Widow Zalfa Limosani couldn't believe it when she received a letter from her insurance company telling her her claim was denied.
Before his death from cancer in August 2009, Zalfa's husband, Ronnie, made certain his affairs were in order.
When they bought a car in 2008, he bought insurance to cover the payments in the event of his death.
"My husband did it to make sure I was protected," said Zalfa.
While Ronnie disclosed to his dealer and the insurance company he had heart problems, he was accepted, despite the condition.
After his death, Zalfa received a letter informing her the company would no longer cover her car payments because his death was related to a pre-existing condition.
"Either you accept to insure or you don't," she said, adding that the decision to provide coverage shouldn't be made after a person's death.
While the insurance company did not want to provide an interview, after several calls were made by CTV, they reviewed Zalfa's case and granted her the claim.
"The company couldn't go into details about the case because it is a personal and private matter," said CTV's Tania Krywiak.
"That being said, they added that they have no records of Zalfa calling them for information, only to check on the status of the claim, this before they decided to deny it."
When a claim is denied, the claimant should follow these procedures:
- Call the insurance company with questions
- If the reasons for refusal are explained and the claimant disputes it, the claimant should file an appeal
- If the claimant isn't satisfied with the decision of the appeal, or final position letter, they should contact the OmbudService for Life & Health Insurance. The OLHI will review the complaint and attempt conciliation between the two parties.
