Insurance

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  1. My insurance company has denied my claim. What can I do?

    There are a variety of reasons why your insurance company may deny your claim, including:

    • the loss that occurred is not covered by the policy you purchased;
    • you have done something that breaches your contract of insurance (i.e., the loss would normally have been covered, but you had acted in a manner that entitled your insurer to deny your claim); or
    • you have not done something which is necessary to complete the claim, such as providing a Proof of Loss form.

      If you had purchased an insurance policy that you believe should cover your loss, you will likely want to seek the advice of a lawyer. We would be pleased to review your policy and determine whether the loss should be covered or whether you had done something to breach your contract of insurance. If the loss should be covered, we can represent you in negotiations with your insurance company in an effort to effect an out-of-court settlement, or possibly to assist you in launching a lawsuit against your insurance company. In order to provide you with the best possible advice, we need to review your full policy.

  2. How long do I have to file a claim against my insurance company?
    The amount of time within which a person must file documents with the appropriate court in order to sue for payment under a policy of insurance varies depending upon the type of insurance contract (i.e., fire, auto, or life insurance). In addition, depending on the type of policy, there may also be additional documentation that you are required to provide to your insurance company before you are entitled to launch an action. As a failure to file within the mandatory limitation period will forever bar a claim on your policy, it is wise to contact a lawyer immediately after you have been denied coverage. The limitation period for claiming may be as short as one year, but there are likely preliminary deadlines for providing Proof of Loss declarations within that one year period. At Emery Jamieson LLP, we can review your contract, discuss your circumstances, and assist you in determining whether you have a claim. If a claim is appropriate, we will help you compile the necessary documentation and launch your action within the required period of time.
  3. What is Subrogation?
    Subrogation is the right of your insurance company to “step into your shoes” to recoup some or all of the money it has paid out to you on your policy from the party that caused your loss. This right allows your insurance company to sue the wrongdoer in your name and to control scope and direction of that lawsuit. When this happens, you have a duty to cooperate with your insurance company and to assist in the recovery of funds.
  4. I purchased insurance for my property/equipment/vehicle, and now I’m selling the property/equipment/vehicle. Can I sell my insurance policy along with the property?
    A contract of insurance is a personal contract between you and your insurance company. As a result, you are generally not allowed to sell your insurance policy to someone else without the prior permission of your insurance company.
  5. I purchased insurance and now the information included on my application for insurance has changed. What should I do?
    You have a duty to disclose all relevant information to your insurance company. If you fail to do this at the time that you are applying for your policy, your contract may not be valid and you may not be covered for your loss. It is important to note that this is an ongoing duty, and you are generally required to report any significant changes relating to the risk insured against to your insurance company. For example, if you have purchased automobile insurance and you are no longer the regular driver of the insured vehicle, this may be considered a “material change to the risk” insured against, and you and the new driver may not be covered under your policy. However, not all your omissions will result in your policy being invalidated. If your insurance company denies your claim on this basis, contact our office immediately and we will review your situation and determine if you are entitled to coverage for your loss.
  6. Do I have to tell my insurance company about a loss even if I do not plan to make a claim on my policy?
    It depends. There is no absolute requirement that all events relating to your policy have to be reported to your insurance company. If you do not intend to make a claim based on the event, you likely do not have to report it. However, if the event or loss results is a “material change to the risk” that is covered by your policy (see above “I purchased insurance and now the information included on my application for insurance has changed. What should I do?”), you are required to report the event to your insurance company even if you do not intend to make a claim on your policy. This is a particular concern in automobile insurance. You may prefer not to report or claim on your collision coverage when an accident occurs, however if the other driver later alleges an injury from that collision, your late reporting of the accident to your insurer may compromise your liability coverage.
  7. Can I sue the person who caused my loss without going through my insurance company?
    The law provides that a person can only sue a wrongdoer once for any particular wrong he has committed. As a result, any action that you may have against the wrongdoer must be combined with your insurance company’s action (because your insurance company may be entitled to later sue the wrongdoer in your name – see “What is Subrogation” above). Since the wrongdoer can only be sued by you one time, a premature lawsuit may result in cutting off the claim of your insurance company for the recovery of any funds it may have paid to you from the wrongdoer. If this occurs, your insurance company would then be entitled to sue you for any losses it incurs as a result of your premature claim. As a result, it is best to inform your insurance company of any insured losses and to contact a lawyer before you commence any action.