My insurer denied my claim — what are my options?

First step: get the reason in writing

An insurer cannot deny a claim on a general impression. The denial must rest on an identifiable exclusion or condition in your contract, and you are entitled to know which one.

Ask for that reason in writing, quoting your file number, and ask for copies of the clauses relied on and of the adjuster's report behind the decision. That document becomes the central piece of everything that follows — you will be asked for it at every stage.

A verbal denial, or one that simply invokes "the terms of the policy", is not an answer. Press for it.

The sixty-day rule

An insurer cannot leave a file open indefinitely. Once the loss report is received — or, where the insurer asked for them, the relevant information and supporting documents — the Civil Code requires payment within 60 days (article 2473).

That deadline applies to damage insurance — home, auto, property. Insurance of persons follows a different rule: the insurer must pay within 30 days of receiving the required proof, or within 60 days for sickness or accident insurance, unless it covers loss of income due to disability (article 2436). See life insurance denials.

In practice that period is often pushed back by successive requests for documents, and each new request can restart the count. That is why it is worth submitting a complete file at once, and dating every submission.

If requests for documents multiply with no apparent end, that pattern itself becomes part of the file.

Exclusion, condition, misrepresentation: not the same thing

An exclusion removes a situation from coverage — a type of damage, a cause, a use. The question is whether your situation genuinely falls inside it, and exclusions are interpreted narrowly.

A condition imposes an obligation on you: report within a certain time, protect the property, allow inspection. Failing one does not always mean losing the indemnity.

Misrepresentation is the heaviest ground and the most misunderstood. It does not automatically void the contract: depending on the circumstances and the insured's good faith, the consequence may be a proportional reduction of the indemnity rather than outright denial. In damage insurance the insurer remains liable in the proportion the premium collected bears to the premium it should have collected, unless bad faith is established or it shows it would not have accepted the risk (articles 2410 and 2411). This is very often where the case is decided.

What the insurer can demand — and its limits

On request, you must inform the insurer as soon as possible of all the circumstances of the loss: probable cause, nature and extent of the damage, location of the property, third-party rights, concurrent insurance. You must provide supporting documents and attest under oath to the truth of the information (article 2471).

The same provision protects you: where you cannot meet that obligation for a serious reason, you are entitled to a reasonable extension. An insurer denying a claim over a missing document, where a serious reason explains the delay, is standing on thin ground.

A warning in the other direction: any deceitful declaration entails forfeiture of the right to indemnity for the risk it relates to (article 2472). Inflating a claim usually costs more than the claim is worth. Forfeiture does stay confined to the category of property concerned where the loss involves both movables and immovables, or both business and personal property.

Adjusters and second opinions

The amount offered almost always rests on an assessment by an adjuster retained by the insurer. That adjuster is competent, but not neutral — one party is paying.

You can have the damage assessed by your own expert. Where the two assessments differ sharply, that gap becomes concrete negotiating leverage, far more effective than disagreement expressed without numbers.

Keep the damaged property until the file is settled, where possible. Property thrown out is evidence lost.

Before signing a release

A first offer is rarely a ceiling. Before accepting, check three things: exactly what the offer covers, what rights it extinguishes, and whether it accounts for all your losses — including those not yet quantified.

A signed release is very hard to reopen. It is the document that deserves the most attention in the whole file, and paradoxically the one signed fastest, because it arrives with a cheque.

The deadlines that matter

The three-year prescription is the one people talk about. But your policy almost always imposes much shorter notice obligations — reporting the loss, filing a statement, providing documents.

Do not rely on the longest deadline. As soon as you are denied, reread the notice requirements in your contract: that is where files are lost, long before three years.