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Why insurers deny claims

Getting a denial letter can feel like the end of the road, but insurers deny or reduce accident benefits routinely — a denial is not proof that you don't have a case. Some of the most common reasons cited include "insufficient medical documentation," missed paperwork deadlines, disputes over whether a treatment plan is "reasonable and necessary," and independent medical examinations (IMEs) — assessments arranged and paid for by the insurer — that come back contradicting what your own doctor found. None of these are automatically the final word. Insurers know that most people who receive a denial simply accept it and never challenge it, which is a big part of why denials are so routine in the first place.

What you can actually do

In Ontario, you generally have two years from the date of a denial or reduction to dispute it. Disputes over accident benefits are heard by the Licence Appeal Tribunal (LAT), a body separate from both the courts and your insurer. Before it gets to that stage, there are often earlier options worth trying — providing further medical evidence to support your claim, or formally requesting that the insurer reconsider its decision. What matters most is not waiting: these deadlines are strict, and the longer a denial sits unchallenged, the harder every option becomes, from gathering supporting medical records to reconstructing details of what happened. See how long do I have to file a claim for how this two-year dispute window fits alongside the other Ontario accident-claim deadlines.

What it costs to fight

You don't need to decide whether to fight a denial before you understand your options. A case review is free, and there's no fee unless your case results in a settlement or award — so there's no financial risk to finding out where you stand. See our guide on how much a personal injury lawyer costs for how that contingency arrangement works in practice. Asking about your options also doesn't notify your insurer or trigger anything on their end; it's a private, confidential conversation between you and our team, with no obligation to move forward afterward.

Not sure where you stand? Find out free.

A free consultation takes one phone call — no cost, no obligation, and your insurer isn't notified.

This is general information, not legal advice — timelines and requirements depend on your specific situation.

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