Insurance Claims

Accident Benefit Claims (eg. No Fault Benefits)

If you have been injured in a car accident, whether as a driver or a passenger, you may be entitled to accident benefits through your own auto insurance company. These benefits are often referred to as “no fault benefits”. People often mistakenly believe that these benefits are payable only if they are not at fault for the accident but this is not the case. As the name suggests – “no fault benefits” – these benefits are payable regardless of fault for the accident. As such, even if you ran a red light and caused the accident, you may be entitled to accident benefits.

There are many different benefits that you may qualify for through your own insurance provider, including income replacement benefits (for loss of income), medical and rehabilitation benefits (to assist with necessary treatment), attendant care benefits (if you are unable to care for a dependant as a result of the accident), housekeeping and home maintenance benefits (if you are unable to carry out household duties and are paying a third party to assist you), non-earner benefits (if you were not employed at the time of the accident but suffer from a substantial inability to carry on a normal life). 

We have experts that specialize in accident benefit claims. These experts can assist you with applying for these benefits, and can help ensure that your insurance company is paying you to the full extent of your entitlement. The insurance forms that you are required to fill out can often be confusing and overwhelming, particularly if you have just been injured in a car accident. Contacting the lawyers at Waterous will not only relieve the burden of making sure that the forms are filled our property, but will put you in a better position to ensure that you are taking advantage of all available benefits.

Long Term Disability Claims (LTD Claims)

If your Long Term Disability Benefits have been terminated or denied, we can assist you with an appeal of the disability carrier’s decision or alternatively, a claim against the insurance company for denying you benefits. Not all LTD insurance policies are the same and in order to efficiently pursue a claim, you need to fully understand the test that you must meet in order to qualify for this kind of benefit. Our team can assist not only with interpreting and understanding your policy, but also with ensuring that you have the evidence you need to fight the insurance company for your entitlement to benefits.

Canada Pension Plan Disability Claims (CPP Disability)

If you are unable to work due to disability, you may be entitled to disability benefits through the Canada Pension Plan. If your claim for CPP Disability Benefits has been denied, you may be entitled to appeal that decision. We can assist you with the appeal process, which can be a complicated and lengthy process.

Life Insurance Claims/Mortgage Insurance Claims

If an insurance company has denied coverage for a life insurance policy, you may be able to challenge the insurance company for such a denial. For instance, you may have life insurance on your spouse yet in the event of your spouse’s death, the insurer might refuse to pay out the life insurance proceeds, claiming that your spouse lied on the insurance form or failed to provide the necessary medical information at the time the insurance application was filled out. Depending on the circumstances, you might have a claim against the insurance company for denying the claim.

Bad Faith Claims against Insurance Companies

Sometimes an insurance company handles an insurance claim in such an unfair way that it is exposed to a claim against it for “bad faith”. If this happens, you might be entitled to compensation for the insurance company’s conduct. There are many different situations in which this can occur including situations where the insurance company has unfairly delayed the processing of your claim, has taken an unfair position given all the evidence available, or has unfairly denied coverage for a particular claim. Courts have punished insurance companies for dealing with their insured in such an unfair manner. In order to determine whether the circumstances of your case entitle you to compensation, you should speak to one of our lawyers as soon as possible.