The Fight-Back Kit: templates that make insurers take you seriously
Editable letters for each step of the escalation. Fill in your details, keep copies of everything you send, and send by a method that proves delivery. These are educational templates, not legal advice — for large or complex disputes, get a lawyer.
1. Request for written reasons & claim file
I am writing regarding claim [number]. Please provide, in writing: (1) the specific decision on my claim; (2) the exact policy provisions and wording you are relying on; and (3) a complete copy of my claim file, including any medical or vocational reports. I am requesting this so I can properly understand and respond to your decision. Please reply within [reasonable period].
2. Internal appeal / complaint to the insurer's complaints officer
I am formally disputing the decision on claim [number], dated [date]. I disagree with the denial for the following reasons: [reasons / new evidence]. I am enclosing [documents]. Please escalate this to your internal complaints/ombudsman office and confirm your final position in writing, including my right to escalate to [OLHI/GIO] if we cannot resolve it.
3. Escalation to OLHI (life/health) or GIO (home/auto)
I have exhausted [Insurer]'s internal complaint process regarding claim [number] and remain unsatisfied. I am asking the [OmbudService for Life & Health Insurance / General Insurance OmbudService] to review the matter. Enclosed are the insurer's final position letter and my supporting documents.
4. Complaint to the provincial regulator
I am filing a market-conduct complaint regarding [Insurer]'s handling of claim [number]. Summary: [facts and timeline]. I have completed the insurer's internal process and [OmbudService] review. I am asking the [FSRA/AMF/BCFSA/etc.] to review the insurer's conduct.
5. Preservation-of-rights / limitation-period notice
This letter confirms I dispute the decision on claim [number] and intend to pursue all available remedies. Nothing in our ongoing discussions waives or extends any limitation period, and I reserve all rights. (Use when negotiating near a deadline — and speak to a lawyer about the actual limitation date in your province.)
Closing note
Keep it factual, dated, and unemotional. The record you build is the leverage. If a deadline is close or the amount is significant, involve a lawyer early — many disability and denied-claim lawyers offer free consultations and contingency arrangements.
Educational only — not legal advice. Limitation periods and deadlines vary by province and require confirmation; verify yours before relying on any date. Robert is a mascot, not an advisor.