Understanding the home insurance claims process in Ontario
Ideally, you’ll never have to make a home insurance claim; if you do have to make one, we want to make the process as easy as possible.
This guide is designed to help Ontarians through the home insurance claiming process. We’ll cover what happens when you make a claim, when you should file a claim, factors to consider when making a claim, how to make a claim, reasons your claim could be denied, and more:
What Happens When You Make a Home Insurance Claim in Ontario?
Making a home insurance claim affects your policy—and in the best-case scenario, it leads to a payout. Here’s what happens:
- You file your paperwork with your insurance company (we’ll explain how in a later section).
- Your insurance claims adjuster reviews the paperwork and determines if your claim meets the criteria for your insurance policy to pay out.
- You pay your deductible (this occurs in one of many different ways depending on whether you’re getting cash or repairs and on the terms of your policy).
- The claim goes on your claims history.
Insurance premiums are, to some extent, based on your claims history—this means that your premium may increase when you renew your policy if you’ve made a claim.
When Should You File a Home Insurance Claim?
There are many factors that influence whether or not you should make a home insurance claim. These factors include:
- The size of the deductible
- The extent of the loss or damage
- Whether you can pay for repairs and replacements out of pocket
- Your claims history
Generally, claiming for small amounts you can pay out of pocket doesn’t make sense—you might not see much payout after your deductible is accounted for, and it may increase your premiums. Some insurers even offer “claims-free” discounts for clients who have never made a claim—claiming even once could remove this discount.
Make a claim if losses are significant and if you cannot afford repairs out of pocket.
Factors to Consider Before Making a Claim
Before making any claim, there are a few important steps to remember:
- Move yourself and your family away from your home if there’s any danger present.
- Do what you can to mitigate damage (moving items away from the source of damage, calling emergency services, getting emergency repairs done, and more).
- Take as many pictures of the damage as possible.
- List all of the items and property that were damaged, stolen, or destroyed.
Water Damage
- When there’s basement flooding or burst pipes and no danger to your person, move as many items out of the path of water as you can. Shut off the water to your home (if applicable).
- Call a plumber as soon as possible if it’s an emergency—if not, contact your insurer to see if they have a preferred service provider.
- Keep any items that may have caused damage.
Theft
- Call the police, and file a police report. Your insurance company is unlikely to process a claim until a police report has been filed.
- Do what you can to secure the premises once it’s safe to do so (changing locks, repairing damage, and more).
- Have the police report on hand when you file your claim.
Fire and Smoke Damage
- Mitigate damage when you can, but do not put yourself at risk. Call the fire department when needed.
Flooding and Earthquakes
- Many insurance policies do not cover flooding or earthquakes unless this coverage has been added to your policy. It is a good idea to review your policy before making a claim to see whether or not you have added flood or earthquake coverage. Don’t hesitate to pick up the phone and have a conversation with your insurance broker about what is happening and if you should make a claim.
Injuries and Liability
- Give your contact information to the person who was injured or whose property was damaged.
- File a police report if necessary.
- Call emergency services if necessary.
- Take pictures of the incident.
Liability may apply any time damage is caused by you, your spouse, your dependants, or your property. You may even be considered liable for a fire that spreads from your house to your neighbour’s house.
How Home Insurance Claims Work
Once you file a claim, a claims adjuster working for the insurance company that provides your home insurance policy will begin to assess your claim. During the claiming process, they may contact you several times with questions or information.
How Long the Home Insurance Claim Process Takes
The home insurance claim process can take time—how long it takes depends on several factors, including:
- The complexity of the home insurance claim (claims caused by multiple factors may take longer to process)
- The extent of the damage
- The amount of documentation available for the home insurance claim (pictures, a detailed list of the items damaged and their cost, and other documents can speed up the claiming process)
- The number of other claims your insurance company is processing during the period when you make your claim
Finalizing your home insurance claim may take weeks or even months—in the best-case scenarios, it may only take a matter of days.
The 4 Steps of the Home Insurance Claims Process
1. Opening Your Claim
If you purchased your insurance through a Westland Insurance broker, we can help you file a claim with your home insurance company.
In case of emergency, once you’ve made it to safety and contacted police, fire, or other emergency resources, you can call your insurance company directly to file a claim, 24/7. Some insurance companies also allow you to file online, but online filing is usually slower than phoning in and connecting with the company directly.
Have paperwork, pictures, and any other documentation ready when you phone in to file a claim. During the phone call, your insurance company or insurance broker will:
- Take a statement from you about the claim you’re making
- Check your insurance coverage to see if the claim is eligible
- Refer you to a recommended service provider for repairs
- Tell you which documents to send them
- Tell you which documents they may send you
- Tell you your deductible
- Give you a claims number to track your claim
2. Assessing the Damage and/or Determining Fault
There are three ways in which damages will be assessed by your insurance company:
Building Damage: The cost for building damage—meaning either repairs or replacement—will be assessed by one of your insurance company’s recommended service providers. Should you disagree with the amount assessed, you have recourse—you can contact a different provider for a different estimate and compare those estimates with the one provided by your insurer’s recommended service provider.
Personal Property Damage: You’ll send your insurer documentation proving that you owned the property you’re claiming for—pictures, receipts, credit card statements, and more can help. Keep an updated inventory of all the items you own to simplify this process.
Liability: Liability is complex. Your home insurance company may contact:
- Witnesses
- Police
- The people who were injured or whose property was damaged—and their insurance company
You will have to send your insurance company:
- Pictures
- Any notices that you are being pursued (legally) for damages
- Invoices, estimates, and other documents related to the liability claim
The process to complete a liability claim takes time—it can take weeks to get police reports and witness statements, all of which are crucial to the liability claim process.
3. Repairs or Settlement Proposal
Building Damage: When possible, your insurance company will repair or replace buildings using their recommended service providers—they will pay them on your behalf (minus the deductible). Your insurer will contact you to authorize recommended service providers to begin repairs.
Personal Property Damage: Your insurer will contact you to propose a settlement for property that’s been damaged or destroyed. Depending on the terms of your policy, they may offer amounts based on the replacement cost or the actual cash value of the items that were damaged.
Liability: When there’s a reasonable case against you, your insurer will attempt to settle out of court with the other party—when settled, they may pay the other party the settlement amount (assuming it’s less than or equal to your liability coverage), then give you documentation protecting you from future lawsuits stemming from the same claim.
There are times when out-of-court settlements are impossible—in these cases, your insurance company may invoke their right of subrogation and represent you in court using their lawyers. In these cases, your insurer will pay all legal fees, in some cases, up to your limit of coverage. Should the court find you liable, your liability coverage may still step in to cover damages.
4. Payment
Payment can occur in several ways. Your insurer may pay you directly to cover costs (such as in the case of personal property damage), or they may pay the service providers you’ve used to repair or replace your buildings (be it dwelling buildings, detached structures, or both). Both repair costs and replacement costs may be covered directly—minus whatever deductible you need to pay.
Your insurance policy may cover more than you expect—your coverage may, for example, offer you payment for additional living expenses incurred while your home is being repaired or replaced.
Reasons Your Home Insurance Claim Can Be Denied
There are several reasons why your home insurance claim may be denied:
- The peril or hazard that caused the damage is not covered by your policy
- The damage was caused by negligence on your part
- The damage was intentionally caused by you, your spouse, your dependants, or someone working on your behalf
- There’s insufficient evidence for the claim
You may see that some portion of your claim is accepted while another portion is denied—this is a fairly common occurrence, especially when it comes to personal property damage.
Advice and Tips
- Contact your insurer as soon as possible when you need to make a claim.
- Keep a detailed list of all of your personal property and its value, along with recent photos—this can help you expedite personal property claims.
- Talk to your insurance broker when claiming—they can help you through the claiming process.
- Don’t be afraid to contest what your claims adjuster has offered as a settlement—you have a right to use your policy. Negotiations are part of the process.
- Get an estimate from an independent contractor—this can help in negotiations.
- Keep a record of all communications with your insurer.
- Consider working with a public adjuster who can advocate for you during the claiming process.
FAQ
Insurers all provide windows of time in which you can open a claim—these windows vary from a few months to up to a year after the event you’re claiming for occurs.
Your insurer cannot deny a claim because of delays on their end—they may, however, deny a claim if you take too long to provide the information they need. Talk to your insurer directly about how long you have to finalize your portion of a home insurance claim.
Should your claim be denied, you can appeal the decision. To appeal, be sure to provide documentation that supports your appeal. There are times that claims are denied simply because there isn’t sufficient documentation.
In the worst case scenarios, if your appeals are denied, and you believe it to be in error, you can appeal to other parties, like your insurance company’s ombudsman. The Insurance Bureau of Canada offers a guide to dispute resolution. As a final resort, you may consider legal action.
Generally, yes. Your claiming history is an important factor in how your premiums are calculated; any claims you make can increase your premium.
In some cases, you may not be obligated to replace the property lost or damaged. For example, if you received a cash settlement for your contents, you do not need to replace the contents if you do not wish to. However, if you received a cash settlement to repair your roof after a hail storm, you must repair it. Your insurance company will follow up for proof of repairs.
There’s no limit to the number of claims you can make each year under most policies—but the fewer claims you make, the better.
You can—but depending on your claiming history, you may find changing insurers more difficult. We recommend speaking to your insurance broker every time your policy is up for renewal to see if you can find a better policy for your needs.
Securing Your Home With Westland Insurance
Looking for home insurance in Ontario? Our knowledgeable brokers will help you find the perfect policy for your needs—and with our exceptional claims support, we can see you through the claiming process when you need to use your policy.
For the perfect home insurance policy for your needs, call Westland Insurance today.