416-460-6823Serving All Of Ontario
Life Insurance can help ease financial burdens when a loved one passes. Grieving the loss is of course immensely difficult, but sometimes insurance companies add insult to injury by denying valid life insurance claims. A life insurance lawyer can help you secure the money you and other beneficiaries are entitled to.
Life Insurance is a special type of contract between the policy holder and the insurance company. Premiums are paid to the insurer in exchange for a promise to pay a specified sum to the beneficiaries upon death of the insured person. Both parties to the contact owe the other a duty of good faith. The person taking out the insurance must be open, honest, and candid when completing the application, and the insurance company must pay legitimate claims.
Common reasons life insurance claims are denied include:
Yes! The law regarding life insurance is complex, and insurance companies do not always get it right. For example, death by suicide, innocently failing to disclose material information, and negligent misrepresentation are generally not valid reasons to deny the claim if more than two years have passed since the insurance policy was issued.
There are sometimes other legal avenues to pursue. Individual life insurance policies are typically obtained through an insurance agent or broker. Sometimes the insurance company properly denies the claim, but the agent or broker made mistakes that caused the denial. If those mistakes amount to negligence, the agent or broker’s insurer may be required to pay what would otherwise by payable by the life insurer.
Some examples of situations where you can challenge a denied life insurance claim include:
You have important legal rights when an insurance company refuses to pay out a life insurance claim, including the right to consult with a lawyer. A life insurance lawyer can help by reviewing the claim denial letter, obtaining the insurance company’s complete file, analyzing the application process, and generally scrutinizing the insurers reasons for denying the claim.
You can obtain this initial legal opinion for free by contacting Michael Jordan, life insurance lawyer. If Michael is of the opinion that the claim denial can be challenged, he will recommend taking legal action on your behalf, which is likely to result in a fair settlement.
A lawsuit does not mean you are going to court. The vast majority of insurance claims settle long before trial, typically at mediation. Mediation is a structured settlement meeting where the insurer, the beneficiaries, and their lawyers are assisted by a neutral mediator. The steps required to get from life insurance claim denial to mediation often include the following, although more or less may be necessary depending on the situation:
Different life insurance lawyers have different fee arrangements. In most cases, Michael Jordan’s fee structure for denied life insurance claims is as follows:
Initial consultation
No fee
Obtaining insurer’s file, analyzing the file, and providing a legal opinion
No fee
Commencing and prosecuting a lawsuit through to settlement or judgment
No fee unless successful. The contingency fee is usually 30% of any recovery, plus HST, plus disbursements. The defendant insurer will contribute to these expenses, increasing your net recovery.
In the event there is no recovery, there is no fee, no HST, and no disbursements.
Contingency fee retainer agreements are governed by the Law Society of Ontario.
Michael Jordan has been practicing insurance law, including denied life insurance claims, for more than 18 years. He has access to a network of experts who can assist with formulating the initial opinion, and well honed strategies that compel insurers to pay. Michael has resolved claims with every major insurance company in Ontario, including Sun Life, Manulife, RBC, Desjardins, and Canada Life, among others. He has dozens of 5 star Google reviews, and recovers millions of dollars for his clients every year.
Contact Michael Jordan for your free consultation today.
QUADRIPLEGIA
$1,950,000
Our client sustained serious injuries in a motor vehicle accident. She advanced claims against her insurance company for income replacement benefits, medical expenses, and cost of care. The claim settled for close to $2 Million dollars.
BIPOLAR DISORDER
$575,000
Our client was a successful business person. When his long term disability claim was denied, he retained Michael Jordan to take legal action against the LTD insurer. Expert medical evidence that was instrumental in resolving the case.
DEPRESSION
$400,000
Our client was unable to work due to debilitating depression and anxiety. The disability insurer denied the claim, but when faced with litigation, a settlement was achieved allowing the client to focus on his recovery.
CANCER
$400,000
Our client was diagnosed with life threatening cancer, which resulted in a severe psychiatric response. The claim was denied based on an exclusion in the policy. The exclusion, however, was poorly drafted and the case quickly settled.
LONG COVID
$275,000
Brain fog, fatigue, and inability to focus and concentrate were the main symptoms. The LTD insurer denied the claim due to lack of "objective medical evidence", even though there was no requirement in the policy to provide objective evidence, and the nature of the impairments were inherently subjective. The case settled after litigation was commenced.
PSYCHOSIS
$270,000
The claim was denied because our client was not participating in appropriate treatment, but his mistaken belief that he did not need treatment was a symptom of his disability. An expert psychiatrist was retained to provide opinion evidence that the failure to participate in treatment was a symptom of the underlying illness. The case quickly settled.
CANCER
$267,000
Our client had surgery to remove the tumour, but was left with severe chronic pain and anxiety. An opinion from an expert oncologist supported disability and a fair settlement soon followed.
VERTIGO AND NAUSEA
$255,000
The long term disability insurer did not believe our client’s self reported symptoms. During the litigation, extensive medical records and reports were obtained that supported disability.
CHRONIC FATIGUE
$250,000
The claim was denied because there was no medical explanation for the sudden onset of chronic fatigue syndrome. Two expert reports were secured, and the case settled at mediation.
ANXIETY
$250,000
Our client suffered from severe anxiety that made work impossible. Despite this, her LTD claim was denied. It settled shortly after a lawsuit was commenced.
CHRONIC PAIN
$250,000
Our client was involved in a motor vehicle accident many years ago. He continued to suffer chronic pain, but the LTD insurer denied his claim. Expert opinion evidence helped secure the settlement.
MIGRAINE HEADACHES
$240,000
The insurance company denied the claim after the two year “own occupation” test of disability changed to “any occupation”. Evidence was secured that the client could not work in any job, and the case resolved.
Previous results are not necessarily indicative of future results. Contact Michael Jordan, long term disability lawyer, for an assessment of your claim.
At Micheal Jordan, we specialize in helping people whose life insurance claims have been denied. If you find yourself in this situation, we have a team of experienced life insurance claims lawyers who can help you potentially get the denial overturned and receive the compensation you deserve.
When you come to us with a denied claim, one of our lawyers will review your case to determine whether the denial was justified or not. If we find that the denial was wrongful, we'll help you file an appeal or take legal action against the insurance company to fight for your rights and ensure that you receive the benefits you're entitled to.
We understand that dealing with a denied life insurance claim can be a stressful and challenging experience, which is why we're here to provide you with the legal support you need to navigate the process. With our help, you can increase your chances of success and get the outcome you deserve.
For a variety of reasons, life insurance claims may be rejected, including:
Non-disclosure or misrepresentation of Information: The claim may be rejected if the policyholder failed to disclose or gave false information, such as pre-existing medical conditions or hazardous occupations when applying for the policy. Suicide or criminal activity: Most life insurance policies have a provision that prevents benefits from being paid out if the insured dies as a result of suicide or criminal activity.
Failure to pay premiums on time: If the policyholder didn't pay their premiums on time, the policy might have expired and the claim might be rejected.
Exclusions from coverage: Some policies do not cover specific types of fatalities, such as those brought on by terrorism, war, or hazardous sports. Unreliable beneficiary information: If the beneficiary information is unreliable or out-of-date, it could delay or even prevent the claim from being paid. Fraud: The claim may be rejected if the policyholder or beneficiary submitted fictitious information or made false claims.
Review the policy and comprehend its terms and provisions to prevent any misunderstandings or problems when making a claim.
The main responsibilities of a lawyer are to uphold the law and defend a client's rights. Lawyers provide legal counsel, conduct research, gather evidence or information, draught court motions and other legal papers related to contracts, divorces, or real estate transactions, and represent clients in court.
A life insurance payout typically takes 14 to 60 days to arrive. Cause of death, beneficiary status, and incomplete paperwork are all factors that can delay the payment. Before completing a payout, the life insurance company occasionally requires more details.
With some term life insurance plans, you can get your money back. They exist. Certain term insurance policies only provide death benefits. Other term insurance plans, on the other hand, let you get your premiums back after the policy matures.
You won't have coverage if you cancel your life insurance policy. Like other types of insurance like health insurance and car insurance, you won't get your money back because you already paid for coverage.
Michael Jordan
Jordan Honickman Barristers
Contact Today
