Insurance Claims

People purchase insurance in many different forms to protect themselves and their families from the financial costs associated with loss or damage of their home, personal property, health or life. Generally, if you suffer a loss for which you hold a valid contract of insurance, you are entitled to compensation or benefits as described in the policy.

insurance

An insurance policy is a contractual agreement imposing obligations on both the insurer and the insured. The insurance settlement process can be complex, time consuming and frustrating. It is often the first time since signing the insurance contract, that you, as the insured, have had contact with your insurance provider. Usually, certain procedural steps must be taken before your insurance company will accept or reject your claim, and furthermore, there are specific timelines regarding when you are able to sue for recovery of funds against your insurance provider. Section 23 of British Columbia’s Insurance Act stipulates that in the case of property loss, a legal action must be commenced within two years after the date that the insured knew or ought to have known the loss occurred, and in all other insurance claims, within two years after the date the cause of action arose. In most cases, this means that you have two years from the date of your insured loss to either resolve the claim with your insurer, or start a legal action against your insurance company.

As an insured, your typical obligations require you to pay your premiums, and in some instances, to notify your insurance provider of any material changes to the thing insured that will affect the insurance company’s risk. When a loss occurs, you have additional responsibilities. You are required to provide notice and proof of your loss within a certain time period and failure to do so can negatively affect your claim. Further, you are required to act in good faith by providing truthful information about your claim at all times.

The insurance company has obligations as well. The person assigned to handle your claim must evaluate it and decide whether to accept or reject it. The insurer does so by assessing the evidence supplied and interpreting the policy. Often the insurer will solicit the help of an adjuster to conduct the full review of your claim. Your insurance provider is legally required to act in good faith toward you and is required to make their insurance decisions on “reasonable grounds.” If your insurance company acts unreasonably or is found by a court to have acted in “bad faith,” you may be entitled to significant compensation over and above your insurance benefits and legal costs. Examples of “bad faith” might include failure to properly investigate a claim, making threats against an insured, unreasonable delay in handling a claim, or unreasonably interpreting an insurance policy against an insured.

A power imbalance is often created between you, as the insured, and your insurance provider. Having experienced a loss, you are likely in a financially vulnerable position. The lawyers at MacIsaac & Company have years of experience negotiating with insurance providers assisting clients to receive fair compensation. Our lawyers have the knowledge and experience to handle all aspects of your claim and will help you gain a fair settlement through negotiation, mediation or trial.

Life Insurance

As a beneficiary collecting life insurance you may encounter problems with the insurance provider when making your claim. Failure to disclose an accurate medical history to the insurer, including prior medical conditions, medical tests or examinations, or any other material fact that may affect eligibility for life insurance, and may operate to void the life insurance contract. Our lawyers can advise you regarding the exceptions to this general rule.

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