A car accident can be an extremely stressful event–not only in the moment, but also in the days and weeks after. You have to deal with the physical and emotional aftermath, as well as navigate the complex world of auto insurance. You pay your premiums every month, so you expect your insurance company to be there for you when you need them. However, sometimes insurance companies refuse to pay out on legitimate claims.
In this blog post, we will explore why insurance companies might deny your insurance claim and what you can do about it.
How Do Auto Insurance Accident Claims Work in Ontario, Canada?
Before we dive into the reasons why your auto insurance company might deny your accident benefits claim, it’s important to understand how motor vehicle claims work.
In Ontario, all drivers are required to carry a minimum amount of insurance coverage. This coverage includes third-party liability insurance, which covers you if you are at fault in an accident and injure someone or damage their property. It also includes accident benefits coverage, which provides benefits if you or your passengers are injured in an accident, regardless of who was at fault.
In addition to the minimum insurance coverage required in Ontario, there is also the Motor Vehicle Accident Claims Fund (MVACF) of Government and Consumer Services. The MVACF is a last resort option for individuals who are injured or whose property is damaged in an accident caused by an uninsured or unidentified driver.
To be eligible for compensation from the MVACF, it must be proven that the accident occurred in Ontario, the accident was reported to the police, and no auto insurance policy exists to cover the damages. While the MVACF provides a safety net for those who have been injured or suffered property damage, it’s important to remember that having proper auto insurance coverage is always the best option to ensure you are protected in the event of an accident. It is also the law of Ontario that car owners must have a valid policy of auto insurance to operate the vehicle. Drivers who fail to renew their insurance or decide not to insure their vehicles are not permitted to start a civil claim for compensation for their injuries in Ontario.
There are many different types of medical expenses that may be covered under your insurance policy. For example, if you require treatment, you may be entitled to reimbursement for medical expenses incurred for medication, physiotherapy, massage therapy, psychotherapy, and chiropractic care, and more. If you are unable to work due to your injuries, you may be entitled to income replacement benefits. Statutory Accident Benefits coverages provide additional benefits for catastrophic injuries, such as traumatic brain injuries, spinal cord injuries, or severe burns.
Why Might Your Auto Insurance Company Deny Your Claim?
There are several reasons why your auto insurance company might deny your claim. One common reason is if your policy does not cover the kind of vehicle use that you disclosed to your agent or broker. For example, if you were driving a commercial vehicle at the time of the accident and your policy does not provide coverage for business purposes, your claim may be denied. Similarly, if you were driving while impaired by drugs or alcohol, your claim may also be denied due to a breach of your insurance policy.
Another reason why your claim may be denied is if the actual cash value of your car is less than the cost of repairs. Your insurance company may consider your car a write-off and offer you a settlement based on the car’s value, rather than the cost of repairs. This can be frustrating for car owners who have a sentimental attachment to their vehicles or who cannot afford to purchase a new car outright.
It’s also important to note that in Ontario, mandatory uninsured motorist coverage is included in every standard auto insurance policy. This coverage is designed to protect drivers and passengers in the event of an accident caused by an uninsured driver.
If you are unsure why your claim was denied, it can be helpful to review your insurance policy and speak with your insurance provider to better understand your coverage. An experienced car accident lawyer from McNally Gervan can also assist you in understanding your rights and detailing your options for pursuing compensation if your claim has been denied.
What To Do If Your Auto Insurance Company Denies Your Claim
If your auto insurance company denies your claim or if have serious injuries (physical or mental), it’s important to take action to protect your legal rights and ensure that you receive the compensation you deserve.
The first step is to carefully review the policy you have with your own insurance company to make sure you understand the terms and coverage provided by your policy.
If you believe that your claim was unfairly denied, you can dispute the decision with your insurance company. Your insurance provider should be able to explain the reasons for the denial and provide you with the steps you can take to dispute the decision.
If you’re still unsatisfied with the insurance company’s assessment and decision after disputing it, you can file a complaint with the Financial Services Commission of Ontario (FSCO) or the independent Ombuds Service your insurance company refers you to. Filing a complaint can help you to escalate the issue and put pressure on the insurance company to reconsider its decision.
Should all else fail, seeking legal action against your insurance company may be necessary to recover the compensation you deserve. An experienced auto accident lawyer can help you to understand your legal rights and options for pursuing compensation. They can also represent you in court and negotiate with the insurance company on your behalf to help you achieve a fair and just settlement.
How a Lawyer Can Help You Take Action Against The Insurance Company
If you find yourself in a situation where your auto insurance company denies your claim, seeking legal advice from a lawyer who specializes in auto accident claims can be incredibly beneficial. There is a special tribunal in Ontario that deals with accident benefits disputes and it is recommended that your lawyer assist you through the dispute procedure.
In addition to providing legal guidance, a lawyer can help you gather evidence to support your case and if necessary, they can also help you take legal action to pursue compensation for damages such as medical expenses, lost income, and pain and suffering.
It’s important to note that every motor vehicle accident case is unique, and the compensation you may be entitled to depends on the specific circumstances of your case. However, having a knowledgeable and experienced lawyer on your side can help you to navigate the complex legal system.
McNally Gervan – Our Lawyers Will Fight Tirelessly for Your Rights
At McNally Gervan, our team of experienced lawyers specializes in helping clients with personal injury and auto accident claims. We understand how frustrating it can be when you and your insurance company disagree about the assessment of your claim. That’s why we are here to help.
If your auto insurance company denies your claim, we can help you understand your legal rights and options for pursuing compensation. Our team has extensive experience in gathering evidence, negotiating with insurance companies, and representing clients in court when necessary.