Grieving the loss of your Health or
the loss of your Loved One
is a lonely and difficult place to be.
When the insurance company denies your Critical Illness or Life Insurance claim, it may seem like too much to bear. We can help by taking the dispute over from you, allowing you the time and energy you need to focus on what really matters.
It's what we do. It's what we can do to help you, at this time.
We are certified in Trauma Informed Practice and Mental Health First Aid.
We know what not to say.
Critical Illness
Critical Illness insurance is a form of health insurance that provides a lump-sum payment if you become seriously ill. You may have this insurance under a group policy through your work or you may have it under a private or individual policy that you purchased on your own.
Some of the illnesses and diseases covered by critical illness insurance include: cancer, multiple sclerosis, heart attack, organ transplants, stroke, kidney failure, blindness, paralysis, and Alzheimer’s. Coverage can also vary according to how severe your condition is. For example, if you are diagnosed with cancer that is treatable and recovery is not expected to take long, you may not be eligible for the benefit.
Clients come to us when their critical illness claim has been denied. The claim could be denied based on when it was made in relation to the diagnosis or because the illness does not fall within those covered under the policy.
Most often, these claims are denied based on the pre-existing condition exclusion. That means that if there was some indication of the illness within a set period of the date the coverage became effective, the claim is denied. These are contractually, legally, and medically complicated denials to dispute.
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We can review your claim to provide you with our opinion and recommendations for proceeding. If we believe you will be successful in proving your entitlement, we will offer to take on your case, allowing you to focus on your health and recovery.
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Holding insurance companies accountable for the impact their decisions have on our clients' lives is what drives us every single day. We know we've done a good job when we've pushed the insurance company to settle for more than it planned.​
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Our Mission --- Minimize our clients' stress and maximize their settlements. Our clients have suffered enough. Certified as a Trauma Informed Service Provider and in Mental Health First Aid, we take our clients' mental health seriously.
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Life Insurance
If you are the beneficiary of a life Insurance policy and the insurance company has denied the claim, you may be wondering why and whether you are able to dispute the denial.
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The basis for denials of life insurance are legally, contractually and medically complex. The fact that the main witness is deceased does not help matters. However, these denials can be successfully challenged in litigation. Some reasons life insurance claims are denied include:
1. Policy exclusions: Some life insurance policies have specific exclusions for certain causes of death, such as suicide or death caused by participating in dangerous activities.
2. Misrepresentation: If the policyholder has provided false information or misrepresented themselves during the application process, the claim may be denied.
3. Lapse in premiums: If the policyholder fails to pay premiums, the policy may lapse and subsequently invalidate any claims.
4. Contestability period: Most policies have a contestability period (usually 1-2 years) during which the insurer can investigate and potentially deny claims if they discover any misrepresentations or omissions in the application.
5. Death occurred outside of policy terms: If the policyholder dies outside of the policy's terms (e.g. the policy has expired), then the claim may be denied.
6. Failure to disclose medical history: If the policyholder failed to disclose their medical history or pre-existing conditions during the application process, the claim may be denied.
7. Fraud: If there is evidence that the death was caused by fraudulent activity, such as murder or suicide, the claim may be denied.
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If you are a beneficiary and the life insurance claim has been denied, we will review the matter and provide you with our opinion and recommendations for how to proceed. If there is a way to fight the decision, we'll offer to take on your case, allowing you to focus on grieving your loss, rather than fighting the insurance company.
Holding insurance companies accountable for the impact their decisions have on our clients' lives is what drives us every single day. We know we've done a good job when we've pushed the insurance company to settle for more than it planned.​
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Our Mission --- Minimize our clients' stress and maximize their settlements. Our clients have suffered enough. Certified as a Trauma Informed Service Provider and in Mental Health First Aid, we take our clients' mental health seriously.
Contact
3042 Bur Oak Avenue, Suite 2, Markham, ON L6B 0R1