A denial isn't the end of the road.
Insurers deny claims for all kinds of reasons, but a denial isn't final. You can demand the specific reason, escalate to a free ombudsperson, and challenge it — usually within two years. Here's how to fight back.
Free. No payment to start. This is information, not legal advice.
In 30 seconds, here's what's true
- A denied claim is not the final word. You have the right to ask, in writing, for the specific reason your claim was denied.
- Every insurer must have an internal complaint process. If that fails, you can escalate for free to an industry ombudsperson.
- You generally have two years to take legal action over a denied claim. Some policies have even shorter deadlines, so read yours.
- For car accident benefit disputes, you apply to the Licence Appeal Tribunal (LAT) — not the regular courts.
- For life insurance, an insurer can usually only deny for misrepresentation in the first two years. After that, generally only fraud.
How the process works
Get the denial reason in writing
Ask your insurer for a written explanation citing the specific policy wording. You can't fight a denial properly until you know exactly why they said no.
Use the insurer's internal complaint process
Every insurer has a complaints officer or ombudsperson. Escalate your complaint in writing and ask for their final position letter.
Escalate to a free ombudsperson
For home or auto, contact the General Insurance OmbudService. For life or health, the OmbudService for Life and Health Insurance. Both are free and independent.
Know the right venue for car accidents
If your dispute is about accident benefits after a car crash, you apply to the Licence Appeal Tribunal — not court — and generally within two years of the denial.
Watch your deadline and get advice
You usually have two years to sue, but check your policy for shorter limits. For a large or complex denial, get legal advice. Start a free PLAIN session for pointers.
What to do next
- Request the specific denial reason in writing.
- Read your policy for exclusions and deadlines.
- File a complaint through the insurer's internal process.
- Ask for the insurer's final position letter.
- Escalate to the right ombudsperson (GIO or OLHI).
- For accident benefits, apply to the Licence Appeal Tribunal.
- Note the two-year deadline to take legal action.
- Get legal advice for a large or complex denial.
Common myths
| Myth | Reality |
|---|---|
| A denial is final. | It isn't. You can demand the reason, use the insurer's complaint process, escalate to an ombudsperson, and take legal action. |
| I can't fight my insurance company. | You can. There's a free ombudsperson for insurance disputes, plus the courts or a tribunal depending on the type of claim. |
| I have unlimited time to dispute a denial. | No. You generally have two years to take legal action, and some policies set even shorter deadlines. |
| I sue in court for car accident benefits. | Not anymore. Accident benefit disputes go to the Licence Appeal Tribunal, not the regular courts. |
| Insurers never have to explain a denial. | They do. You have the right to a written explanation of the specific reason for the denial. |
| Life insurance can be denied years later for any reason. | Generally no. After the first two years, an insurer can usually only deny a life claim for actual fraud. |
| I never need a lawyer for a denied claim. | For small claims maybe not, but for a large or complex denial, legal advice can make a real difference. |
| If I missed telling the insurer something minor, I have no case. | Not necessarily. Whether a non-disclosure lets an insurer deny depends on whether it was material. Get advice before giving up. |
Last reviewed June 2026
Written and reviewed by the founder of PLAIN, checked against primary government and legal sources. How we research these guides
Sources
PLAIN gives legal information, not legal advice. It is not a substitute for a lawyer or paralegal — and we'll point you to free ones. Laws change; we review these pages regularly, but always confirm current rules with a licensed professional.
Free. No payment to start. This is information, not legal advice.