How Long Do Insurance Claims Take? What You Need to Know About Insurance Claims in Ontario

When an illness or injury keeps you from working—or when a car accident suddenly turns your life upside down—insurance should offer a safety net. It’s meant to be there when you need support the most.

But for many people in Ontario, the experience is anything but simple. Instead of getting help quickly, they’re met with long delays, vague explanations, and increasing frustration.

How long do insurance claims take? The answer depends on several factors, including the type of claim, type of injuries, how the insurer handles the file, and whether everything is submitted on time.

In this post, we’ll walk you through what to expect. We’ll focus on disability claims, which are among the most misunderstood and commonly delayed, and provide some important context on auto insurance claims too.

 

The Two Sides of the Auto Insurance Claims Settlement Process: Speed vs. Complexity

Most people in Ontario have had some experience with a car insurance claim—whether for a fender bender or something more serious. In straightforward situations, where no one is disputing what happened, a car accident claim can move fairly quickly.

If the damage is minor and the paperwork is complete, it’s not unusual for a car insurance company to resolve these files in under two weeks.

Things take longer when the accident leads to injuries to the drivers involved or when it’s unclear who was at fault. In these cases, your insurance company may need time to assess what happened, determine liability, and calculate what you’re entitled to under your policy.

Ontario drivers are no strangers to the financial weight of these claims. According to the most recent data from Statistics Canada, Ontario has the highest average auto insurance premiums in the country. With that level of investment, people expect prompt and fair treatment when they file a claim—but the reality doesn’t always align.

If your claim involves medical expenses or lost income, the claims process is rarely quick. These types of cases often benefit from legal support to ensure your insurance provider is treating you fairly.

 

What Causes Auto Claim Delays?

Ontario’s modified no-fault system means you typically deal with your own insurer, regardless of who caused the auto accident. But that doesn’t always mean your claim will be resolved quickly.

Delays often occur when documents are missing, injuries are still being assessed, or multiple parties are involved. Sometimes the insurer is waiting for a police report or needs clarification from an adjuster before they can move forward.

In more serious cases, they may request additional medical evaluations before approving your benefits.

It’s important to stay in contact with your adjuster and provide clear information. If the delays continue without explanation, don’t hesitate to reach out for legal advice.

 

Short-Term Disability Claims: What to Expect

If you can’t work because of an injury or illness, short-term disability (STD) benefits can provide important financial relief while you recover.

These benefits are often part of your workplace insurance plan or purchased privately. They typically cover a portion of your income, usually between 60% and 75%.

Most short-term disability claims in Ontario are reviewed within a few weeks. Once your forms are submitted—by you, your doctor, and sometimes your employer—the insurer will decide whether your condition qualifies under the policy.

Payments don’t usually begin right away. There’s often a brief waiting period, usually around one or two weeks from the date you stopped working.

Delays happen when paperwork is incomplete or when the insurer questions whether your condition meets their definition of “total disability.” If your doctor and the insurer’s medical consultants don’t agree, your claim may be denied.

If that happens, you have options. We regularly help clients appeal denied short-term disability claims and get the support they need to focus on their recovery. You can read more about our work with short-term disability claims.

 

Long-Term Disability Claims: A More Complex Process

Long-term disability (LTD) claims are often more difficult to navigate than short-term ones. These benefits are meant for people who can’t return to work for a prolonged period, usually beyond 120 days.

In most cases, it takes two to four months for insurers to review a long-term disability claim. But it can take longer, especially if your condition is complex or the insurer wants more medical evidence.

To qualify, you’ll need to show that your condition makes it impossible to do your job. Over time, most policies shift that definition, requiring you to prove you can’t work in any occupation—not just your previous one.

This is where many people run into problems. Insurers may demand updated reports, independent assessments, or even conduct social media surveillance and hire private investigators to follow people to see if they are working and what activities they are doing. Mental health claims and brain injury claims are particularly prone to delays because symptoms aren’t always visible on paper.

That doesn’t mean your claim isn’t valid. It means the insurer is looking for reasons not to pay—and that’s where experienced legal support can make a real difference. We assist clients through every stage of the LTD process, including appeals and litigation. Learn more about our approach to long-term disability claims.

 

Why Disability Claims Are Delayed or Denied

Understanding why a disability claim has been delayed or denied can be incredibly frustrating. Often, clients are told they don’t meet the criteria—without a clear explanation.

Here are some of the most common reasons insurers give:
• Forms are missing or incomplete
• Medical opinions are inconsistent
• The definition of “total disability” isn’t met
• Treatment plans aren’t being followed
• The condition isn’t documented clearly enough

In many cases, these issues can be addressed. But doing so takes persistence—and sometimes a legal advocate who knows how to deal with insurance companies.

 

What Are Your Legal Options If a Claim Takes Too Long?

Insurers in Ontario are expected to process claims in a reasonable amount of time. But “reasonable” isn’t clearly defined, and it varies from case to case.

If your claim is being delayed without explanation—or denied unfairly—you may be able to take legal action.

Depending on the circumstances, you could be entitled to:
• Reinstatement of benefits
• Back pay for what’s been withheld
• Damages for financial or emotional hardship and distress
• Punitive damages in cases of bad faith

Taking legal action is never the first resort. But knowing it’s available—and having a team that’s ready to act—can help push the insurer to treat your claim more seriously.

 

Other Insurance Claims We Can Help You With

Disability and auto insurance are just part of what we do at McNally Gervan LLP. We help clients across Ontario with a wide range of insurance disputes.

If your insurer has delayed, denied, or undervalued your claim, we can assist. Our team regularly handles:

• Property insurance claims for damage caused by fire, flood, theft, or other insured losses
• Travel insurance claims, including denied medical coverage or cancelled trips
• Life insurance disputes, especially where claims are rejected due to alleged misrepresentation
• Critical illness insurance claims, when lump-sum payments are unfairly withheld 

We’re here to explain your options, challenge unfair decisions, and help you move forward with confidence.

 

Take Action Before Your Rights Expire

Most insurance policies have firm deadlines—whether for submitting documents, appealing a denial, or starting legal action.

In Ontario, you generally have two years from the date of denial to sue your insurer. However, for property insurance claims the time limit can be one year.  Miss those deadlines, and you could lose your chance to recover anything at all.

If your claim is stalled, don’t wait until you’re out of options. Legal advice early in the process can save time, stress, and financial hardship down the road.

 

Your Next Step Matters. We’re Here to Help.

If your insurance claim is delayed or denied—and you’re not getting the answers you need—McNally Gervan LLP is here for you.

We offer free consultations and clear guidance. We’ll help you understand your rights and take the steps necessary to protect them.

Contact us today to get started.