Can an insured person appeal an insurance company's denial of a claim?

An insured person can indeed appeal an insurance company's denial of a claim, and the correct approach involves utilizing either an internal process within the insurance company or seeking external arbitration. This option is significant because it provides a structured procedure for dissatisfied policyholders to contest decisions they believe are unjust.

The internal process typically allows the individual to request a review of the claim denial by a higher authority within the insurance company, which may lead to a reassessment of the decision based on the initial evidence or policy terms. External arbitration serves as an alternative method where an independent entity evaluates the dispute between the insured and the insurance company, often resulting in a more impartial outcome.

Having these avenues ensures that individuals have a mechanism to advocate for their rights and ensure that their claims are fairly assessed, promoting accountability and customer satisfaction in the insurance process. Other responses limit available recourse or impose conditions that are not necessary for the appeal process, failing to reflect the rights of insured persons in the context of Ontario's insurance regulations.