In the aftermath of a serious motor-vehicle accident, injured victims and their families often console themselves thinking that their insurance coverage will take care of their expenses. Hospitalization and medical treatment, rehabilitation, therapies etc, coupled with dwindling family finances caused by the injured victim’s inability to work can create a highly stressful situation. The victim and family have to undergo severe physical, financial and emotional trauma for an extended period if the injuries are serious.

Ontario’s insurance premium rates are the highest in the country. Ontarians pay nearly 55% higher rates than the national average, although they also have the lowest rates of accidents.

Unfortunately, in certain circumstances, insurance companies can deny, dismiss or dispute your claim, leading to a financial and mental crisis. You and your insurance company may disagree on the benefits you feel that are due to you based on your understanding of the contract you have with the insurer.

Ontario offers statutory benefits to all those injured in motor-vehicle accidents, regardless of fault. This amount is to be paid out by your own insurance company. Additionally, injured victims are also entitled to file a personal injury suit against the at-fault party whose fault, negligence or flouting of safety norms resulted in the accident.

Contact an experienced Scarborough personal injury lawyer if you or a dear one has been injured in an accident. You may be entitled to compensation, based on the circumstances, nature and extent of your injuries and their effect on your life.

When Claims Are Refused

Strictly speaking, the insurance company has a right to refuse a claim. The Financial Services Commission of Ontario (FSCO) regulates the insurance industry and has incorporated an Auto Insurance Bill of Rights which sets out rights and responsibilities of the consumer very clearly.

One of the points mentioned here is that you cannot be denied insurance without being provided with reasons given in writing. The insurance company cannot deny you renewal or cancel your policy without informing you about the reason for this.

Making small at-fault claims under your comprehensive coverage may result in higher deductibles or the insurer may refuse to sell comprehensive coverage under your policy. If you have more than two at fault accidents over the last five years, you may be seen as a higher risk.

All insurance companies are allowed to use their own underwriting rules and guidelines. However, these must be submitted to FSCO and approved every year prior to being enforced. Insurers cannot deny claims based on credit history, physical/mental disability, residential address, new immigrant status or whether you’ve only recently got your.

In general, claims are denied because:

• Your policy doesn’t cover what you’re claiming
• The policy may specify the number of traffic offense convictions and at-fault accidents above which no coverage will be provided
• Repeated instances of cancellation of policy due to  non-payment of premiums
• Record of providing misleading, incomplete or incorrect information to the insurance company

Hence, it’s important to read your policy thoroughly and understand all the conditions and clauses in it. An experienced Scarborough personal injury lawyer who regularly handles such cases can assist you in case you have to file an auto insurance claim.