to your injuries, then you might have a case against the other company.

    You appear to have a claim as against your employer for wrongful dismissal.

    If you were getting and/or were eligible for Short Term Disability [STD’s] or Long Term Disability [LTD’s] then you might have a claim as against your employer and/or Desjardins for same.

    I would strongly recommend that you meet with a lawyer, to discuss your potential claims.

    Any meeting with me would be free.

    You should commence any action within 2 years, at the latest, or your claims might be statute barred. You have a very short window to submit a claim for WSIB benefits.


    Andrew Suboch
    416-815-1331 x221

  89. Rona 07/11/2011 at 3:38 pm

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

  90. Andy Suboch 07/11/2011 at 3:39 pm

    I am not exactly certain what you are asking. If it was confirmed that your injury took place at work, you should have the ability to make a claim to the WSIB. If you have been fired because of your injury, you could make a claim for wrongful dismissal as against your company. If you made a claim for either STD or LTD benefits, and such claim was denied, then you might be able to claim as against your disability carrier. I cannot tell what your situation is from the above caption.

    If you would like a free in-person consultation, please call Sarah, 416-815-1331 x221 to arrange such a meeting. I have an office in downtown Toronto and one in Scarborough near the 401 and Kennedy Road.


    Andrew Suboch

  91. Andy Suboch 07/18/2011 at 6:38 pm

    Dear Sir and Madam,

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

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

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

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

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

    Best wishes,

    Andrew Suboch

  92. Lemor 07/18/2011 at 6:43 pm

    ....... Claim originating from Emerg .....for 3 days.

    Every aspect screwwed upFollow up appointment with Neurologist / Dr ...... Dr told me I should be admitted - I did whayt I was told

    We Called Air Insurance and got a claim number before proceeding.

    WE were told to not cancel flights and just book new flights on April 10.

    On release from hospital ...., ..... Representative said we wer not covered Because of health info from family physician in .... Dr had noted appoinment with specialist that took place in .... 2006 as .... 2007. We were then told that winthin 90 days pre-existing condition made our travel Medical and trip interuption claim denied.

    We knew this to be untrue and did not worry as we said we would prove this info from doctor not entered properly in her records.

    I was very ill for the next several years (relating to auto accident, brain injury, spinal damage, visual loss, in .... .

    I attempted to the best of my ability but reallly could not comprehend aspects of what I was doiing but tried my best.

    We where in fact tod by Christian Monin that we intentionally bought travel insurance policy with intention of being hospitalized even before we submitted claim or documentation.

    I realized that there was no fairness whatsoever with this comany after going to .... Supervisor as all she did was support the harm that was done to me by her subbordinate,

    Claim went in finally and was denied.

    Everything went wrong.

    Dr did not fill in claim form properly, wrong year on a follow up letter, did not put the right diagnosis in for claim.

    It took a few years before I started to understand this problem an contacted Dr for supporting letter for Emerg hositalization in the right year.

    Although Dr .... told me and ..... that indeed it was non elective emerg admittion and wrote leters to this end for Reliable insurance company. I contacted admississions about the error in my admissions as being marked elective was wrong. Although they understood they told us that it was a difficult problem to change.

    I did go to complaints officer with reliable and ended up no better off.

    I knew I had to submit for OHIP coverage emerg out of country care coverage. Once again as I was submitting for 2 different claims of care in USA there was a mistake and OHIP comined the 2 separate as one and denied.

    I immediately made an appeal with OHIP and the end is because of appointed times and postponed with OHIP to Oral appeal into March 30 2011. I just received Health services and appeal board that indeed the Emerg admittance to ... was allowed and they paid according to regulations. As far as nuclear imaging that was done in August .... it was denied re did not file pre approval out of country not filed.

    I feel that under the Disability Act, Insrance Act, Limitations Act, Health Act, Civil rights Act that I must have a case still with Air Miles Insurance/Reliable as the Ohip Appeal request was ongoing before the denials of Coverage from both Air Miles and reliable. It took almost 4 years to finish Health Services and Appeal Boaed to give me final decision on ..... The claim was probably in the $10-12G USD and CDN range.

    I do feel that there still should be laws that help my case.

    I realize that I took a great deal of time to finalize with OHIP and everything else, but I am definately dumb as a stone when it comes to the most simple tasks. It can take me months to write a letter like I wrote to reliable, actually ... months.

    Can you help Please?

  93. Andy Suboch 07/18/2011 at 6:45 pm

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

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


    Andrew Suboch

  94. Louise 08/03/2011 at 1:31 pm

    I am having a problem with a life insurance policy. My husband and I took out a term life policy on him and one on me in 19.. We paid it faithfully up until Aug of 20... He was an alcoholic and suffered from alcoholic liver disease..cirrhosis. This had caused a separation and a divorce ultimately. The premium used to be auto drafted, but he changed it to his paying it. He had been in the hospital numerous times...practically in a coma. He was no longer able to handle any of his personal affairs. His brain was just ravaged by the effects of the disease. He didn't realize this either...denial being part of the disease as well. So I would ask if he paid the premium. He said he had. Knowing he was just unable to manage things and recall if he did or not, I called the insurance company and asked if I needed to send a check. I didn't know what his portion was since I started paying mine and he his. They told me I was not the owner and could not tell me. I finally got him to call and he told them "my wife does this" so its ok for her to handle. They gave him a number to catch it back up. (I didn't know by this time he had missed the january payment.) I sent them a check for the amount. They sent it back to me. I thought it was because he paid it. They sent the explanation to him. He could not mentally manage any personal affairs by this time. The next due date I sent them another check. Same thing happened. Then he died in September this past year. And they deny the claim. They never told us when we bought the policy that we would need special authorization for the beneficiary to handle the premiums and get account information. They never mentioned it when I called before the payment lapsed, nor to him when he said that I could handle it. I think this is terribly unfair. Married people usually presume they will take care of things for the spouse if they are too sick and unable to physically or mentally. WE paid since 19... and I TRIED to pay it. We didn't even have money to bury him. I am hoping I can get help collecting this. He died on ..... . Is there a time limit on this?
    Thank you,

  95. Andy Suboch 08/03/2011 at 1:32 pm

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

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

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

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

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

    Yours very truly,

    Andy Suboch

  96. Alec 08/03/2011 at 2:32 pm

    Hi Louise,

    What an awful situation. I can't believe how the insurance company treated you and your husband.

    I wish you strength and courage. I hope the Andy Suboch will be able to help you get fair treatment.

  97. Lisa 08/23/2011 at 2:42 pm

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

  98. Andy Suboch 08/23/2011 at 4:46 pm

    Without reviewing the documents I cannot give you a formal opinion as to whether you have a case or not. It certainly appears that Manulife improperly cut you off LTD benefits. Without a review of the documents I cannot provide a formal opinion.

    If you were to fax the termination letter and a copy of the return to work form it would help me evaluate your case. I will do so for free but if you retain me then I would work on a contingency basis.

    If you want me to look further into your case for free, please fax and/or scan the documents to my attention. My fax is 416-815-1257. There is no cost for the initial consultation.


    Andrew Suboch
    416-815-1331 x221

  99. Curious 09/03/2011 at 11:02 pm

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

  100. LSM Insurance 09/04/2011 at 12:01 am

    Thanks for the note. Insurance companies base their underwriting decisions on risk. You may be able to qualify a simplified issue plan (no health tests and 3 to 12 health questions) You can get more details at link to

  101. Sonia 09/05/2011 at 12:31 pm

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

  102. Andy Suboch 09/05/2011 at 12:32 pm

    The matter seems to be straight forward and based on what you have described, it seems like the insurance funds should be paid to either you/ your siblings or to your Mother's estate.

  103. Tanis 09/05/2011 at 12:36 pm

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

  104. Andy Suboch 09/05/2011 at 12:39 pm

    Based on what you have described, I WOULD NOT sign the document that the insurer apparently wants you to sign. It sounds like the insurer is trying to set up a defence of pre-existing condition to your husband's claims.

    If you would a free consultation with my offices, please call Sarah 4166-815-1331 x221 to arrange for a meeting. I have offices in both Downtown Toronto and Scarborough.

    Andrew Suboch

  105. Francis 09/06/2011 at 7:06 pm

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

  106. Andy Suboch 09/06/2011 at 7:20 pm

    Thanks for the note. If the beneficiary is revocable -your mother is free to change the beneficiary she should contact the insurance company or broker if she wants to make a change.

  107. Mert 09/22/2011 at 11:00 am

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

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

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

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

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

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

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

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

    Any advice?

  108. Andy Suboch 09/22/2011 at 11:01 am

    Unfortunately, your insurer, pursuant to the standard contract of automobile insurance in Ontario, is only obligated to pay the lessor of the repair cost or replacement value of your vehicle once it is damaged. That is subject to the caveat UNLESS you have purchased replacement vehicle coverage. I suspect that you have not given the age of your vehicle. With respect to the modifications unless these have been reported to the insurer and the vehicle's "true value" known to them, their assessment of your vehicle will be vis-à-vis other vehicles of similar age and wear/ mileage. If you want to show that the insurer is wrong in their assessment of your vehicle, then the onus is on you to show how their assessment is wrong due to the special nature of your car. Although their assessment seems to be based on less than thorough methods, I suspect it would hold up in court if challenged.

    I do not understand the last part of your email. You should be at liberty to not have the repairs effected and to have the vehicle repaired at your own expense. The insurer should not deny you coverage as a result. If they do however, your remedies are not that great. If the vehicle is labeled as a "write-off" by your insurer, then you might have a cause of action for slander of title and even perhaps punitive damages but the legal costs associated with such a civil action would far exceed the value of the car. I do not understand why they would care if you withdraw your claims and fix the car yourself. That is something that I cannot answer and do not understand. Most insurers in my experience are ecstatic when their insureds pay for repairs normally payable under a policy of insurance.

    I trust that this answers your questions.


    Andrew Suboch

  109. Josh 09/22/2011 at 2:17 pm

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

  110. Andy Suboch 09/22/2011 at 2:19 pm

    Please be advised that I am an individual duly licensed to practice law in Ontario. You and your siblings and/or other close family relatives may be able to claim up to $25,000.00 from your Father’s auto insurer. In addition, you and your siblings and/or other close family relatives may be able to claims thousands of dollars from the person who caused the crash. Without more information, I really can’t advise you as to your rights and the value of your possible claims. If you would like to discuss this matter further, please contact Sarah of my offices and my an appointment to either come in or to review the case over the phone. Until I am properly retained I really can’t give you more information or assistance. Time is of essence and you need to move and make your claims prior to the 2 year anniversary of your Father’s death.


    Andy Suboch
    416-815-1331 x221

  111. Louis 09/29/2011 at 11:34 am

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

  112. Andy Suboch 09/29/2011 at 11:37 am

    Once you are on LTD the onus is on the insurer to show why you are no longer entitled to ongoing benefits. If, as you have described below, you have complied with the insurer's requests for information and all the medical evidence supports your position, I can see no reason why the insurer would try to deny your ongoing claims. What you describe below to me suggests a bad faith policy of the insurer that could result in punitive and/or aggravated damages.

    I can't really say more without meeting you and reviewing relevant documents including medical evidence and the relevant policy of insurance.

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


    Andrew Suboch

  113. Andy Suboch 10/17/2011 at 7:01 pm

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

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

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

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

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


    Andy Suboch

  114. Louise 11/03/2011 at 3:20 pm

    My husband .... had a fall, he broke his back and sustained a spinal cord injury. The cord was not severed but sustained significant nerve damage. His diagnosis is "incomplete parapalegia". He can not walk without assistance and requires a wheelchair. He can move his lower extremities however has only "patches" of feeling in his legs. His diagnosis will not change, he is now considered parapelgic. The insurer, ...., has denied his claim for compensation. This was a workplace injury and WSIB is involved. The insurer, ..... , is the provided through his union hall. Can we appeal this discision? If so, what "type" of lawyer would we need.

  115. Andy Suboch 11/03/2011 at 3:21 pm

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

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

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

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


    Andy Suboch

  116. Tracey B 11/14/2011 at 1:47 pm

    I suddenly got very sick in May and have been struggling ever since was diagnosed with Chronic Fatigue Syndrom in September from a Multiple Sclorosis neurologist.
    My insurance .... denied my claim and I am on my third and apparently last appeal.
    My Dr agrees with the diagnosis but is not very good at clinical notes and writting referals he asks me to write my own letters to Manulife and he edits them he has sent me in for lots of tests and refered me to specialists. He keeps on brining up anxiety.

    I have an appointment with a Ryumatologist on ....
    I have seen two neurologists one said its anxiety the other one said Chronic Fatigue.
    I have seen an Ear nose and throat specialsit , ........ I am struggling with extreme fatigue , muscle pain and weekness, memory problems , blurry vision , dizzyness , loss for words anxiety and many more things.

    My whole life has changed I was a very energetic social person, I worked out every day went for 5 km walks , planned social gatherings . I no longer can excersise , and have no energy to socialize. If I even clean the bathrooms I am exhasted for days after.
    My marriage and friendships are suffering .
    we have exhausted all funds and can not even get a loan because i am not working.
    I worked at the ...... .... since ..... and I loved my job
    We moved to Prince George in .....

    .... says that they can not rule out anxiety because I had a perscription and have been on adavan for years ( one perscription would last me for months )
    They suggested to me to see a Phyciatrist to get an assesment. They say that they dont have any objective medical evidence and I undersatnd that but i told them that CFS is diagnosid by process of elimination and I have had all the tests to eliminate everything else.
    I know that my anxiety is due to been so sick and having no support.
    I am scared that they are setting me up to say that it is a pre excisting condition.
    I need to write a letter of appeal and i cant even think straight to write it .
    I am at my wits end and would love any help I can get.

  117. Andy Suboch 11/14/2011 at 1:50 pm

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

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

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


    Andy Suboch
    416-815-1331 x221

  118. Drew 11/14/2011 at 4:36 pm

    Need advice for family friends. Wife, 36 years, had a policy taken just over 3 years ago, had a doctor's appointment the week after for some tests, had a doctor's appointment week before for minor stomach ailment but forgot to disclose honestly. Policy got approved in 2 weeks, tests got done week after, discovered stomach cancer, policy delivered to her in 3 weeks after. Went through treatments for 3 years finally passed away now. Insurance company is dragging the claim, asking for authorization the 2nd time to go back to her family doctor and specialists, which was already part of claim forms, any chances of claim being rejected or they are just delaying. The point is when the application was signed and first premium paid, there was no knowledge of this ailment at all. Thanks for some guidance, and if legal recourse is necessary.

  119. Andy Suboch 11/14/2011 at 4:37 pm

    Dear Sir,

    This is further to your enquiry below.

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

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

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

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


    Andrew Suboch

  120. Melisa 11/15/2011 at 5:18 pm

    I have been signed off work for over three months and have been transferred to ..... Assistance programme. I have issued all my consultants reports and my doctors reports and have been seeing my companies occupational health, during my time off I have applied for another job internally and have been successful, however I have been put into a holding pool pending a vacancy for that role. My current contracted job involves repetitive living and stretching and my new role does not. Both my doctor and the company occupational health department has confirmed that I am presently unable to do my contracted role, however they feel that I am able to do the role that I am in the holding pool for. My doctor has also issued my with a fit for work certificate as long as I don't lift or stretch, which to be honest means I am unable to do my contracted role for the next two months at least. I have been communicated with my HR only to find them reluctant to accommodate me in my new role or anywhere else. Their statement is that they have to liaise with .... before I can come back to work. I am desperate to get back to work, and in fact get on with my new role or at least attend relevant training, forfeiting my annual leave if necessary. Where do I go from here? Can I approach .... directly, am I at the point of being given the sack or will I be accommodated elsewhere in the company until have fully recovered or am I destined to stay at home bored for another three months??

  121. Louise 11/16/2011 at 2:03 pm

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

  122. LSM Insurance 11/16/2011 at 5:36 pm

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

  123. Andy Suboch 11/16/2011 at 5:38 pm

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

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

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

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


  124. Stan 11/17/2011 at 5:39 pm

    Good Day,
    I am one of 4 beneficiaries to an estate (We have found an $2000 insurance policy from the 1940's. We also found a second letter from the insurance company from 2009 when the recently deceased's spouse had passed away and changes to the beneficiaries had to be made. This letter states that the 70 year old policy was now only worth $7000. All beneficiaries have agreed that something just doesn't seem right and would some legal advice/policy interpretation on whether a further investigation would be warranted or not. Thanks for your time.

  125. Andy Suboch 11/17/2011 at 5:40 pm

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

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

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

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

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


    Andrew Suboch

  126. Mona 11/22/2011 at 7:22 pm

    My brother in law passed away this year he was very private, and not very organized person. We recently found a life insurance policy dating back to ... . We have no idea if he continued to pay the premiums or not. Would this policy be null and void if premiums were not paid, it is possible this insurance was through his work and he retired approxiamtely ... years ago with a limited pension which is why we believe the premiums were likley not paid over this time and possibly before this if it was not a work related policy Would the premiums/value of the policy be lost completly?

  127. Andy Suboch 11/22/2011 at 7:23 pm

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

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

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


    Andrew Suboch

  128. Susan 11/28/2011 at 1:22 pm

    Is there something about negotiating a contract in good faith which should apply to medical travel insurance providers. An appeal filed when they denied coverage, supported by our Doctor's letter that we would not have know a trip to emergency before we left home would be an indication of an unstable medical condition has been denied. Frustrated with the lack of fairness - we bought the deluxe medical package to find out it covers nothing of the .... hospital bill from the U.S. Don't know whether it is worth pursuing but it just strikes me these insurance companies are not there for the people who buy it!

  129. Andy Suboch 11/28/2011 at 1:36 pm

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

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

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

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


    Andy Suboch

  130. Fran 11/28/2011 at 1:52 pm

    Hi,I had a car accident on 1st feb 2011, since then i am having lots of problem with my Neck , back and low back due to which I am not able to perform as I use to pre accident.
    It has come down to a situation where my company does not have any other option to accommodate me, they either want me to get back to work on the same job or want me to go on employment insurance or long term disability. My problem is i am with out pay since one month and I have faxed my Dr`s note and required reports to my LTD carrier. IF THEY DENY MY CLAIM WHAT ARE MY RIGHTS AND RESPONSIBILITIES IN REGARDS TO GET THE APPROVAL? I AM IN ONTARIO CANADA

  131. LSM Insurance 11/28/2011 at 1:59 pm

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

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

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


    Andy Suboch

  132. Lisa 12/13/2011 at 3:28 pm

    after .. yrs of payments of a long term disability claim with .... , they terminated my file, saying I did not forward copies of the denial letter from ... Dis. (which I mailed to them in the ... of this yr). They say they sent letters to me, but I received nothing. They are saying because of the length of time it took, the can terminate my claim. I have no income now.

  133. Andy Suboch 12/13/2011 at 5:31 pm

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

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

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

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

    Best wishes,

    Andrew Suboch

  134. Lilly 12/14/2011 at 4:59 pm


    I have been off work since ..... due to depression/stress/anxiety/addiction/suicidal thoughts. I was sent to Emergency by my GP for a crisis assessment. Its important to note that I am the primary breadwinner in the family.

    On ..... saw a psychiatrist in Emergency who thought the appropriate course of treatment would be a referral to Homewood on an emergent basis (gambling addiction). I have a history of depression/previous suicide attempt.

    Since then, things have dragged on. My GP dragged her feet about submitting the forms to ..... and my claim has only now been adjudicated, and declined. Primary cause for disability was listed by both my GP and psychiatrist at the hospital as addiction. Last week, I was sent to the hospital again by my GP, due to another 'breakdown'. The psychiatrist seen at that time believed the primary cause and necessity for treatment is depression, and has agreed to take me on as a patient and I will be under his care. However, .... did not take his information into consideration, before closing their file. I'm now faced with formally appealing the decision, based on the new information.

    In the meantime, however, my family is unable to survive financially. I have not brought in any income for the last two pay periods, and will not be bringing in an income, any time soon. I need help today. As it is, mortgage payments, car payments, etc. are bouncing and utilities are not getting paid and about to be shut off. What kind of immediate help can I get?

    I've asked my HR dept. what they need from me to return to to work. Of course, they require a doctor's note and I'm not sure that either my GP or the psychiatrist will be willing to sign off that I'm capable of returning. I certainly don't feel I'm in any shape to return to work, with typical signs of depression, and given the level of responsibility I have in my job - I could end up jeopardizing the company by not making competent decisions at this time. However, I cannot survive without income. What kind of help is available?

  135. Andy Suboch 12/14/2011 at 8:55 pm

    Dear Madam,

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

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

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

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


    Andrew Suboch

  136. Tina 12/22/2011 at 12:40 pm

    Having to deal with a Insurance Co. in the East even though I reside in the West is becoming a complete nightmare. I was diagnosed for needing 2 surgeries was on STD the problem kicks in with LTD while awaiting surgeries. The Insurance Co. have a "Ghost" Dr. who says a person can work without seeing them and contrary to the Dr.'s that I have seen. In the interim of this claim I end up with another surgical issue, still not on LTD and getting conflicting information from the Insurance Co., I end up on Med. EI. Between this nightmare I end up with a note from employer advising that because of this "Ghost" Dr. saying I could go to work while waiting for the surgeries if I did not show up I would be terminated. Long story short never got terminated but still never received notification from the Insurance Co. in writing about this Ghost Dr.'s recommendation. To be quite frank I am confused if this person even exists. Now, I end up having one of my surgeries most recently and am now
    told I have to start the LTD process ALL over again. I am not kidding, forgive me but personally this feels like the employer is just wanting me to quit and to be honest with you to now have this Surgeon fill out these new forms is not going to be for another month, I am not running around like I have had to do in the past only to have further damaged my health to be in this position.

    My question to you and in asking you because the Insurance Co.. is in the East, how is it that a Ghost Dr. who is 3500 miles away can say you should go to work without seeing you vs. Dr.'s that you see say you cannot.

    It is apparent I am in a loosing battle with the Insurance Company and feel sorry for anyone that has to endure the additional stress because honestly at the end of the day who needs the stress when you need to rest in order to get you health back in order.

    Appreciate your time,

  137. Andy Suboch 12/22/2011 at 12:42 pm

    Dear Madam,

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

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

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

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


    Andy Suboch

  138. Ethan 01/01/2012 at 8:42 pm

    We had a fire at our place of business and the insurance company agreed to relocate us, the hired contractor chosen by the insurance company started to do the work without applying for building peermits and the city has stopped the job now, resulting in additional expenses and 4 to 5 week delays. Who is liable for this , the extra money being spent was unnecessary if they would have properly gone about this, but they didnt so what are my rights in this situation?

  139. Andy Suboch 01/01/2012 at 8:44 pm

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

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

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


    Andrew Suboch

  140. Harry 01/06/2012 at 3:51 pm

    On .... .... .... , my mother was using the back entrance of the apartment building she resides in. The building management had not salted the walkways, she slipped fell backwards and suffered a fractured skull and bleeding in the brain. She died ..... .... . I need some help or advice.

  141. Andy Suboch 01/07/2012 at 2:12 pm

    First let me pass on my condolences on your loss.

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

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

    Regards and I again extend my condolences.

    Andrew Suboch

  142. Martha 01/07/2012 at 2:47 pm

    I have been off work ..... I have filed for my ... with ..., I was ordered by my doctor to take some time off work ... weeks due to depression, I have been thru alot of issues in my life the last year and a half and just couldn't deal with anything anymore, my doctor sent my forms to ..., my claim came back denied, saying they need more medical evidence, my doctor then sent a letter explaining my situation, it was denied again, I am at wits end they said because I went off my meds that I am taking action to deal with this, I went off the meds because of side effects of the drug, my doctor and I decided I seek counseling instead, which I am doing I am seeing 2 counselers. I am now back to work because I can't deal with the financial strain they are putting on me thru, right now they owe me ... pay checks, ... weeks pay. Is there anything I can do to get them to pay me the money they owe. any advice would be appreciated. thanks

  143. Andy Suboch 01/07/2012 at 2:48 pm

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

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

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


    Andy Suboch

  144. Luke A 01/10/2012 at 3:32 pm

    Good Day

    Back in ..... my wife purchase a life insurance policy from .... for the amount of .... it is a term policy there is a clause stating if death should should happen with in 2 years of the policy date the insured would not be paid the $50,000.00, however, the premiums that were paid up to that point would be paid. The policy date was ..... my wife died ..... almost ... days past the policy date. I sent in all the required paper work her doctor has sent 250 pages of her medical file. I have been patient with them and gave them enough time to go through everything.
    My wife was diagnosed with .... in ...... I have been phoning the insurance company every week and I get the same answer call next week it is still in judication. They haven't given me any reason why it is taken so long or what they are looking for. I could only assume it is the date of death which is after the 2 years or they are looking for preexisting which it wasn't there are 3 bills of my wife's hospital bills and 2 others which constantly call me I am now paying them a small amount monthly until her estates settles. Is there anything else I can do. At the end of the month I was going to seek legal help by sending a letter but I am concern about the cost of it.

  145. LSM Insurance 01/10/2012 at 3:36 pm

    Dear Sir,

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

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

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

    Andy Suboch

  146. Nowlen 01/13/2012 at 6:32 pm

    my mom passed away on ...... . she had several life insurances and payed insurance on her credit cards, line of credit everything prety much. my dad is having huge issues getting them to pay and is about to lose everything which isn't right in my opinion. how can we get them to pay without him having to get deeper in debt having to pay a lawyer? if thats what we have to do so be it but when mom passed away my dad lost his job as well he was a contractor working for my mom. so he has no income and a ton of bills. can you help? anything would be great.

    Thanks in advance

  147. Andy Suboch 01/13/2012 at 6:44 pm

    Dear Sir,

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

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

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


    Andy Suboch

  148. LSM Insurance 01/15/2012 at 9:16 pm

    my mother took out insurance in .... and it lapsed in ..... She was reinstated a couple months later in 2008. She passed away this passed ..... . The insurance company asked for medical papers from her doctor. She had died of coronary artery disease and wanted to make sure she did not have it prior to the policy. Now they are sending the policy to the underwriters to see if she would have been approve when she was reinstated. First i do not understand why the are doing this after she is gone and it has been in force for more then 3yrs and her health never change between policies that we knew of, and what is the reason for doing this for policies under 5yrs i thought it was 2 yrs to not payout a policy. I am very depressed and stressed out about this going on and I have a handicapped sister to take care of with this money and I do not know how I am going to it if I do not get it soon also pay for her funeral costs. What do you think is going on and what should I do I am tired of
    waiting I think I have been patient long enough.

    Thanks, loving daughter

  149. LSM Insurance 01/15/2012 at 9:21 pm

    Dear Madam,

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

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

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

  150. Hillary 01/16/2012 at 3:23 pm

    I'm currently on .... leave but I'm due back .... but will not be going as I'm reopening my LTD case. I'm interested in suing my employer for pain & suffering as the job has caused this condition which didn't go away. I have no past medical complaints of mental distress. Before I left on .... I was at work based on a return to work program from long term disability from depression and stress from this particular job. .... handled my case and their independent psychiatrist suggested at that time .... that I remain on LTD but I wanted to show I was willing to try my hardest to return to work so I returned in .... with modified duties and hours. I was still on LTD, return to work on modified hours and duties when I left on maternity. My LTD case manager said it would automatically close
    when I left on ..... I wasn't depressed or anxious
    before this job and .... has my full file to state
    this job has brought on this condition. Before it got to
    anxiety and depression, I notified my supervisor and
    manager numerous times to make arrangements to lessen my load my load temporarily but the manager just tried coaching me on time management which I
    already excelled at. All my performance reviews show
    I'm above average employee and my manager stated
    that when I just go into the position all the higher
    managers were talking about my work and how
    impressed they were with my details. I have just
    requested through HR my employment file and all my
    reviews. Even if my LTD is accepted, can I still successful sue for the mental anguish and mental condition I'm still dealing with because of the employer?

    Thank you.

  151. Andy Suboch 01/16/2012 at 3:27 pm

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

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

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

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


    Andrew Suboch

  152. Louise 01/23/2012 at 5:52 pm

    .... ago my car ran over my leg. I had ...surgerys plus .... my leg has a lifetime scar . and in places still not heeled . had a nurse come in .... . I have received medical benifits from the insurance company ..
    but they said that In .... they changed there policy
    and benifits have been cut in ... . from ..... .... rehab . has been cut from ..... to .... they also changed the policy . that I was not aware off .
    oh ,such a great deal (price) when i bought the insurance .
    now they tell me . I don't have insurance for PAIN and SUFFERING . or for the disfigurement scars on my leg.
    I will never be the same .

    they said I had to purchase these . I don't understand .they never told me that when I bought the insurance a year ago.

    should I get a lawyer and go to court ??

  153. Andy Suboch 01/23/2012 at 5:53 pm

    Dear Madam,

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

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

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


    Andrew Suboch

  154. Fran 01/23/2012 at 5:54 pm

    My grandmother has past on since ... . she said she left everything for me.

    I was a child I though she meant her shoes and clothing. My mother and uncle wont let anyone see her will her death papers her birth papers. Mom said she spent some of the money, know one knows how much she got or how much she spent. How could she when my grandmother said everything is for me.

  155. Andy Suboch 01/23/2012 at 5:55 pm

    Dear Madam,

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

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


    Andrew Suboch

  156. Terrey 01/31/2012 at 7:13 pm

    I was parked illegally (on the wrong side of the street) on a residential street and my vehicle was struck by a person reversing. I live in Ontario, and I believe that I won't have to file a claim against my own insurance because this happened through no fault of my own - she hit my parked car, which was a fixed object, regardless of whether it was illegally parked or not. Will I be forced to claim against my own insurance policy, or will I be determined to be not at fault?

  157. Andy Suboch 01/31/2012 at 7:13 pm

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

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

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


    Andy Suboch

  158. Fran 02/13/2012 at 1:27 pm

    I have been off from work for over ... years due to the car accident my case with car insurance has been settle but im still on LTD from work insurance and ... due to my ... illness, My question is is there any way i can buy out myself from my work insurance to avoid any future harassment. My medical issue is not in the best stage so I need to stay away from anything what can make me even more sick due to stress.

  159. Andy Suboch 02/13/2012 at 1:28 pm

    Dear Sir or Madam,

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

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


    Andrew Suboch
    416-815-1331 x221

  160. Shelly 02/16/2012 at 5:41 pm

    Hello, I have been off work since .... after a fall down the stairs at a relatives. Been on STD for lower back pain. I was eligable for the first 15 weeks of ... . Went on EI for the next 15 weeks, during this time manulife gave a top up amount and cut me off as of ....

    On ... , I was in a MVA, and haven't gotten anything from ..... . Diagnostic testing sent MRI on neck shows pinched nerve and other damage, MRI on lumbar shows disc disease, scoliosis, and other amounting to arthrirtis... Doctor also diagnosed me with Fibromylasia.Looking for info as to my next step. Have been waiting for decsion since jan 24. No pay since oct 6. Thank u

  161. LSM Insurance 02/16/2012 at 5:42 pm

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

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

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


    Andy Suboch

  162. Thomas 02/17/2012 at 10:33 am

    I will give the quick version. I had contractors damage my hardwood floors. They admitted responsiblity and attempted to fix it ( got a quote for ... ,not including replacing trim paint etc) then decided to go through there insurance. I had the insurance adjuster said she had to come in and measure the floors to confirm same as the quote the contractors got. She said she needed to do this before the stautory limit date (which I did not know was), and se did. We did the claim, I signed, and she said it was all done and would be filed that night. A week later got an offer for ... , I refused and she said I was not entitled to anything because past the stat date. They called back a week later and offered ... , I refused. I have not heard back since and both these offers were made after the stat date, even though we had a deal before the stat date? DO I have a case even though passed the stat date?

  163. Andy Suboch 02/17/2012 at 3:21 pm

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

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

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


    Andy Suboch

  164. Belfour 02/22/2012 at 2:06 pm

    Thank you for having a site where we can get our short questions answered.

    I became ill .... and took my two weeks sick leave from my employer and then started EI.... . After EI, I then started STD for the remainder of the year of my illness which ended .....

    I started .... and am currently still on LTD and will be for an undetermined period.

    I discovered last week (from calling my insurance company because I was not reimbursed for my meds) that my health benefits had been cancelled by my employer as of Jan 18, 2012.

    Am I not entitled to have been informed or given notice that my health benefits were to be cancelled? I never received a benefits book advising the benefits terminated upon 12 months of disability.

    I would appreciate your assistance in this matter, I believe my employer has done this (not provided notice of benefit termination) out of spite.

    Thank you.

  165. LSM Insurance 02/22/2012 at 2:12 pm

    Dear Sir,

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

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


    Andy Suboch

  166. Frankie 02/22/2012 at 2:19 pm

    I was involved in a serious car accident which has left me with closed head injury resulting in continuous dizziness, altered awrareness, headaches, sleep disruption just to name a few. I had a lawyer handling my LTD case, but we had major dsiagreement on the settlement offer. I think it is low, and unfair. It barely covers the first two years of monthly income and counsel cost. I have been unable to work for .... years now. I need a lawyer who listens to me, and sees my symptoms. I readyour company's profile and it is very promising. How much will it cost for me to hire you, or any specialized lawyer from your firm?

  167. Andy Suboch 02/22/2012 at 2:21 pm

    Dear Sir,

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

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


    Andy Suboch

  168. Fergus 02/24/2012 at 2:17 pm

    My condo Unit was damaged by water from ... floors above ..... Damage to Unit is covered by Corporations's insurance.

    I immediately called in a restoration Company which estimated damages at approx...and several months later, when the corporation had failed to notify the corp. insurer, I contacted them (and they appraised damages at approx. ...

    In ... the Prop Mgmt company sent me a copy of the damages report which the board was to review. Later I was cc'd on the Insurer's letter of theri intent to pay me .... and ... Ins. deductible. The damage was not caused by an act omission of mine, but a common element failure, and our bylaw does not make the deductible my responsibility, nor does the Act.

    I have received no final documentation regarding:
    1) What damages are covered (and no discussion with me)
    2) What the payout amout is
    3) Whether or not I want a payout or for them to undertake the repairs. Only this,

    Hi ...
    The cheques for repairs were just mailed to your attention today it was based on the repair estimate from less the deductible.
    It's 10 months since this started, and I only received this response because I wrote to the insurer on Tuesday and mentioned the phrase "bad faith"...which I'm sure prompted the response.

    How do I get my .... which they are deducting?

  169. Andy Suboch 02/24/2012 at 2:23 pm

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

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


    Andy Suboch

  170. Yurgen 02/24/2012 at 4:33 pm

    My partner, has been on disability from work since .... . He had to stop working due to problems with depression and anxiety. His short term disability coverage ran out in ... , at which point he applied for long term disability. Earlier this month, he was told that he does not qualify for long-term disability, as the depression was deemed a pre-existing condition, as he received treatment for it in the six months prior to the beginning of his ltd coverage. He was told he could appeal this decision based on new medical evidence. Yesterday, a rheumatologist diagnosed him with .... He spoke to the insurance company today, and told then that he had been misdiagnosed, and that he is actually suffering from .... and is thus appealing based on this new medical information. The insurance company told him that they would have to review all the we information, but that depression was a component of .... , indicating that they would still class this as
    a pre-existing condition. Can they do that? How do we get them to see that while he may have been treated for depression, he was not being treated for the greater condition of .....?

  171. Andy Suboch 02/24/2012 at 5:08 pm

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

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

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


    Andy Suboch

  172. Shelly 03/02/2012 at 4:55 pm

    I started short term disabiliy;in ... .Ihave this forms work.everthing was ok until jan.2;from that point on; i been fighting for my money. I submitted all forms. AS of feb.12 i was cut off. MANAGEMENT are reporting false information. HOW do i fight what management says. PLEASE HELP . I broke my shoulder. the doctors told me ;it was the worse brake. MR suboch i'm living off 700.00 since ... help please.

  173. Andy Suboch 03/02/2012 at 4:56 pm

    Dear Madam,

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

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

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


    Andy Suboch

  174. Bonnie 03/08/2012 at 11:37 am

    on .... l fell and injuired my .... On .... the told me that the injury has been permananent and i have lost the use of the foot. it ws operated on a few times. i tried using it after the injury and never got rid of the problem. i tried filing a claim with ..... and they told me that i was to late. There is peramanent nerve damage. wsib awared me a nel. i dont want the time frame to run out. do i havea case?

  175. Andy Suboch 03/08/2012 at 4:16 pm

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

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

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

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


    Andrew Suboch

  176. Mona 03/08/2012 at 4:50 pm

    Hello; I am a Registered .... . I have been off on Short Term Disability since .... . My coverage is for"own occupation" for the first 24 months. I am in regular contact with my insurance companies. A representative called to book an appointment to come by my house, as he says, to "update" my doctor's appointments. As this can be done over the phone my thoughts are he wants to take a physical look at me. Mine are RSI/work related medical issues, well documented. What do you think about this?

    Thanks for your help with this.

  177. Glenn 03/08/2012 at 8:08 pm


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

  178. Lonny 03/08/2012 at 9:52 pm

    Thank you for your consideration, Ill be waiting

  179. Lonny 03/11/2012 at 4:32 pm

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

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

  180. Andy Suboch 03/11/2012 at 4:33 pm

    Lonny, From what you have described below, it sounds like you have a very serious medical condition (or conditions) that might entitle you to make a claim for STD benefits and possibly LTD benefits. The only way to force the issue is to make a claim and stay away from work. You'd have to run the risk that your work might terminate your employment. That might give rise to a claim for punitive damages as against your employer.

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


    Andy Suboch

  181. Andy Suboch 03/11/2012 at 4:40 pm

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

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

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


    Andrew Suboch

  182. Louis 03/11/2012 at 4:42 pm

    I started a CI plan through my company .... I went for a physical the.... and my doctor indicated I had an elevated .... count so he ordered another test. I was diagnosed with .... in .... . .... denied my claim due to the fact that I had elevated counts within the 90 waiting period. Even though I never got diagnosed until .... they denied it. Now they say that I cannot ever claim for ... again but my premiums will remain the same.

    If I would have waited until .... to do a physical this would not be an issue.

    ...... The count was only .... and in my doctors eyes this was nothing to worry about as it could be anything. Even when I saw the specialist he indicated that is was rare with a count like that to have cancer. Her proceeded with biopsy which identified the .... ?

    I since sent a letter to the claims department in regards to the appeal and they have remained unchanged.

    The policy is $50K and it is not large but its the point of this.

  183. LSM Insurance 03/11/2012 at 4:45 pm

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

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


    Andy Suboch.

  184. Risa 03/14/2012 at 7:07 pm

    Hi I have been on leave for ... due to an accident. I
    have soft tissue injury and ripped , as well as arthrities now, in my
    thighs, shoulder, etc. (joints) and can't do my job anymore. I was in
    sales and was on my feet all day long and I have not been sble to that
    for more than about an hour anymore (grocery shopping etc.), before
    having to rest awhile. There is no other way to do a sales job selling
    furniture since it is a commission paid position. So if you unavailable
    to help customers, you cant make money...... decided suddenly that I
    was able to go to work even though the doctor has continued to say that
    I needed a sedentary position. They cut me off and said I could appeal
    which I did and the doctor said the same thing and still to no avail. I
    dont know who to turn to or what to do at this point. This makes no
    sense to me at all. The only thin they tell me is that the company is
    willing to allow to work ..... first week and up each week for a
    ... , and take breaks or sit whenever I need to. There is no such
    opportunity and it was a big no-no in the first place. So I truly
    believe that they want me to go back and then I would have to go back on
    medical and start all over again. Is it better to say I am so ....
    that I am .... ? They are truly being unreasonable. Pls help - I
    havent been paid for almost .....

  185. Andy Suboch 03/14/2012 at 7:08 pm

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

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

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

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


    Andrew Suboch

  186. LLoyd 03/19/2012 at 1:39 pm

    My wife was a ...... . She was striken
    with breast cancer and went on long term disability in .... . She passed
    away at the age ..... basic life insurance
    is MANDATORY for all regular ft\pt employees of which enrollment is
    automatic according to their guide. that my wife
    opted out of this plan, but cannot provide proof of such. My wife would
    have received ..... her annual salary from this plan.

  187. Andy Suboch 03/19/2012 at 1:40 pm

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

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

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

    I again express my condolences on your loss.


    Andy Suboch

  188. Jay 03/23/2012 at 1:05 pm

    Insurance Company ... has been delaying paying out on a policy for 5
    months. The policy was in place for 10 years. What recourse do I have?

  189. Andy Suboch 03/23/2012 at 1:05 pm

    Dear Sir,

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

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


    Andy Suboch

  190. Jimmy 03/30/2012 at 12:30 pm

    My father had a policy in which he had a pre authorized check
    coming out of his acct. for approximately 10 years. He switched banks
    and when he did he forgot to notify the insurance company.
    The policy lapsed, he applied to be reinstated and when he did he did
    not disclose that he was being tested for colon cancer. He went on to
    live for ... more years.
    The insurance company is contesting the policy. Does the 2 year
    incontestability clause apply here and if it doesn't do they have to
    repay the premiums from the reinstatement date on.

  191. Andy Suboch 03/30/2012 at 12:30 pm

    Dear Sir,

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

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

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


    Andy Suboch

  192. Lony 04/15/2012 at 6:14 pm

    My son had a life insurance policy through work. He worked
    there for a little less than two years when he had an atv accident where
    he was over the legal limit and was killed.
    The claim is taking awhile to settle and his beneficiary thinks it
    won't get paid out at all. your thoughts..... Thanks.

  193. Andy Suboch 04/15/2012 at 6:15 pm

    Dear Madam,

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


    Andy Suboch

  194. Tom 04/19/2012 at 10:59 am

    On family (my wife, myself and son) were
    rear-ended by a van on the .... Both my wife and son were taken in an
    ambulance to the North York General Hospital where the medical team
    diagnosed my wife with whiplash and discharged her. They found no
    visible injuries on my son and he was also discharged. Subsequently,
    both my wife and I went through physiotherapy and massage treatment for
    whiplash. son My was not treated for any injury and his claim was
    closed. Between ...... , my son spent time with his
    mother in Africa where his mother was teaching. On his return to Canada,
    our family doctor noticed that my son had a curvature of the spine which
    he thought was acute so he ordered x'rays and also put in motion a
    referral to a pediatrician. When my son was seen at Sick Kids he was
    diagnosed with scoliosis. The doctor indicated no medical reason for his
    scoliosis. We had not disclosed any accident because we were more
    focused on getting him help. His curvature was about 75 degree so the
    doctor recommended surgery to correct it. His has had two surgeries
    since .... and expected to have surgery every 6 month until he is
    about 12. He is now 8. In the last couple of months, I contacted my
    insurance company given the history of the car accident. The accident
    could have impacted the development of Nii Aduam's spine. When the
    accident occurred, my son was sitting in the middle of the back seat in
    a child car seat. He was impacted by the force of the impact of the
    other car on our car, and being just over 2 years old with challenges
    associated with his premature delivery, his frame may have been
    adversely affected by the accident. Given the time when the accident
    happened what is my best course of action. What role is the at-fault
    driver? I have read about the 2 year limitation and it exceptions
    (discoverability and minor). Do I have a strong case?

  195. Andy Suboch 04/19/2012 at 11:08 am

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

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

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

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

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


    Andy Suboch

  196. Liz 04/23/2012 at 4:52 pm

    I am trying to obtain a death certificate of my ex-boy friend

    who died Est. .... over seas in .... ...and I were together

    for ... years and after the first year he broke his .... in two places

    and was told he would never walk again so I was a full time mom and I

    worked full time and I was a full time nurse for Nick my house was to

    small for him and his wheel chair wouldn't even come into the house it took

    Ontario housing like .... years to find him a handy cap unit apt. He always

    told me that he wouldn't take my name off the policy because he

    appreciates every I did and gave up for him. He was living in the apt

    only a year and a half and he married some girl is Serbia. I have called

    the Canadian Embassy to try to obtain copy of his death certificate so I

    can send it to the insurance co. I am the beneficiary in his policy.

    Apparently he told his apartment manager that he was going into rehab

    for a bit so he paid his rent in advance and took a plane to Serbia and

    apparently he got married a few months prior and he went to see her and


    The ..... tried to contact her but apparently she has

    disappeared. The family wants nothing to do with me so I was wondering

    what legal recourse do I have in acquiring a copy of the death

    certificate to

    settling the life insurance claim.

  197. Andy Suboch 04/23/2012 at 4:53 pm

    Dear Madam,

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

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

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


    Andy Suboch

  198. Amanda 04/24/2012 at 3:47 pm

    My husband has stage 4 .......he worked for ....He has been on long term disability since .... His employer has
    terminated his employment as he is unable to return to work.

    In the process that leaves him and me his wife with no benefits as per
    drug plan etc. We have called to try and get an extended plan and the
    response is this...$..... A MONTH FOR PREMIUMS....this will only cover
    his drug benefits for up to $ insurance is apparently
    still covered from Manulife as long as he is still receiving long term
    disability. I am so frustrated as well my husband needn't have this
    stress added to his already problems. He was sent home from .... ago to die but as if a light switch went off his .... quit
    growing. But for the grace of God he is still here. However this recent
    termination has opened us up for all types of finacial as well as health
    problems. We have not the funds to pay such premiums or the finances to
    afford us the drugs should that light switch go on again....Please help
    In Kindness

  199. Andy Suboch 04/24/2012 at 3:48 pm

    Dear Madam,

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

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

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


    Andy Suboch

  200. Trish 06/19/2012 at 1:32 am

    Hello, my brother was diagnosed with stage ...... He was covered by 2 critical illness policies - one through Blue Cross which was paid out quickly and one through ..... which they have refused to pay twice and it has been 5 months now that we are fighting this. My brother had dental work done .... and had a round of antibiotics after that to clear up an infection in his jaw. .... is saying that this was a "sign or symptom" of his cancer even though he has medical notes from 2 doctors saying it was not related. We gave the same information to .... and ..... so we feel that we are being penalized by .... so they can avoid paying out the claim. After reading all of the stories on your website it is shocking to me how insurance companies can get away with so much unethical behaviour. Would appreciate any advice you have we think we need legal help now. Thank you.

  201. Andy Suboch 07/05/2012 at 10:56 am

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

  202. Allistar 07/05/2012 at 10:57 am

    Hi, Good day! I hope you could be of help to our situation. My wife was diagnosed with a stage 3 breast cancer last ... . Before she was diagnosed, she got a Term Life Insurance with a Critical Illness rider. Unfortunately the Insurance Company terminated her Insurance Policy after she was diagnosed. Hope to hear form you soon. Thank you,

  203. Andy Suboch 07/05/2012 at 10:59 am

    Dear Sir,

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

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

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

    Regards, Andy Suboch

  204. Salvatore 08/28/2012 at 3:57 pm

    I had an accident on ,,,, . It was a shattered .... and I had pins and rods in for .. weeks. I have just recently
    been upgraded to a cast and still have physio to go through. Apparently
    my insurance was terminated on ....due to nsf. I did not
    receive my 30 day termination notice(in policy), so was unaware there
    was a problem. The payments were being taken out of my checking account.
    The bank didn't use the over draft to make the payments, but did for
    everything else.They took out over a ... during the time period I lost
    my insurance. I had even gone in on .... to make sure I had enough
    money in the account to cover the payment and was told I had enough.It
    was the day after the payment was due. I mentioned why I was there and
    the teller informed me, "Don't worry, we wouldn't do that to you." But
    she did not mention that the payment was missed in Feb. and Mar.. Had
    she, I would have done something about it. So, unaware there was a
    problem, I went on thinking everything was okay. So when the accident
    occurred, I sent for the forms, filled them out, waited a month for the
    doctor to fill out the forms for him, sent everything in and three weeks
    later received my first notice of there being a problem. I was
    terminated without notice. There was nothing in the policy telling me to
    keep them apprised of an address change and I thought that by keeping
    the address on my checking account and ..... (same company )up to date,
    was sufficient. It was a Broken Bone Benefit.... and Hospital
    I.... Do I have any chance of
    getting anything?

  205. Andy Suboch 08/28/2012 at 3:58 pm

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

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


    Andy Suboch

  206. Linday 09/11/2012 at 2:38 pm

    I am ... old and my parents divorced when I was
    eight,my mother died while being married to another man six years ago
    and was left fifteen thousand.My father died about a year ago and we
    just received the cause of death and Coroners report and his death was
    classified as accidental due to ...... n.It was accidental
    because he only took the medication prescribed to him as in
    percocet,sleeping oils and pills for his gastritis,it stated that he
    was vomiting pure blood all night before he was found dead and that "the
    significant degree of blood loss would have likely exacerbated the
    physiological effects of .......

    My father left me a accidental life insurance policy and his death came back as accidental,I am not sure what to do

  207. Andy Suboch 09/11/2012 at 2:42 pm

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

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

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


    Andy Suboch

  208. Terrence 10/09/2012 at 7:56 pm

    In .... while waiting for provincial health coverage, I have purchased private medical coverage.
    On .... I filled out an insurance claim (2 pages) for an emerg room visit. The 2nd page of the claim included an Authorization section that states: “I authorize any doctor, hospital, or facility providing medical or health related services, and any other insurer to release and exchange with TIC or its representatives, any information that is required to process this claim.” The said authorization was signed on ..... .
    In .... I filed another claim with the same insurance company for a 3 day hospital stay, unrelated to the previous claim. This time around I have NOT signed the authorization section as I have decided to provide the insurance company the documents needed for processing the claim myself (save the dr some time and headache).
    The insurance claim manager used the 2nd page of the claim I filed with them in February (the one including the signed authorization) in order to obtain info from my dr’s office for the claim filed in April, despite the fact that in April I did NOT sign another authorization for the 2nd claim submitted to them.
    Can the info collected in such a manner be used by the insurance company? (what they did is – to me - similar to forging my signature) Is this “procedure” legal? Can the info collected by the insurance in the manner explained above be used to deny my claim? It is quite obvious to me that this is what they are trying to do: the claim has been filed in April, and they are still “processing” info, while they normally process claims in approximately 30 days. Would I be able to pursue the matter legally and “win” given the circumstances?
    Thank you.

  209. LSM Insurance 10/10/2012 at 4:43 pm

    Dear Sir,

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

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

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

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


    Andrew Suboch

  210. Andy Suboch 10/22/2012 at 6:54 pm

    Submitted on 2012/10/22 at 3:31 pm

    Without reading the policy of insurance I cannot advise you as to whether you may or may not have a cause of action as against the insurance company. However, if you had no idea that the vehicle was modified and changed in a MATERIAL way then I am of the general opinion that the insurer is acting improperly in denying your claim. Even if the policy stipulates that if you modify your vehicle without notifying the insurer, it can and will deny my claim, I am of the opinion that any such “modification” must be “material”. That is a question of fact that a court might have to determine. I would try raising this issue with the Ombudsman and if that doesn’t work then consider legal action.

    If you would like to discuss this further, on a free consultation basis, please contact my offices to arrange for a meeting. 416-815-1331 x221 ask for Fran.


    Andy Suboch

  211. Andy Suboch 10/24/2012 at 4:52 pm

    Dear Madam,

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

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

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


    Andy Suboch

  212. Teresa 11/04/2012 at 11:19 pm

    I am a beneficiary on my ex husbands insurance along with a friend of his plus his present wife. He died ..... the present wife is holding up my claim as she is claiming all the money under the Succession Law Reform Act. Can she do this/.... wont pay until this is settled.

  213. Andy Suboch 11/07/2012 at 1:21 pm

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

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

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


    Andy Suboch

  214. Rudy 12/02/2012 at 11:16 pm

    I am an .... ,my wife and I own a ..... we specialize in .... t. In .... I fell and injured my shoulder making all of my daily duties impossible to complete.I am covered by the .... insurance from .... which should pay me if I am unable to work. My wife takes care of all customer relations,billing and service advisor work. Last year we hired our only other employee an apprentice.If not for him we would be shut down period. My wife does not drive so each day I drive her to work to open up and stay there to pass the time and to supervise our apprentice to ensure his safety and that of our customers, I consider this supervision as voluntary , the company claims that my being there is a gainful occupation making my disability only partial. I must ensure that the apprentice is supervised,the apprenticeship contract requires it. I should be able to receive benefits since I am unable to be productive. Do I have any chance of winning an appeal? I have written a detailed letter to send to the company in hopes that it will make them understand my situation ,should I bother sending it?

  215. Teddy 12/03/2012 at 1:50 pm

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

  216. Andy Suboch 12/03/2012 at 1:50 pm

    Please be advised that I am a lawyer who has been asked to respond to the below.

    In regards to mva-related damage, there are rules prescribed by Regulation that determine who is deemed to be at fault for an mva. They are referred to as the "Fault Determination Rules", in particular, Ont. Reg. 668/90 - FAULT DETERMINATION RULES.

    You might be able to negotiate a settlement with your insurer whereby you agree to the value of the repairs, get a cheque to cover same and do them yourself. That is for you and your insurer to arrange on a mutually agreeable basis. The insurer does not have to do that and they are only obligated to pay for the lesser of the cost of repairs or actual cash value of the vehicle at time of collision.


    Andy Suboch

  217. LSM Insurance 12/03/2012 at 6:50 pm

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

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

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

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

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


    Andy Suboch

  218. TheoWalcot 01/11/2013 at 10:48 pm

    This is what exactly I was searching, the information was overall very useful for me, thanks a lot.

  219. LSM Insurance 01/12/2013 at 10:11 am

    Thanks for the kind words

  220. Teddy 01/21/2013 at 7:56 pm

    I was injured while working. The resulting injury required surgery. My LTD insurance provider provided me with my benefits during recovery an ongoing. I was forced back to work and within a month was unable o work again due to my injury.
    Physicians, surgeons and specialists all said I was not capable of doing my job. My employer is unwilling to accommodate me. My LTD insurance provider has been making me fill out paperwork, get doctors reports and then different reports and tests and exams; an the. Requesting different things saying the things they initially requested wasn't what they needed. They also closed my claim before the .... month period was up for deactivation.
    Recently it was outlined what I would need to get LTD benefits reinstated ( keeping in mind I've ha no income for 8months now). So I got my surgeon to see me on a rush and he was willing to fit me in thankfully. He said I needed an MRI and more surgery. And he said I should not be working at all. Despite the reporting given the insurer came back saying I can be retrained and can work in a different job with a different employer and I am. Not entitled to LTD benefits. My surgeon has written a new letter in plain English after he was made aware of the insurance companies decision, that clearly states that I cannot work any job at this time. I need additional surgery and am now seeing problems with my other arm due to overcompensating.
    They are refusing to back pay me and support my disability claim

  221. Andy Suboch 01/22/2013 at 7:47 am

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

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


    Andy Suboch

  222. Tory 01/30/2013 at 7:10 pm

    Hi, I'm glad I found this forum. I have been off work due to illness since the end of ... . I was suffering from sever diarrhea and other. I had been to see my family Dr Back in ... for the same issue and was referred to see a GI specialist. That appointment was scheduled for September 10th. On A... I was admitted to hospital. I was not taking care of myself and now dehydrated and unable to keep anything down. It was then that I was seen by a psychiatrist. I was diagnosed with... and then a couple days later after many tests, I was diagnosed with ... . After that was figured out then the drs dealt with the depression. I was in hospital for ... on one of the ... I went to group therapy and saw a ... daily. When I was discharged on ...h I was referred to the hospital's day program. This was five days a week for 3 to 5 hours. Originally this this an 8 week program. Due to the ... I could not attend for the first three weeks. I have now just finished that program. My ... had me off work the entire time and my return to work date is march 1st. I did not have sick pay at work so I collected medical EI for the first ... weeks. After that I submitted to my insurance company(from work) for long term disability on ...h. I finally had my interview about my claim with .... on Monday this week and today I received a call telling me my claim is declined. I was too upset to listen to this guy. He said that my illness did not fit criteria. What? How does that work? What do I do now? He said that I can appeal, how does that work. This same company originally denied my claim for medications that were required for my ... diagnosis. Totally frustrated! Any advise?

    Thanks for your time.

  223. LSM Insurance 01/31/2013 at 3:33 pm

    Dear Madam,

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

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

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


    Andy Suboch

  224. Ted N 02/09/2013 at 10:36 am

    Here is my dilema. I was insured by group benefits through work. I was
    off for ... on ltd. During that time my employer switched
    insurance carriers in which I did not know till I returned to work. I
    paid premiums to the new insurance company and thought everything was
    fine, until I got sick again. I now know I will never be able to go to
    work in any job. I filed a claim with my new carrier for ltd. I was
    denied. They state that its a re-occurance and the old carrier is
    responsible. However the old carrier says the new carrier is responsible
    as I have past the six month reoccurance. They consider it a
    pre-existing condition and should not be denied a new claim with my
    current carrier. So what do I do now? Neither insurance company will pay

  225. Andy Suboch 02/09/2013 at 10:38 am

    Dear Ms Cater,

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

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

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

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

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


    Andy Suboch

  226. Jake 02/11/2013 at 6:17 pm

    I am having issues with the accidental part of a policy that I was listed as beneficiary on of my late ex husband which was crushed at work doing what he loved. The insurance company is telling me that they cannot get the coroners report and they have a whole bunch of reasons why they can't pay if out. I'm not sure as to what kind of lawyer I need. I talked to one lawyer and he told me that when the insurance policy is signed there is a part of it where the insuance company has the access to this report. I talked to the lady at the insurance and she keeps saying she doesn't know what the hold up is. Says there is litigation to the company he worked with says that the next of kin is withholding the coroners report. Says the dr moved offices and they can't find her. Says she is going to talk to their lawyers to see what can be done. He passed away .... so it is coming up one year and she said something about putting it in trust then I can apply for it. I just want t his over so I can get back to my life. Can you help???

  227. Andy Suboch 02/11/2013 at 6:30 pm

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

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

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


    Andy Suboch

  228. Tony 02/15/2013 at 2:06 pm

    My wife's mother was diagnosed with cancer and passed away in ...
    and I have been back tracking through their financial records trying to
    make sense of it all. They had a mortgage that went into arrears, it was
    then bought out by a bank and is now in the hands of a lawyer. One of
    the reasons it went into arrears is because she became ill. I've tried
    to get information out of the original mortgage lender to see if there
    was any insurance in place before the arrears but they are not
    cooperating. One rep said yes and another says no and to get a lawyer.
    What my question would be is if their was a policy in place before she
    became ill can we back track and have the insurance company help pay for
    this mess.

  229. Andy Suboch 02/15/2013 at 2:07 pm

    Dear Sir,

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

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

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


    Andy Suboch

  230. Ted 02/17/2013 at 7:05 pm

    My daughter has been divorced approximately 6 months and her
    ex-husband's life insurance policy was part of the divorce settlement.
    He had a kidney transplant over ... years ago; therefore carried a life
    insurance policy.

    He died of terminal cancer on ...., which was diagnosed
    approximately a year ago. He remarried just before ....

    When they separated (approximately 2 years ago) their 17 year old son
    lived with her in the residence. She continued with the insurance
    payments, for which she took responsibility during the 20 year marriage,
    with the understanding that upon his death, she would be the beneficiary.

    It should also be noted that because of his terminal illness he had to
    quit work and she was not provided alimony or child support.

    Their home was assessed at .... and her ex-husband purchased 1/2 the
    share of the home. She also received half of their RRSP's. The total
    value of her settlement was approximately $.....beneficiary of
    the insurance which is in the area of $....

    She moved from the residence and purchased a small apartment - their ...
    year old son remained in the residence when she moved (approximately
    .... but moved into the apartment and living with her
    once again.

    She is employed at Wal Mart on a part-time basis, earning ..... There is reason for concern that she is no longer the

    Is it legal to have the beneficiary changed, after the divorice is

    She phoned the insurance company on .... and was advised that up
    to that date, no changes were made to the policy. He died on ......

  231. Andy Suboch 02/17/2013 at 7:07 pm

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

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

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

    Yours very truly,

    Andy Suboch

  232. Glenda 02/19/2013 at 5:51 pm

    My husband was in a workplace accident that has left him with a torn
    ligament in his right shoulder and bleeding on the brain. He is
    currently on WSIB and is going to therapy daily . His memory has
    deteriorated and so has his motor skills.

    He is truck driver. He is being pressured to go back to work even though
    his company has nothing for him with this injury... He is still in pain
    (it will be two years this ....
    he has been told he will never regain 100% of his hand

    What are his options for pain and suffering? Can he sue?

  233. Andy Suboch 02/19/2013 at 5:52 pm

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

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

    I wish you best of luck with your future endeavors.


    Andy Suboch

  234. Toby 02/25/2013 at 2:13 pm

    My father passed away in ... .... He had cosigned on a vehicle
    loan for my brother, and opted for the life insurance that was offered.
    I just received the coroner's report, and it indicates the immediate
    cause of death as ..... . Contributing
    factors are listed as .... and tobacco use.

    My father had been diagnosed with .... just prior to applying
    for the life insurance,but was managing it well at the time of death. He
    had not been diagnosed, investigated or given any treatment for the
    ...... and the medical records will confirm this.
    Can the insurance company deny on the basis of the diabetes even though
    it was not the immediate cause of death? As well, the forms filled out
    when the loan was obtained did not require my father to answer any
    medical questions or submit to any medical exams. It is a situation, I
    believe, of my father being taken advantage of. The difficult is, the
    estate is on the line for the loan and as executrix I have to deal with
    it and it appears they will not remove the estate from it.

  235. Andy Suboch 02/25/2013 at 2:15 pm

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

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

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


    Andy Suboc

  236. Latasha 04/10/2013 at 6:02 pm

    Hi I just have an enquiry really, My dad had a life insurance and upon reading his insurance policy, It says that pre exsisting conditions only apply after 3 yrs. My dad died a month before this 3 yrs is it even worth it to claim on this?

  237. LSM Insurance 04/10/2013 at 6:09 pm

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

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

  238. Norma 04/19/2013 at 11:22 am

    My wife was identified with genetical disease in .... Disease was progressive and very rare disease. she was able to do all activity during insurance started in 2003. Insurance agent came to home and filled all application form and she just signed the form. She informed all medical conditions and gave her medical health card information for medical history review. Insurance agent also took swab sample. mean, we clearly told about her medical conditions.
    Now, she got permanent disabled in 2011 as she can't walk and can't do any activity at age of 34 years. so, we tried to claim her permanent disability then Insurance company denied the claim. and also took all premium which we paid during ...years. I wish to ask that when person need support than insurance company tried to skip from their support. she becomes very scared and gone to big depression. she lost all hopes from her life to survive.
    I would request to support her for survival.

  239. Andy Suboch 04/19/2013 at 2:34 pm

    Dear Sir,

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

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

    If different facts emerge then my opinion could change.


    Andy Suboch

  240. Marlene 04/23/2013 at 11:57 am

    My husband passed away on March 21, 2013.
    Can you advise the status of his policy ....

  241. LSM Insurance 04/23/2013 at 2:13 pm

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

  242. Yuri 04/25/2013 at 2:14 pm

    I've been on an insurance claim for ... years now I've seen a specialist and he said its easier to go back to school instead of surgery.

    But the last insurance doctor I've seen said I can go back to pre accident job which was a Working Forman on the carpenters union. My family doctor said he wouldn't sign off on that cause he doesn't want me to do more damage.

    My insurance company wants to settle with me but i don't no if i should take it to court the insurance company has the report from back specialist so they no that their doctor did not do a proper assessment on me and it shows in his report.

  243. Andy Suboch 04/25/2013 at 2:16 pm

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

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

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

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

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


    Andy Suboch

  244. Ryan 04/25/2013 at 3:14 pm

    I was diagnosed with anxiety because of the fiscal and mental abuse from my boss who was fired because , but I am still sick and was refused long term disability . I work in a hospital and I am retiring the end of July . They feel that I just want a change of life . Where my doctor tells me I am not fit for any job

  245. Andy Suboch 04/25/2013 at 3:15 pm

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


    Andy Suboch

  246. ANDREA 04/25/2013 at 6:43 pm

    my mom passed a month ago. She had 3 life insurance policies each $100000.00 her finace man told us they are only worth $10000.00, can this be true?

  247. LSM Insurance 04/25/2013 at 7:03 pm

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

  248. Donna 05/06/2013 at 1:30 pm

    took out ins on my mom now .... is not wanting too pay off on the claim been over 5 months now

  249. Andy Suboch 05/06/2013 at 2:03 pm

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


    Andy Suboch

  250. Elizabeth 05/20/2013 at 8:03 am

    I have sent in claim forms as my husband .... died on ..... and I haven't heard anything yet. Could you let me know what ia happening do I need to fill out more forms Did you receive my forms Would you send me new forms to fill out so I can get some action Thank you

  251. LSM Insurance 05/20/2013 at 11:23 am

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

  252. petro 06/06/2013 at 6:24 am

    My husband has had his kidney removed
    due to failure caused by blockages by kidney
    stones. He has an old norwich life insurance policy that
    claims only benefits for accidental loss.
    the company is now liberty life . the policy was taken out in 1991. can he claim

  253. LSM Insurance 06/06/2013 at 6:31 am

    Hi Pedro, Sorry to hear that. You would have to first check with the insurance carrier - they can start the claim process.

  254. shelley 06/14/2013 at 10:39 am

    I have applied for my ltd benefits in april 2013 no response since
    I have been requested to put pressure on my doctor and his staff for documents requested by your ins company.
    This is not my job to do so....
    I would like a response to my claim in writing by mail....
    I have not received any support from my employer or else....
    please help me

  255. LSM Insurance 06/14/2013 at 12:27 pm

    Thanks Shelley,

    Sorry to hear that. We would not be able to respond on behalf of the insurer. Sometimes doctors does respond quicker when a patient requests the urgency of the completed paperwork.

  256. Arlene 06/17/2013 at 12:27 pm

    I am interested in actually talking to someone there regarding disability insurance that would pay if something was to happen and was unable to work? Please contact me thank you!

  257. LSM Insurance 06/17/2013 at 1:30 pm

    Thanks for the note. We will be in touch. Regards,

  258. Orysia 06/21/2013 at 9:35 am

    Hi I was sent some information on a life insurance policy, in case I became ill.
    I must have given my Visa number to person.
    I do not want the insurance. Please cancel and do not charge my visa card anymore.
    My name is Orysia ....

  259. LSM Insurance 06/21/2013 at 1:30 pm

    Thanks for the note. But you would have to contact the insurance company directly. Please visit our life insurance directory link to

  260. Mario 07/10/2013 at 8:36 pm

    Dear BMO Insurance, I am enquiring about Michelle Bechamp's policy. I am the beneficiary and paying for the insurance. I think I am to renew this August, can someone please look into this and get back to me. I can give you the policy number. Thank you

  261. LSM Insurance 07/11/2013 at 10:52 am

    Hi Mario, Thanks for the note you can contact BMO directly at 1-800-387-9855. Regards,

  262. Lee-Ann 07/14/2013 at 8:04 pm

    Hello, I am hoping you can answer a question for me. Recently a friend of mine committed suicide. He left behind a 4 year old, a 1 year old and a beautiful wife. They had life insurance and mortgage insurance. It turns out he committed suicide 7 days before the 2 year suicide clause was up. His agent indicated he would fight for the family with the insurer, and try to get the claim paid as it was within 1 week of the 2 year clause expiring and would do so as it was a hardship case. The insurer ultimately denied the claim. My question there any chance an insurer would pay this claim due to the fact it is so close to the expiry of the clause? It just seems so unfair to the family that is left behind when it was so close. I understand the clause is in place for a reason, however, I wonder if there is room for exception in situations like these?

    Thank you in advance for your advice.

  263. Peter 07/19/2013 at 12:50 pm

    My mother passed away and we found a group policy from my father's work. I would like to know if there are unclaimed funds. Group Policy No.....

  264. LSM Insurance 07/19/2013 at 1:07 pm

    I'm sorry to hear that. You should try calling the insurance company or your father company to see if the plan was active. Get confirmation in writing. Regards,

  265. Deno B 07/20/2013 at 11:52 am

    Hello, My Dad passed away on .... 2013. His Wife ( my mom) passed away on .... 2013. We found a London Life ..... . Is there anything that should be done with this policy? Thanks.
    Deno Bartman

  266. LSM Insurance 07/21/2013 at 1:41 pm

    Hi Deno, I'm very to sorry to hear that. Yes you should contact London Life and they can start the claim process.

  267. DIANE FREEMAN 07/24/2013 at 11:37 am

    I worked for a company for ten years and had life ins. they shut down ,i went to work at another textile company we had life ins but they dropped it ,,heres the kicker one guy recieved a check for back payments a refund so my question ,,the company i worked for for ten years dont they owe me me a percentage of my payments back im not dead ,,,

  268. LSM Insurance 07/24/2013 at 12:41 pm

    Thanks for the note Diane. You would have to check the provisions of the policy if it has some type of cash value or return of premium provision.

  269. EM 08/09/2013 at 10:25 am

    My husband passed away .... . I am his wife and would like to claim the insurance settlement.
    The contact humber I have is no longer in service. Please give me directions.
    Thank You

  270. LSM Insurance 08/09/2013 at 12:26 pm

    We are very sorry to hear that. If you let us know the company we can look up the contact number for you.

    Or visit our insurance company directory page link to

  271. Maribeth 08/11/2013 at 9:26 pm

    I am trying to look up my life insurance polocy

  272. LSM Insurance 08/12/2013 at 1:53 pm

    Thanks Maribeth. You would have to contact the insurance company directly. Our directory link to may be helpful.

  273. Philip 08/27/2013 at 4:59 pm

    I am former ... employee. I have pension plan ..... What benefits are available to me. B.M.O does not appear to have records.

  274. LSM Insurance 08/27/2013 at 5:42 pm

    Thanks Philip. Unfortunately we would not have these details you would have to contact BMO Insurance or you Pension carrier directly. BMO's contact number is 1-800-387-9855

  275. Dave 08/29/2013 at 4:26 pm

    My late wife and I purchased insurance about a in..... . We were accepted, with a 2 year suicide clause provision.

    My wife about 3 months ago was diagnosed with Borderline personality disorder and Bipolar Depression, due to this issue she was placed on many different meds which were not working for her. She ended her life.
    I was understood that there were provisions made to protect those with these types of disorders with regards to insurance. I just received a letter from the insurer that my claim was denied and they refunded the money we paid into the policy.
    My wife loved her life and I know that she would not have done this in her right mind.
    Is there something I can do? Being that she had no previous mental illness that I know of, can they just disregard the illness and leave me stranded?

  276. Andy Suboch 09/01/2013 at 4:09 pm

    I am a lawyer who is duly licensed to practice law in Ontario. I have been asked to response to the below enquiry.

    Quite frankly, based on what you have set out, I do not see a viable case as against the life insurer. When the policy was issued, you [and your ex-wife] apparently clearly understood that there was a 2 years suicide exclusion. Unfortunately, your wife took her life before the expiry of said 2 year exclusion. I understand that she was not in her proper state of mind when she so acted but that is, in my opinion, the very reason that such a clause exists.

    I extend my condolences to you for your obvious tragic loss.


    Andy Suboch

  277. Hilda 09/01/2013 at 5:39 pm

    My father had a polisie for me.he died 16 years ago he left my grandmother incharge of the money but she wants nothing to do with me.i need the money im 19 years old an i have a baby she is 4 months old my boyfrend lost his job so need the money to take care of me and my baby girl please help me

  278. LSM Insurance 09/02/2013 at 10:08 am

    I'm sorry to hear that Hilda. It would depend who is the policy owner. If she is the owner she would have control over the policy.

  279. Helena 09/08/2013 at 2:28 pm

    Hello do you deal with denial of mortgage life insurance? I am a financial planner and I representing my client; here is her story her husband past way in Feb this year and she applied for the Mtg Ins. she received a letter stating due to his medical conditions and that he did not reveal it at the time of application that we was denied.

    Is there anything that can be done I am looking for a solution to help this family.

    Thank you,


  280. Andy Suboch 09/09/2013 at 12:58 pm

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

    Without more information I can't really make any useful comment. I will grant you/ your client a free meeting and/or phone discussion if you'd like to discuss this matter further. Call Usha 416-815-1331 x221 to arrange for same.

    There is a general 2 year limitation period in Ontario. I don't when the claim was denied so I can't indicate when the limitation period might start.


    Andy Suboch

  281. Ian R 09/12/2013 at 1:26 pm

    Found life ins father dated .... was it paid out? Policy number ....

  282. LSM Insurance 09/12/2013 at 1:46 pm

    Thanks for the note. You would have to contact the life insurance company directly.

    You may find this link helpful it has all the Coordinates for the different insurance companies in Canada link to

  283. PG 09/16/2013 at 7:55 pm

    I am on canada pension disability for three years since being diagnosed with squamas cell carcinoma and was treated with radiation and chemo and can not work anymore so wanto know if there is any help from my insurance or is there any point in continuing with it.

  284. LSM Insurance 09/17/2013 at 5:28 pm

    Thanks for the note, but I'm not sure what you are asking. If you have a disability insurance plan you should try and submit a claim.

  285. LD 10/09/2013 at 5:44 pm

    I was involved in accident on ..... I was getting into the truck and my foot got slipped and i fall down. I enjured my back. Since then i am not able to wrok my policy.... . Please call me or send me the clam forms. Thank you.

  286. LSM Insurance 10/10/2013 at 8:53 am

    I'm sorry to hear that. Which insurance company are you covered with?

  287. Joyce 10/13/2013 at 3:01 pm

    My father had irrevocable trust leaving 2 sisters as trustees. His trust states they have all right with the exception of life insurance. Does all of the beneficiaries' have the right to know who received the life insurance as well as who received individual item that have not been provided for sell or for one of the beneficiaries' to keep

  288. LSM Insurance 10/13/2013 at 3:59 pm

    Without seeing the documents it's difficult to say. But generally speaking life insurance policies should be paid out according to the beneficiary designation stated in the policy

  289. Ray 10/16/2013 at 8:58 pm

    We have been getting the travel insurance through .... which ended up being a ..... out of Saskatchewan that gave us an annual coverage that covered us for 35 days 100% coverage then if we went longer would top it up for 2 months. I sprained my .....l and was told to go to the Eisenhower ER That was March and it was only just over $400 and still has not been paid out so now I have a collection agency calling and harassing me. My policy was .......

  290. LSM Insurance 10/17/2013 at 8:21 am

    Hi Ray, For a dispute this size it will difficult to get a lawyer to assist you.

    The link below may be helpful in getting your dispute resolved. link to

  291. Robert 10/22/2013 at 2:17 pm

    Hello Andrew.

    I've bin having a lot of problems with the Insurance company My first call from ... was very unpleasant. The questions they were asking me made me feel upset. They were prying into my personal life. My Doctor has sent a number of reports to the based on my condition. I have bin with out pay for over a month and the still want more information. I do not know what to do. I am forced to return back to work next week .... . I have so many Doctor's App that I have to take time off work to attend them. I'm also facing some issues with my Employer as well regarding time off work. PLEASE HELP. Thank you.


  292. Andy Suboch 10/22/2013 at 6:45 pm

    Please be advised that I am a lawyer who practice's law in Ontario, who has been asked to respond to your inquiry below.

    I am not exactly certain as to the type of benefit that ... is giving a hard time over. I am assuming that such benefit is either Short Term Disability [STD] of Long Term Disability[ LTD]. If your doctors have confirmed that you are disabled as defined by the relevant policy re STD's [usually an inability to perform the essential tasks of your occupation] then you should not return to work. I really can't say more but this is probably an issue that we should discuss either face-to-face or over the phone. If you would like a free consultation, please call Usha 416-815-1331 x221 to arrange for a meeting.

    I look forward to discussing this with you further.


    Andy Suboch

  293. TA 10/24/2013 at 4:23 am

    hi my dad just passed away and had a .... he paid over 7000.00 into it but the amount was only 1800.00 is there anything i can do to recover all the money he paid into it? .... said its one of their old policies, i wonder how many other people are paying into the same policy thinking they will receive much more than 1800.00

  294. LSM Insurance 10/24/2013 at 9:16 am

    Thanks for the note. I agree this seems like a very bad deal. But if the company is acting in accordance with the policy I'm not sure there is much you can do.

  295. Tony 12/02/2013 at 3:12 pm

    i went on long term disability with cpp in ..... i just realized i have insurance on my line of credit for my business (which i sold in ...)
    i have initiated a claim and am awaiting to hear from insurance company. question. do i have to tell them i sold my shares of company and for how much? can i retro the claim to start of disability? is claim amount based on the balance of line of credit at start date of disability?

  296. LSM Insurance 12/02/2013 at 3:18 pm

    Dear Sir,

    You have asked many questions for which there really isn’t a correct or incorrect answer. Without looking at the application and the policy of insurance and without the insurer giving you a response to your claim I cannot answer whether the questions posed below ought to be answered.

    If you would like to discuss this further, please call Usha of my offices at 416-815-1331 x221 to arrange for a free consultation.


    Andy Suboch

  297. Kirsten 12/09/2013 at 2:11 pm


    We had an accident while away and had to tow our car back to Ontario.
    Our car is a total write off, we had just had the engine replaced 2 days before the accident along with the whole front end work done 1 week before our engine ceased. Insurance says they will consider the engine work bill. Do they have to look at all the major work we had done which was about 5000 in repairs? What are they obligated to pay out as they have the vehicle as an 2006 with 170k instead of 98k that they engine now has

  298. LSM Insurance 12/09/2013 at 2:12 pm

    The short answer is that an insurer, absent an endorsement to the contrary, is only obligated to provide the ACTUAL CASH VALUE of the vehicle as it was at the time of the mva. If you disagree with the value assigned by the insurer, your option is to go to arbitration after a certified appraiser has valued the car.


    Andy Suboch

  299. Mike S. Ward 12/22/2013 at 1:43 pm

    I have been unsuccessful in getting any replies from BMO insureance about my policy.I would like an updated version of my account.With proper forms for change of address,beneficiary to fill out.My main concernces are I have never missed a monthly payment and now have paid more into claim than what i'll receive.I was never informed about changes from BMO when they took over from IGA.Was told if I want to stop claim I will get $1.43 for all the money I have put into,never was I told about these changes!Send me all forms and updates to 259 box 14 Nelson St.Kincardine,ON.n2z-1e6 Thank-you Mike Ward

  300. Sandra Jacobs 12/22/2013 at 6:57 pm

    We paid $10,000 for a funeral expense plan with Purple Shield to get paid $6000 on my Mothers' death. Is 40% a little steep for insurance costs?

  301. 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.

  302. LSM Insurance 12/27/2013 at 9:15 am
  303. LSM Insurance 12/27/2013 at 9:17 am


    You need to contact the insurance company directly.


  304. 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 ?

  305. 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.


    Andy Suboch

  306. 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.

  307. 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.


    Andy Suboch

  308. 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

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

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

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

    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?

  311. 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.


    Andy Suboch

  312. 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

  313. 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

  314. 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

  315. 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.


    Andrew Suboch

  316. 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

  317. 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.


    Andy Suboch

  318. 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,

  319. 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.


    Andy Suboch

  320. 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 ?

  321. 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.


    Andrew Suboch

  322. 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?

  323. 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.


    Andrew Suboch

  324. 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,

  325. 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,

  326. 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?

  327. 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.


    Andrew suboch

  328. 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!

  329. 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.

    Andrew Suboch

  330. 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 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.

  331. 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.


    Andrew Suboch

  332. 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.

  333. 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.


    Andrew Suboch

  334. 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

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


    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.


    Andrew Suboch

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


    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.


    Andrew Suboch

  337. 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.

  338. 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.


    Andrew Suboch

  339. 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,

  340. 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.


    Andrew Suboch

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

    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?

  342. 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.

  343. 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?

  344. 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.

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

    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?

  346. 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.


    Andrew Suboch

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