A denied claim isn't the end of the conversation.
Free, practical playbooks for filing well and fighting back — the first 30 days, what to document, the deadlines that matter, and exactly who to escalate to.
Universal principles (every claim)
- Write everything down. Dates, names, what was said, claim and reference numbers.
- Put it in writing. Confirm phone calls by email — “as we discussed today, you said…” creates a record.
- Get the denial reason in writing, including the specific policy wording relied on.
- Know your deadline. Every claim has a limitation period — often around two years, but it varies by province. Don't let it lapse while you negotiate.
- Escalate in order: insurer's internal complaints office → the independent OmbudService (OLHI for life & health, GIO for home/auto) → your provincial regulator → legal action.
The escalation ladder
Step 1
Insurer's internal complaints officer
Every federally regulated insurer has one. Submit your complaint in writing; they must respond.
Step 2
Independent OmbudService (free)
OLHI for life, disability, CI, health, and travel medical. GIO for home, auto, and business.
Step 3
Provincial regulator
FSRA (ON), AMF (QC), BCFSA (BC), and the others handle market-conduct complaints.
Step 4
Legal action
Before your limitation period expires. A lawyer's demand letter alone often reopens a stalled file.
Playbooks by claim type
Home insurance claim: the first 30 days
Document before cleanup, ALE receipts, and pushing back on a lowball.
Open playbookAuto claim: what to do at the scene and after
At the scene, no-fault vs tort, and accident-benefit deadlines.
Open playbookMaking a life insurance claim
The beneficiary's steps, contestability, and contested claims.
Open playbookFighting a denied or terminated LTD claim
The most-fought coverage: functional evidence and the month-24 cliff.
Open playbookClaiming a critical illness benefit
The definition controls — how to file and respond to a denial.
Open playbookTravel medical claim: don't let the stability clause sink you
Call before treatment; beat the stability-clause denial.
Open playbook
The Fight-Back Kit
Editable template letters for each step of the escalation — request your claim file, appeal internally, escalate to the OmbudService, complain to the regulator, and preserve your rights near a deadline.
Open the Fight-Back KitEducational only — not legal advice. Limitation periods and deadlines vary by province and are being confirmed with legal review; treat any date here as “generally” and verify yours. For large or complex disputes, involve a lawyer early.