A denial letter is not the end. Canadian insurers have an internal appeal, then a senior review, and after that a free external ombudsman. The key is to go in order and to watch the deadline printed in your denial letter.
Step 1: Read the Denial Letter Closely
Find the exact reason (pre-existing condition, exclusion, missing documents, late notice), the claim and policy number, and any appeal deadline. Contact the insurer using the details on the decision letter and ask for the full claim file and the policy wording they relied on.
Denial Reasons and What to Send Back
| Reason in the letter | Your best evidence |
|---|---|
| Pre-existing condition not stable | A letter from your doctor: no new symptoms, tests or medication changes in the stability period (often 90, 180 or 365 days) |
| Wrong answer on the medical questionnaire | A copy of the questionnaire and your records showing the answer was true |
| Didn't call the assistance line | Proof it was an emergency, or proof that you did call (phone logs, emails) |
| Travel advisory or known event | The date the advisory was issued and the date you bought the policy |
| Missing documents | Itemized hospital bills, receipts, medical reports and proof of travel dates |
Bought the insurance through a credit card? The claim and the appeal go to the insurance company named in the card's certificate of insurance, not to the bank.
Step 2: Submit a Written Appeal
If you believe the evidence behind the decision is wrong, or you have new evidence (medical records, receipts, a doctor's letter, proof of dates), submit an appeal in writing with supporting documents. At Allianz Global Assistance, for example, the appeal must be filed within 180 days of receiving notice that the claim was denied. The insurer also notes it may apply other terms, limits and exclusions when it re-reviews your file, so make your appeal complete and accurate.
Step 3: Ask for the Insurer's Final Position
If the internal appeal fails, many insurers have a senior office that issues a final written response. In Allianz's process this goes to the underwriter's office (for example, the Co-operators' Office of Fair Client Practices or RBC's Client Complaints Appeal Office), and its written response is considered the insurance company's final position. Reviews can take weeks or months, so ask for the expected timeline in writing.
Step 4: Go to an Independent Ombudsman (Free)
| Body | Use it for | Contact |
|---|---|---|
| OmbudService for Life and Health Insurance (OLHI) | Life and health insurance complaints, including denied medical expense claims. Free, English and French. Aims to conclude most complaints within 120 days. You contact OLHI once you have the insurer's final position. | 1-888-295-8112 · olhi.ca |
| General Insurance OmbudService (GIO) | Property and casualty insurance disputes. Allianz's own process points to GIO for external review, and says you must complete the insurer's complaint process first. | 1-877-225-0446 · giocanada.org |
Which body applies depends on the type of claim and the insurer. Ask your insurer which ombudservice it recognizes for your claim, and put that question in writing. See our explainer on GIO: General Insurance OmbudService.
Timeline at a Glance
| Stage | Typical time |
|---|---|
| Original claim decision | A few weeks to a few months |
| Deadline to appeal | The date in your denial letter (180 days at Allianz) |
| Internal appeal and final position | Weeks to months |
| OLHI review | Aims to finish most complaints within 120 days |
Other Options
- Quebec residents: You can complain to the Autorité des marchés financiers (AMF).
- Information on your rights: The Financial Consumer Agency of Canada (1-866-461-3222, English) provides information on consumer rights and handles federal consumer protection compliance for insurers.
- Large claims: If the amount is significant, a lawyer or Small Claims Court may be an option after the complaint process.
Turn your denial letter into a clear appeal letter.
Draft It With Asya →Frequently Asked
Is there a deadline to appeal?
Yes, many insurers set one in the denial letter. Allianz's published deadline is 180 days from notice of denial. Always use the date in your own letter.
Can I go straight to the ombudsman?
No. Allianz states you must follow its complaint process first, and OLHI says to contact it once you have the insurer's final position.
Does the ombudsman cost anything?
OLHI states its services are free for consumers across Canada. GIO describes its help as free and impartial.
What should my appeal include?
The claim and policy number, why the decision is wrong, new documents, a timeline of events, and the outcome you want (for example, full reimbursement of a specific amount).
Can a travel insurance claim be denied because of a travel advisory?
Yes. Many policies exclude trip cancellation, trip interruption or other claims if the Government of Canada had already advised to avoid all travel or avoid non-essential travel to that place before you bought the policy or left. Check the advisory clause in your policy, the date the advisory was issued, and keep a copy of the advisory from travel.gc.ca.
What are the most common reasons travel insurance claims are denied?
A pre-existing medical condition that was not stable or not disclosed, an exclusion in the policy, a travel advisory or known event, missing receipts or medical records, and calling the insurer's assistance line too late. The denial letter must name the reason, so start there.
How long does a travel insurance claim take in Canada?
There is no single legal deadline. A simple claim with all receipts often takes a few weeks; a medical claim that needs foreign hospital records can take a few months. Send everything the insurer asks for at once, keep copies, and ask in writing for the claim status and an expected decision date. If it drags on with no answer, use the insurer's complaint process, then the ombudsman.
What should I do if my travel insurance claim is denied?
Read the denial letter for the exact reason and the appeal deadline. Ask for your claim file and the policy wording, then send a written appeal with new evidence, such as a letter from your doctor. If the appeal fails, ask for the insurer's final position and take it to the free OmbudService for Life & Health Insurance (OLHI, 1-888-295-8112).
Who do I complain to if my credit card travel insurance claim is denied?
To the insurance company named in your card's certificate of insurance, not the bank. Use that insurer's appeal and complaint process, then take its final position letter to the OmbudService for Life & Health Insurance (OLHI).
Sources & Verification
Figures and contacts in this article come from official sources:
- Allianz Global Assistance: Claim denial appeal process
- OLHI: OmbudService for Life and Health Insurance
- GIO: General Insurance OmbudService
General information, not legal advice. Details and deadlines can change, so confirm with the agency before acting. Learn more about how ComplaintCA verifies information on our About page.