Matters Lawyers Handle in This Sector
- Life and health claim denials
- Disability claim terminations and reassessments
- Group benefits coverage disputes
- Policy lapse, reinstatement and beneficiary issues
Your Rights
- Written reasons citing the policy basis
- Your policy documents and claim file where available
- Internal appeal and free ombudservice escalation
How to Escalate a Matter
1Insurer internal appeal
First step, in writing.
2OmbudService for Life & Health Insurance (OLHI)
Independent review for life and health disputes.
3Provincial regulator
Market conduct oversight.
Escalation routes and their requirements change. Confirm the current process before relying on it.
Frequently Asked Questions
- The insurer relied on an independent medical assessment I disagree with — what can I do?
- You can submit your own treating-physician and specialist evidence on appeal. Conflicting medical opinion is common and is precisely what the appeal and ombudservice processes exist to weigh.
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This page is educational information about the regulatory framework and your options in this sector. It is not legal advice, contains no complaints, ratings, reviews or rankings, and makes no statement about the conduct of any organization. LegalCounselNearMe is not a law firm and is not affiliated with Canada Life.