When Your Insurer Denies Your Claim: The Ontario Dispute Process Explained

Receiving a denial letter from your insurance company can feel like the end of the road. In Ontario, it isn't. The accident benefits system comes with a formal dispute resolution process handled through the Licence Appeal Tribunal — Automobile Accident Benefits Service (LAT-AABS) — but it's only available to those who understand it exists and act before the deadline.

Why Insurers Deny Claims

• The insurer disputes whether your injuries meet the threshold for a particular benefit
• An independent medical examination (IME) arranged by the insurer concluded your injuries are less severe than claimed
• The insurer alleges a procedural issue — missed forms, late notice, or missing documentation
• The insurer argues the treatment is not "reasonable and necessary" under SABS
• The insurer believes your injuries pre-dated the accident

The 2-Year Deadline to Apply for Dispute Resolution

Step 1: Internal Review Request

Before applying to LAT-AABS, review the insurer's denial letter, request clarification if needed, and gather supporting documents. Do not assume informal discussions pause any formal deadline. Consider qualified legal advice promptly if a denial or deadline is involved.

Step 2: LAT-AABS Dispute Process

The Licence Appeal Tribunal — Automobile Accident Benefits Service (LAT-AABS) resolves disputes about an insured person's entitlement to statutory accident benefits or the amount payable. Use official LAT-AABS rules and forms before relying on any general summary. Official source: https://tribunalsontario.ca/lat-aabs/

What to Do if Your Claim Was Denied

• Note the date of the denial letter and any deadline language
• Read the denial carefully and identify the stated reason
• Gather medical records, treatment plans, and insurer correspondence
• Consider getting qualified legal advice promptly about whether a LAT-AABS application deadline applies