Was your life insurance claim denied in Vancouver? When the worst happens and a loved one passes, life insurance is supposed to be there to help ease the financial burden families face at one of the most difficult times of their lives.

Most people would never think that after paying insurance premiums for years, their claim for life insurance benefits would be denied. Still, the unfortunate reality is that many life insurance benefit claims are denied by all insurance companies.

The first thing an insurance company does when they receive notice of a claim for life insurance benefits is to see if they can deny the claim. There are many ways they can do this.

Why Would My Insurance Company Deny My Claim

One of the most common things insurance companies do to deny life insurance claims is look at the cause of death and see if it fits into any exclusions in the life insurance policy. Different policies will have different exclusions

Examples of Causes of Death Often Excluded in Life Insurance Policies:

–Suicide

-Overdosing on drugs or alcohol

-Death while flying a plane or skying diving

-Death occurring during illegal activities

Misrepresenting a material fact

Another common reason to deny a claim is if the deceased misrepresented a material fact to the insurer during the application process.

For example, if the deceased confirmed in the policy that they were not smokers, but the insurer finds out at one point they were, this could be considered a material misrepresentation.

If the insurance company can prove a misrepresentation during the contestability period (usually the first two years of the policy), they will deny any claim for life insurance benefits.

If the insured passes away outside the contestability period, it is harder for the insurance company to deny claims because proving a misrepresentation alone is usually not enough to deny a life insurance claim. They will have to prove not only that a misrepresentation occurred but also that it was fraudulent.

What To Do When Your Life Insurance Claim Is Denied

Just because your claim for life insurance benefits is denied does not mean you don’t have recourse.

There is often an internal appeal process if you disagree with the insurance company’s decision. Unfortunately, the reality is that in cases where they’ve been denied a claim for life insurance benefits, there is not much of a chance that anything you say will be able to change their mind.

You can also hire a lawyer to help you sue to make the insurance company pay you the life insurance benefits you are entitled to.

Claim Denied in Vancouver

Life insurance lawyer and partner at Taylor & Blair LLP Brian Jacobson says, “While it may seem like there’s nothing you can do when you’re faced with being denied life insurance benefits, that’s not true. The first step is to request the insurance company’s entire file.

This will contain all the information on which they’ve based their decision to deny the life insurance claim. These documents can be used to see how the insurance company made its decision and whether it stands up to scrutiny, which it often doesn’t.

If your life insurance benefits claim is denied, you should speak to an experienced insurance denial lawyer immediately. They will understand the nuances of this area, and most importantly, there are strict timelines in which you have to start a legal claim if you need to sue to enforce your rights.

Legal Cases In Vancouver

In late 2022, a highly publicized case of a denied life insurance claim stirred debate and ignited conversations about insurance regulations in Vancouver.

The case involved the family of the late Jack Williams, a prominent entrepreneur and philanthropist, whose life insurance claim was denied under a cloud of controversy and legal scrutiny.

Jack Williams, 52 at the time of his death, was a successful businessman in Vancouver’s tech industry. He was known not only for his professional achievements but also for his commitment to various charitable organizations.

His sudden death in June 2022 shocked his family and the Vancouver community. Williams was a diligent man who had planned for all eventualities, including securing a substantial life insurance policy to protect his family financially in the event of his untimely death.

This safety net seemed to disappear when the insurance company, Canadian Assurance Group, denied the claim made by his widow, Emily Williams.

Canadian insurance market

CAG, a major player in the Canadian insurance market, invoked a rarely used clause, claiming that Williams’ policy had been voided due to “material misrepresentation” on his application. They asserted that Williams failed to disclose a pre-existing medical condition during the application process.

This shocked Williams’ family, who contested the claim, arguing that Jack had always been meticulous about his health and records and maintained that he would not have intentionally withheld such information.

Media attention on the case heightened due to Jack’s public profile and the sheer magnitude of the denied claim – a staggering $10 million.

Public interest was fueled by debates around the ethics and legalities of insurance policy denial, particularly when non-disclosure claims are made posthumously. The case quickly became emblematic of a broader discussion about insurance practices and the rights of policyholders.

Launching a legal battle

The Williams family hired a team of high-profile lawyers to contest CAG’s decision, launching a legal battle that drew considerable media coverage.

The court proceedings were closely watched, and every development became headline news. The case was discussed in talk shows, online forums, and opinion pieces, and the public was largely sympathetic toward the Williams family.

The lawsuit unearthed some crucial information which further inflamed public opinion against CAG. It was revealed that Jack Williams had undergone a medical check-up just a few weeks before his life insurance application, and no serious ailments were found.

The family’s lawyers argued that Williams had answered the application questions truthfully based on this medical report.

A former employee of CAG came forward with allegations that the company had a history of engaging in post-claim underwriting. In this practice, insurance companies accept applications without thorough investigation and then deny claims later based on undisclosed pre-existing conditions.

This revelation cast the company in a negative light and bolstered the Williams case.

Vancouver Life Insurance claim settlement process

The legal battle continues today. While the case has yet to be resolved, it has already left an indelible impact. It has led to calls for stricter regulations on insurance companies and increased transparency in the claim settlement process.

A push for legislative change has begun, advocating policies to protect consumers better and penalize companies for unjust claim denials.

This case has underscored the need for individuals to be thorough and meticulous when applying for life insurance, ensuring that every detail of their health history is disclosed to avoid future disputes. It has also highlighted the importance of understanding the fine print of insurance policies.

Jack Williams’s high-profile life insurance claims denial has set a precedent in Vancouver and beyond, serving as a warning about the potential pitfalls of life insurance policies and the need for regulatory changes in the insurance industry.

With all eyes on the unfolding courtroom drama, the outcome of this case will undoubtedly have far-reaching implications for the insurance sector and its consumers.

What the law says about getting your claim denied in Vancouver

The denial of a life insurance claim in Vancouver, or anywhere in Canada, is governed by several key pieces of legislation. The complex legal landscape intertwines provincial statutes, federal acts, and specific industry regulations, such as the British Columbia Insurance Act, the Insurance Companies Act, and the Life Insurance Policy Exemption Regulation.

The British Columbia Insurance Act is the first statute to provide a legal framework for insurance practices in British Columbia. This Act outlines the rights and responsibilities of insurers and policyholders.

It stipulates the conditions under which a policy may be voided, such as fraud or misrepresentation by the insured.

Section 13 of the Act is particularly relevant to denied claims. It states that an insurer may contest a life insurance contract within the first two years of the policy due to misrepresentation or failure to disclose material facts.

Unfair or Deceptive Acts or Practices

The Insurance Companies Act is a federal law that regulates the actions of insurance companies across Canada. This legislation contains provisions for insurers’ reasonable conduct, ensuring that they act in good faith towards policyholders.

If a life insurance claim is denied, the policyholder may have grounds to dispute the decision under this act if they can demonstrate that the insurance company acted in bad faith.

Under the Insurance Act, the Life Insurance Policy Exemption Regulation is another important piece of legislation concerning life insurance in British Columbia.

This regulation details the protections available to life insurance policyholders, specifically regarding the exemption of a policy’s cash surrender value from seizure by creditors.

This doesn’t directly relate to a denied claim, but understanding these protections can be important when considering the broader context of a claimant’s rights and the insurer’s obligations.

If a life insurance claim is denied, the Unfair or Deceptive Acts or Practices regulations might apply. These laws, part of the British Columbia Business Practices and Consumer Protection Act, govern business practices within the province and include provisions against unfair practices by insurance companies.

If an insurer denies a claim based on incorrect or unclear information, a policyholder might allege a UDAP violation.

Federal Life Licenses Qualification Program

Finally, the Federal Life Licenses Qualification Program sets the professional standards for life insurance agents across Canada, including Vancouver.

Agents must abide by these standards when selling life insurance policies and handling claims. While not a statute or act per se, the LLQP is a crucial part of the regulatory landscape that ensures ethical and professional conduct in the life insurance industry.

It’s also worth noting that policyholders can appeal a denied life insurance claim through internal appeals with the insurance company and potentially through the courts.

When navigating a denied claim, it’s advisable to consult with a lawyer specializing in insurance law to fully understand one’s rights and options.

If your insurance claim was denied in Vancouver, speak to a law firm.