Personal Injury Resources

Claims Denial Options

Filing a personal injury claim in the wake of a car accident in Ontario can be hard enough as it is, but what happens if your claim is denied?

Not many people know where to turn in face of a denied claim by an insurance company. Many traffic accidents occur in the GTA (which includes Toronto, Mississauga, Brampton, Scarborough, Richmond Hill and Markham), and these fall under Ontario's Insurance Act, which sets out specific regulations about the benefits that a person injured in a car accident is entitled to.

It's important to have your claim represented by a licensed paralegal or qualified car accident or personal injury lawyer. This will ensure a professional is handling your claim, and that you receive the full range of accident benefits to which you are entitled.

A car accident injury claim made in Ontario can be denied for a number of reasons. For example, your insurance company may ask for an independent medical exam to further evaluate your injury; if you decline the exam, your insurance provider can refuse your claim on the basis of 'non-compliance'.

If you do agree to such an examination, your insurer must then review your claim for possible accident benefits. Such benefits vary depending on a bevy of circumstances, i.e. whether or not you were employed at the time of your accident, or if you are listed as the primary caregiver of your household - even things like lost time or tuition at an educational facility.

However, if your insurer denies your claim after you've already gone through with an independent medical examination a copy of which you should always keep your accident attorney may recommend a rebuttal examination. This exam will consist of a second medical assessment, addressing the issue at the heart of your claim's denial. Your insurance company will be billed for this second examination.

Having a qualified car accident lawyer representing your case can be crucial; a claim denial is often just the first of many steps toward a successful claim.