If a car accident happens in Mississauga or Toronto, the last thing anyone needs is to have their insurance claim denied—but it happens to hundreds of local drivers each year. As an experienced insurance broker serving these communities, understanding the most common claim denial reasons—and knowing how to respond—can make all the difference.
Why Car Accident Claims Get Denied
Policy Issues & Coverage Gaps
The most frequent denial stems from policy limits or missing coverage. If the damages exceed coverage, or if a type of coverage (like collision) was never purchased, the insurer may legally deny the claim. Always review your policy for exclusions and make sure your coverage fits your needs.
Non-Payment or Cancelled Policy
Missed premium payments can void your policy. If a claim is filed during a lapse in coverage, insurance companies may refuse payment altogether.
Misrepresentation & Non-Disclosure
Failing to provide accurate or updated information—such as changes in vehicle use, listing all drivers, or updating address details—may lead to denial due to misrepresentation. Be honest with your broker about all factors that affect your insurance.
Driver Issues: Suspended, Unauthorized, or Unlicensed
Claims are often denied if an unlisted or suspended driver was behind the wheel during the accident. In Ontario, this is a strict breach of policy terms.
Criminal Activity or Fraud
If the accident happened during criminal activity (like street racing) or if there’s evidence of fraud, policies are voided and claims denied.
Incomplete or Inaccurate Claim Filing
Not providing enough evidence (medical records, police reports, witness statements) or submitting incomplete forms are common pitfalls. Ontario insurers require thorough documentation to process claims.
What You Can Do If Denied
Review and Appeal the Decision
First, review the denial letter and your insurance policy to understand the insurer's rationale. If you believe the decision was unfair, contact your broker to clarify and gather any missing information.
Gather Additional Evidence
Provide supplemental documentation—like medical reports, accident details, and witness statements—to strengthen the appeal. In many cases, missing paperwork is the only barrier.
Resubmit or File an Appeal
Ontario law provides the right to resubmit claims denied for non-compliance. You may appeal further with the Licence Appeal Tribunal (LAT) if the insurer stands by their decision. The LAT oversees disputes between claimants and insurers.
Seek Professional Help
Experienced insurance brokers and personal injury lawyers in Mississauga and Toronto help navigate complex claims, advocate with insurers, and prepare appeals or legal action if necessary.
Escalate the Issue
If insurer responses are unsatisfactory, file a complaint with the Financial Services Regulatory Authority of Ontario (FSRAO) or consult the Ombuds Service to escalate your grievance.
Frequently Asked Questions
Why are claims denied most often in Toronto and Mississauga?
Common issues include incomplete applications, missing coverage, unauthorized drivers, or non-disclosure of information.
Can I appeal a car accident claim denial in Ontario?
Yes, via the Licence Appeal Tribunal (LAT), and most brokers will help guide you through the process.
What documents do I need to support my claim?
Medical records, accident reports, witness statements, and photos are essential.
Who can help with a denied claim?
Contact an insurance broker or personal injury lawyer specializing in auto claims in Mississauga or Toronto.
How can I avoid future denials?
Be transparent with your broker, review your policy annually, and keep all information—driver’s license, vehicle ownership, etc.—up-to-date.