Insurance Coverage Denials

Facing an insurance coverage denial can be frustrating and confusing.

After experiencing a loss or accident, the last thing you want to deal with is a rejection from the very company you’ve trusted to protect you. Insurance policies are often filled with complex terms, conditions, and exclusions that can be difficult to interpret without legal guidance. Denials can feel personal and overwhelming—especially when you believe your claim is legitimate.

You don’t have to face a powerful insurance company alone.

Insurers have teams of adjusters and legal advisors reviewing every claim with their bottom line in mind. That’s why having your own advocate can make all the difference. Whether your claim was denied due to an alleged misrepresentation, a technicality, or an exclusion you weren’t aware of, it’s important to know that you have rights—and options.

At our firm, we step in to turn the tables on unjust claim denials.

We approach every case with determination and attention to detail. Our team examines the full history of your claim and coverage, identifying where the insurer may have acted unfairly or in bad faith.

We meticulously review your policy, negotiate with insurers, and advocate on your behalf to ensure you receive the benefits you're entitled to.

This includes gathering supporting documents, clarifying ambiguous policy language, and challenging improper denials. We also handle communication with your insurer so you’re not left dealing with their tactics or red tape on your own.

Whether you're dealing with a complex denial or need clarity on your coverage, our dedicated team is here to fight for your rights and help you secure a favourable resolution.

From initial consultation to final resolution—whether through negotiation or legal action—we’re committed to standing by your side and protecting your interests every step of the way.

Call us at (647)581-3720

Auto Insurance Claim Denials in Ontario: Frequently Asked Questions

• Why did my insurance company deny my claim?

  Common reasons include:

  • Missed premium payments

  • Misrepresentation or failure to disclose material facts

  • Policy exclusions (e.g. flood damage, wear and tear)

  • Claims filed after the deadline

  • Disputes over the cause or extent of the damage

• What is considered “misrepresentation” on an insurance application?

  Misrepresentation includes:

  • Lying or omitting facts (e.g. prior accidents, convictions)

  • Underreporting mileage or using the car for commercial purposes

  • Failing to disclose all household drivers Even unintentional omissions can void coverage if they’re deemed “material.”

• Do you have to tell your insurance company about a DUI?

  The answer depends on the specific language in your insurance policy. Most policies in Ontario include a requirement to inform your insurer if you're charged with or convicted of a DUI offence.

  • If your DUI resulted from a collision—especially one where you're at fault—you are typically required to report it to your insurer right away.

  • If there was no accident, your duty to report may depend on the policy terms. Some require disclosure at the time of the charge, others only upon conviction.

  Failure to notify your insurer as required can be considered a breach of your policy. This can result in your policy being voided and any claims being denied, even retroactively.

• Can your insurance deny coverage after a DUI?

  Yes. Under Ontario law, insurance companies are allowed to deny claims if the insured driver is convicted of an impaired driving offence. This includes charges related to refusing a breathalyzer or other forms of impaired operation.

  If your accident was caused while you were impaired, don’t expect your insurer to cover damage to your own vehicle. In fact, they may also refuse to cover liability or third-party damage—leaving you personally responsible for significant out-of-pocket costs.

  DUI Conviction = High-Risk Driver Status

  A DUI conviction will almost certainly result in your insurer classifying you as a "high-risk driver." This can lead to one or more of the following:

  • Cancellation of your current insurance policy

  • Refusal to renew your policy at the end of its term

  • Sharp increases in your auto insurance premiums

  Insurance companies are allowed to make these decisions because a DUI represents a “material change” to your risk profile. In simple terms: you’re now seen as a bigger liability.

  Can You Still Get Auto Insurance?

  Yes—but it won’t be cheap.

  Ontario requires all drivers to have basic auto insurance coverage. Even high-risk drivers must be insured, though it often comes at a steep price.

  • Some insurers specialize in high-risk policies and offer limited coverage with premiums ranging from $2,000 to $10,000 annually.

  • If you’re unable to secure a policy through a traditional provider, you may be insured through Ontario’s Facility Association, a last-resort insurance pool.

  The financial burden of a DUI doesn't go away quickly. While a first offence may be cleared from your driving record after three years, insurance companies can continue treating you as high-risk for up to six years.

• If I wasn’t at fault for the accident, can my insurance still deny my claim because I was impaired?

  Yes. Even if another driver caused the crash, your impairment can still be grounds for your own insurer to deny coverage for your vehicle or injuries. The other driver's insurer may still be liable for your losses—but expect a battle.

  If you’ve received a denial—or want to prevent one—speak to a lawyer today to understand your options and protect your rights.

• Can my claim be denied because I didn't call the police after an accident?

  Yes. Many auto insurance policies require a police report for certain claims—especially where there's injury, a hit-and-run, or suspected fraud. Failing to report in time could result in a coverage denial.

  If you’ve received a denial—or want to prevent one—speak to a lawyer today to understand your options and protect your rights.

• What does “material change in risk” mean?

  A material change in risk is any change that increases the insurer’s risk—such as:

  • Modifying your vehicle

  • Moving to a high-theft area

  • Letting an unlisted driver use your vehicle regularly If you don’t inform your insurer, they can deny future claims or cancel your policy.

  If you’ve received a denial—or want to prevent one—speak to a lawyer today to understand your options and protect your rights.

• Can my insurance company deny a claim due to late notice?

  Yes. Most policies have strict reporting timelines. Failing to notify your insurer “promptly” (usually within 7–30 days) could lead to denial, especially if the delay caused prejudice to the insurer.

  If you’ve received a denial—or want to prevent one—speak to a lawyer today to understand your options and protect your rights.

• What can I do if I think my insurance claim was unfairly denied?

  You have several options:

  • Request a written explanation and review your policy

  • Use the company’s internal dispute resolution process

  • File a complaint with the General Insurance OmbudService (GIO)

  • Consult a lawyer for legal review or to pursue a claim in court

• What if my claim was denied due to alleged fraud, but I believe it’s a mistake?

  Fraud is serious—if you’re wrongly accused, you should immediately seek legal advice. A fraud flag on your insurance record can make it extremely difficult to get coverage in the future, and may even lead to criminal investigation.

• Can a denied claim affect my future insurance applications?

  Yes. Insurers share claim and policy history through centralized databases (like AutoPlus in Ontario). A denial—especially for fraud or misrepresentation—can lead to:

  • Higher premiums

  • Refusals from mainstream insurers

  • Being forced into the high-risk market

  If you’ve received a denial—or want to prevent one—speak to a lawyer today to understand your options and protect your rights.