When a damage occurs, you naturally expect your insurance to cover the damages. Yet, there are times when your insurer refuses to compensate you—whether because the damage isn’t covered under your policy or due to a failure to meet your contractual obligations. In this article, we explain your rights and the steps you can take, based on Quebec law, to challenge an insurer's refusal.

The Insurer’s Fundamental Obligation: To Compensate You for a Covered Loss

According to Article 2463 of the Civil Code of Quebec (C.c.Q.), an insurer is required to indemnify the insured when the damage is covered by the policy. Whether you’re the victim of a loss or the party responsible for damages caused to someone else, property or liability insurance is designed to protect you financially. However, this obligation hinges on one key condition: the loss must be reported promptly.

Timely Reporting Is Crucial:

Once you discover the damage, it’s imperative to notify your insurer immediately. A delay not only risks exacerbating the damage but also provides the insurer with grounds to reduce or deny your claim.

Your Responsibilities as an Insured

1.    Mitigate the Damages

Under Article 1479 C.c.Q., you are required to take all reasonable steps to minimize the harm caused by the loss. This means that, as soon as a loss occurs, you must act diligently to prevent further damage. Failure to do so can be used by your insurer to justify a reduction in or complete denial of your claim.

2.    Report the Loss Promptly

Per Article 2470 C.c.Q., you must report the loss to your insurer as soon as you become aware of it. Delaying the report can lead the insurer to argue that they suffered additional harm because of the delay, which may justify a reduction in the compensation or even a refusal to pay.

Reasons Your Insurer Might Deny Your Claim

Several factors can justify an insurer’s refusal to indemnify:

• Incomplete Initial Risk Disclosure:

When you sign your insurance policy, you are obligated to disclose all relevant facts about your situation. Omitting key details—even unintentionally—can result in your insurer refusing the full amount of your claim, citing a breach of the duty of good faith.

• Intentional Misconduct:

Insurance only covers unforeseen risks. If damage is caused intentionally, the insurer is not obligated to cover the loss.

• Change in Risk After the Policy is Issued:

Should your circumstances change in a way that increases risk after the policy is in effect, you are required to inform your insurer. Failure to do so can result in your insurer modifying or even canceling your coverage.

• Contractual Exclusions and False Declarations:

The insurance contract operates on the principle of good faith. Any false or misleading information that influences the risk assessment can lead to an exclusion from coverage.

What to Do If Your Claim Is Denied

1.    Review Your Insurance Policy

Before taking further steps, carefully read your policy to understand the specific clauses regarding timely reporting, mitigation obligations, and any exclusions that may apply. This will help you pinpoint the insurer's grounds for denial and identify any possible mistakes on their part.

2.    Gather All Supporting Evidence

Keep all documents related to the incident—photos, expert reports, and correspondence with your insurer. These pieces of evidence are critical in building a robust case that demonstrates you met your obligations.

3.    Consult an Insurance Law Expert

If your insurer still refuses to pay, consider consulting an attorney who specializes in insurance law. An expert can assess your case, advise on the best course of action, and represent you in court if necessary. With proper legal support, you can challenge the insurer’s decision and claim what you’re rightfully owed.

Conclusion: Don’t Let Your Insurer Overstep Their Boundaries

Facing a denial of your insurance claim can be both frustrating and costly. It’s essential to meet your obligations—such as promptly reporting the loss and mitigating further damage—but if you believe your insurer is acting in bad faith, you have several options for recourse.

With the assistance of experienced Law Firm like in ASC-avocat-Flex, you can effectively challenge an unjustified refusal and secure the compensation you deserve. Don’t let your insurer intimidate you: know your rights, act swiftly, and pursue the justice you are entitled to under Quebec law.