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How to File an Insurance Claim in Canada: Step-by-Step

Updated

Filing an insurance claim can feel overwhelming, especially when you are dealing with a car accident, property damage, or a serious health event. This guide walks through the process step by step for each major type of insurance in Canada.

Auto insurance claims

Immediately after an accident

  1. Ensure safety — move to a safe location if possible, call 911 if there are injuries
  2. Exchange information — name, insurance company, policy number, licence plate, driver’s licence number
  3. Document everything — photos of damage, road conditions, traffic signs, and all vehicles involved
  4. Get witness contact information — names and phone numbers of anyone who saw the accident
  5. File a police report — required in most provinces if damage exceeds $2,000 or there are injuries
  6. Visit an Accident Reporting Centre — required within 24 hours in Ontario for minor collisions

Filing the claim

Step What to Do Timeline
1. Report to your insurer Call or use the app to report the accident Within 24 hours
2. Provide documentation Photos, police report number, other driver’s info At time of report
3. Adjuster assigned Insurer assigns a claims adjuster to your file 1-3 business days
4. Vehicle inspection Adjuster or approved shop inspects damage 3-7 business days
5. Estimate approved Insurer approves repair estimate 5-10 business days
6. Repairs completed Approved shop completes repairs Depends on damage
7. Payment issued You pay deductible; insurer pays the shop directly At time of pickup

At-fault vs not-at-fault

Scenario Your Deductible Your Premiums Process
You are at fault You pay your deductible Likely increase 15-40% Claim through your collision coverage
Other driver at fault Usually $0 (your insurer recovers from theirs) Should not increase Claim through your insurer; they subrogate
Hit and run You pay your deductible Should not increase File police report; claim under uninsured motorist
Single vehicle (you hit a pole) You pay your deductible Likely increase Claim through your collision coverage

Home insurance claims

Immediate steps after damage

  1. Prevent further damage — shut off water, cover broken windows, turn off electricity if water near wiring
  2. Document damage — take photos and videos before cleaning up or making temporary repairs
  3. Keep damaged items — do not throw anything away until the adjuster has seen it
  4. Make temporary repairs — cover a leaking roof, board up broken windows (insurer pays for these)
  5. Keep receipts — for all temporary repairs, hotel stays, and emergency expenses

Filing the claim

Step What to Do Timeline
1. Report to insurer Call your insurer’s claims line Same day as damage
2. Adjuster visit Adjuster inspects the damage in person 1-5 business days
3. Document losses Provide a detailed list of damaged/lost items with values During adjuster visit or shortly after
4. Get repair estimates Insurer may require 2-3 estimates for major repairs 1-2 weeks
5. Claim approved Adjuster approves the claim amount 2-4 weeks
6. Payment issued Insurer pays you (minus deductible) or pays contractors directly Within days of approval

Tips for home claims

  • Keep a home inventory — a list and photos of your belongings dramatically speeds up claims
  • Understand replacement cost vs actual cash value — replacement cost pays what it costs to buy new; ACV deducts depreciation
  • Notify your insurer of any renovations — unreported improvements may not be covered
  • Do not admit fault to anyone before speaking with your insurer

Life insurance claims

How to file a life insurance claim

Step What to Do
1. Locate the policy Find the policy document or contact the insurer directly
2. Notify the insurer Call the insurer’s claims department; provide the policy number
3. Submit required documents Death certificate (certified copy), completed claim form, beneficiary ID
4. Insurer reviews Insurer verifies the claim (typically 30-60 days)
5. Benefit paid Tax-free lump sum paid to the named beneficiary

Common reasons life insurance claims are delayed or denied

Reason What to Do
Missing documents Ensure you have a certified death certificate and completed forms
Policy lapse (premiums not paid) Check if a grace period applies; some policies have automatic premium loans
Contestability period (first 2 years) Insurer may investigate if death occurs within 2 years of policy issue
Misrepresentation on application If the deceased did not disclose health information accurately
Excluded cause of death Check policy exclusions (suicide within first 2 years, illegal activity)

Travel insurance claims

Steps to file

  1. Get medical treatment — your health comes first
  2. Call the insurer’s emergency assistance line — most require you to call before seeking non-emergency treatment
  3. Keep all receipts — medical bills, prescriptions, accommodation, transportation
  4. Get medical reports — obtain written reports from treating physicians
  5. File the claim — submit all documentation within the deadline (usually 30-90 days after return)

What to document

Document Purpose
Medical receipts and invoices Proof of expenses
Doctor’s reports Medical necessity
Airline/hotel change receipts Trip interruption costs
Police report (if theft) Proof of loss for baggage claims
Pharmacy receipts Prescription costs

How to handle a denied claim

Step 1: Understand the denial

Request a written denial letter that cites the specific policy clause or exclusion. Read your policy carefully to understand whether the denial is valid.

Step 2: Gather evidence

Collect any additional documentation that supports your claim — photos, expert opinions, contractor estimates, medical records.

Step 3: File a formal appeal

Write a formal appeal letter to the insurer’s claims department. Include:

  • Your policy and claim number
  • Why you believe the denial is incorrect
  • Supporting evidence
  • Reference the specific policy language that supports your claim

Step 4: Escalate if needed

Escalation Path Description
Insurer’s internal ombudsman First escalation — every insurer has an internal complaint process
General Insurance OmbudService (GIO) Independent body for home, auto, and business insurance
OmbudService for Life & Health Insurance (OLHI) Independent body for life, health, and disability insurance
Provincial insurance regulator FSRA (ON), AMF (QC), BCFSA (BC), etc.
Small claims court For smaller amounts; no lawyer needed
Civil litigation For large claims; consult an insurance lawyer

Tips for getting claims approved

  1. Report immediately — delays give insurers grounds to question your claim
  2. Document everything — photos, videos, receipts, and written records
  3. Follow policy requirements — if your policy says to get 2 estimates, get 2 estimates
  4. Be honest — exaggerating a claim is fraud and can void your entire policy
  5. Keep copies — retain copies of everything you submit to the insurer
  6. Keep a claims diary — log every phone call with date, time, name, and what was discussed

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