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There are two types of mortgage insurance benefits: mortgage life and mortgage disability insurance. These mortgage insurance policies protect Canadians who purchase a property and, due to illness or death are unable to make their mortgage payments to the lender or lenders because they don't have enough money to pay the property value outright. These policies either pay off the mortgage in its entirety or pay monthly mortgage payments for a defined period of time.
These mortgage insurance policies are most often sold at the time the real estate deal for your property or house is negotiated with your real estate agent and with a bank or financial institution, and payments are generally made to the bank or financial institution when the mortgage insurance claim is approved.
Mortgage disability claims can be denied because, like a more conventional disability insurance policy, the insurance company does not accept that you are not able to work as defined under the policy.
In the case of both mortgage life and mortgage disability claim denials, the claims are denied due to coverage disputes over allegations of misrepresentation at the time the policy was purchased and reviewed by a mortgage insurance lawyer.
How we can support you
After being denied your mortgage insurance benefits, you might not know where to turn next. You may feel hopeless in this moment, but rest assured you are not alone. When you call Share Lawyers, you will speak with someone who knows what you are going through and can offer you the best possible advice at no cost to you.
Why you should contact us:
- It’s free to talk to us
- There are no fees unless you win
- We specialize in mortgage insurance claims and can go through your options
- Make arrangements for a free consultation with one of our mortgage insurance claims lawyers to see how we can help you get your mortgage insurance benefits
- Be there to answer all of your questions
Our lawyers can help with mortgage insurance denials
Mortgage insurance is designed to pay off a mortgage (or a number of mortgage payments) in the event of death or a disabling condition. This insurance is typically purchased as part of a mortgage application with your financial institution, and an approved mortgage insurance policy would pay mortgage payments to the financial institution.
Claims are often denied because of the way the insurance was taken out. A short medical questionnaire you're asked to fill out will be scrutinized against your medical records, and any pre-existing condition not disclosed can cause an immediate denial of the policy.
Why was my mortgage insurance claim denied?
When you fill out a mortgage insurance application, there are a number of questions that must be answered. The questions can be confusing and rather lengthy, and if not read carefully, may be easily glossed over. Answering these questions without disclosing any relevant medical history can come back to haunt you or your family when your mortgage insurance claim is submitted as the insurance company can allege that had they known about your medical history, they would not have issued the policy. If your mortgage insurance claim is denied due to misrepresentation, we recommend speaking to our team of mortgage insurance lawyers to see how we can help you.
Insufficient Medical Evidence
On Mortgage Disability Insurance claims, the insurance company may refuse to pay your claim if they are not satisfied that you are unable to work. They may not agree with your doctor’s medical opinion and come to a judgment of their own. If you are denied due to insufficient medical evidence, you should contact one of our mortgage insurance lawyers to see how we can fight their denial.
Your mortgage insurance policy will include exclusions. Here are the most commons ones seen:
- Medical conditions due to alcohol or drug abuse
- Disabilities resulting from cosmetic surgery
- Partial disabilities, meaning you can still perform the regular duties of your occupation part of the time
- Disability or Death, which occurs during the commission or attempted commission of a criminal offence
If your mortgage insurance claim was denied due to your conditions resulting in an exclusion in the mortgage insurance policy, we suggest contacting our mortgage insurance lawyers to see if we can assist.
Example: Was There a Material Misrepresentation
Here is an example of how a mortgage disability insurance claim may be denied.
A 47 year-old man has mortgage disability insurance that provides coverage that will pay off his mortgage if he suffers a severely disabling illness. He is diagnosed with Parkinson’s Disease and is unable to work at his heavy construction job.
He submitted his claim to the insurance company and several months after the claim was submitted, he was advised that his claim was denied and the policy was being cancelled because he misrepresented his prior health conditions on his initial application.
The man had a past history of consulting doctors for digestive problems which were under control, however, he failed to appreciate that in answering no to the following question:
In the past five years have you been diagnosed with or had any known indication of, or taken any medication, or had an abnormal test result, received treatment, counselling, required follow-up or seen a physician or other health care professional for: …problems related to your stomach, bowel, rectum, bladder or prostate,…
His claim would be denied due to misrepresentation. He was not familiar with medical terminology and did not appreciate that “bowel” was part of his digestive system. He had only seen the specialist once, who prescribed some medication that treated his digestive issues.
While the question included a whole list of medical conditions, he just didn’t understand this question when he answered no.
In a case like this, we may be able to recover all or part of the payout he was entitled to by arguing that the question was confusing, and he did not intentionally misrepresent his health. Furthermore, expert evidence was obtained that suggested that the severity of his pre-existing bowel condition was not material to whether he qualified for the insurance coverage.
This type of situation is one that Share Lawyers can review to see if there is a chance of success in pursuing the claim. A thorough review of the medical information that the insurance company reviewed as well as additional medical records that may have been overlooked would have to be undertaken and experts would have to be consulted to determine whether the insurance company’s interpretation of the policy wording was too strict.
We can help before accepting a refusal by your insurance company to pay out on your mortgage insurance policy, our lawyers for mortgage insurance claims encourage you to consult further with us to determine whether we can assist you in recovering all or part of what rightly belongs to you or your family.
We Can Help
Before accepting a refusal by your insurance company to pay out on your mortgage insurance policy, our lawyers for mortgage insurance claims encourage you to consult further with us to determine whether we can assist you in recovering all or part of what rightly belongs to you or your family.
How much time do I have?
There are time limits to all disability claims and any delay in proceeding may be subject to a deadline so you should not delay in proceeding with your disability claim or obtaining legal advice to clarify these deadlines. We understand how important these timelines are and will respond to any call or email as soon as we can.
Disability Lawyers in Toronto, proudly serving clients in Ontario and across Canada
Are you looking for a disability lawyer to fight for your rights? Our law firm has unmatched experience in disability law and we don't let provincial borders stop us from helping you in your time of need. Your insurance company has a presence throughout Canada and it makes sense to hire a disability law firm that has a true expertise in disability law and has a national presence too. Your insurance company knows who we are and knows that we won’t back down.
Regardless of whether you have just applied for your insurance benefits or have been denied your benefits by your insurance company and need support, we will talk you through all of your options — free of charge. It’s important to be informed about the insurance claim process and to know your rights.
No fees unless you win your case
We understand your situation and that paying for an insurance lawyer can feel out of reach. We are here to help you no matter where you are in the process. That is why we offer a free consultation, why there are no upfront costs to you, and why there are no fees unless you win your case. You’re not alone. We believe in your case, which is why we only get paid when you do.
When you work with us, you get guidance and tools to help you along the way. You will become a member of a privileged group of clients that have access to our hub, called Life reBUILDER™, exclusively from Share Lawyers. It offers six unique services to help rebuild your life and get you back on track, beginning with the expertise of a full legal team all working for you.