Alberta · Insurance Claims

Insurance Claim Denied in Alberta? Your Next Steps

A denial letter is a position, not a final answer. What you do next depends on which claim was refused and which deadline is running.

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Short answer

Get the denial in writing with the reasons, identify which claim was refused and under which policy, and note the deadline. An action to recover Section B accident benefits must start within 2 years after it arose. A claim against an at-fault driver has its own 2-year limitation period. For crashes after Care-First starts, benefit disputes go to the Alberta Automobile Care-first Tribunal.

Last reviewed September 16, 2026. General legal information for Alberta, not legal advice.

First, work out which “no” you received

What happenedWhat it usually means
Your own insurer stopped or refused Section B benefitsA dispute over accident benefits under your policy.
The other driver’s insurer says their driver was not at faultA liability dispute in a tort claim. The insurer’s view is not a finding.
An adjuster says your injury is “minor”A dispute over the minor injury cap, which has its own process.
Your insurer denies coverage altogetherOften an allegation that a policy condition was breached, such as late notice.
No one will pay because the driver fled or was uninsuredA claim involving the Motor Vehicle Accident Claims Act fund.

What to do after a denial

  1. Ask for the decision and reasons in writing if you only received a phone call.
  2. Get a copy of your policy, including the Section B wording and any endorsements.
  3. Write down every deadline mentioned, and do not assume it is the only one.
  4. Collect the evidence the denial relies on, such as a medical report or an examination the insurer arranged.
  5. Do not sign a release or accept a final payment while you are still disputing the claim.
  6. Get advice before the limitation period runs. Negotiations do not stop the clock.

Deadlines after an insurance denial

ClaimDeadline
Section B claim noticeWithin 30 days of the accident, or as soon as practicable
Lawsuit to recover Section B benefitsNo later than 2 years after the cause of action against the insurer arose
Hit and run claim notice to the AdministratorWithin 90 days of the accident
Claim against an at-fault party2 years from discovery, 10 years at most

When the dispute is about the minor injury cap

If the insurer treats your injury as a capped minor injury and you disagree, either side can require an assessment by a certified examiner, but not until at least 90 days after the accident. The examiner’s written opinion is prima facie evidence on whether the injury is minor. Preparing properly for that assessment is one of the most important steps in a disputed soft tissue claim. See the minor injury cap.

Your duties, and the insurer’s arguments

Every Alberta auto policy includes statutory conditions. You must promptly give your own insurer written notice of an accident, forward claim documents you receive, not settle or admit liability on your own, and cooperate with the insurer. Insurers sometimes deny coverage by pointing to a breach of those conditions. Late notice is the most common allegation, and whether it actually defeats coverage depends on the facts.

Those duties run to your own insurer. They do not require you to give a statement to the other driver’s insurer. See giving an adjuster a statement.

When an insurance claims lawyer helps

A lawyer helps most when benefits have been cut off during treatment, when fault is disputed, when the insurer calls an injury minor that is affecting your work, or when a limitation date is close.

In Alberta, a contingency fee agreement must be in writing and signed, set out how the fee is calculated and how disbursements and costs are handled, and give you 5 days to cancel without paying a fee. You can also ask a review officer of the court to review the agreement and the charges.

Denied benefits under Care-First

The Government of Alberta says its Care-First auto insurance system starts January 1, 2027. The new Automobile Insurance Act takes effect by proclamation, so always confirm the start date that applies to your crash.

Crash before Care-First starts: the current rules keep applying to it, including the right to sue the at-fault driver, the minor injury cap and Section B benefits (Automobile Insurance Act, s 103).

Crash after Care-First starts: injured people receive benefits from insurance, and the right to sue narrows to specific cases, such as a driver found guilty of a prescribed criminal or traffic offence, certain third parties like a vehicle manufacturer, a parts supplier or the municipality responsible for the road, and some losses above the benefit limits. Benefit disputes go to the Alberta Automobile Care-first Tribunal. The tribunal has exclusive jurisdiction over insurer decisions on those benefits, and its decisions on appeal are final, subject to narrow exceptions in the Act.

Sources

  1. Automobile Accident Insurance Benefits Regulation, Alta Reg 352/1972, Schedule A (Section B)
  2. Insurance Act, RSA 2000 c I-3, s 556 (automobile statutory conditions)
  3. Minor Injury Regulation, Alta Reg 123/2004 (Alberta King’s Printer)
  4. Limitations Act, RSA 2000 c L-12
  5. Motor Vehicle Accident Claims Act, RSA 2000 c M-22
  6. Alberta Rules of Court, Alta Reg 124/2010 (Rules 3.26, 4.16, 4.33, 10.7)
  7. Automobile Insurance Act, SA 2025 c A-47 (Care-First)
  8. Government of Alberta, Care-First auto insurance

Denied insurance claims: common questions

My Section B benefits were cut off. What can I do?

Ask for the reasons in writing, get the medical report the decision relies on, and have your own treating practitioners respond. If the insurer will not reconsider, an action to recover the benefits must start within 2 years after the cause of action arose.

Can the other driver’s insurer deny my injury claim?

It can refuse to pay, but that is a negotiating position. Fault and damages are decided by a court if the claim does not settle, and the limitation period keeps running in the meantime.

Does late notice mean my claim is lost?

Not automatically. The Section B regulation allows notice as soon as practicable when 30 days was not reasonable. Give notice in writing now and keep proof.

How much does an insurance claims lawyer cost?

Injury lawyers commonly work on contingency. Alberta’s Rules of Court require a written agreement explaining how the fee is calculated, with a 5-day right to cancel and the right to have it reviewed.

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