Back to all terms

Contestability

Contestability refers to the period of time after an insurance policy is issued during which the insurer has the right to review and investigate the accuracy of the information provided in the application. If the insurer discovers that any information was omitted, misstated, or misrepresented during this period, it can deny a claim or void the policy.

In most Canadian life and health insurance policies, the contestability period lasts two years from the date the policy takes effect. During this time, the insurer can contest a claim based on errors or nondisclosure in the application, even if the omission was unintentional. Once the contestability period has expired, the policy generally becomes incontestable except in cases of fraud.

Contestability protects insurers from inaccurate disclosures while ensuring fairness to honest applicants who provide complete and truthful information. It also reinforces the importance of accuracy during the underwriting process.

Example:

If you apply for a life insurance policy and fail to disclose a serious medical condition, and you die within the two-year contestability period, the insurer may investigate and deny the death benefit if it determines that the omission affected the underwriting decision.

What to Watch For:

Always provide complete and accurate information on your application to avoid claim disputes. Even minor inaccuracies can trigger a review if a claim occurs during the contestability period. Keep a copy of your application for reference, as insurers rely on the original answers when assessing eligibility and claims.

Related Terms

Calendar Year

The calendar year defines a benefit period that runs from January 1 to December 31. Many annual maximums, deductibles, and claim resets follow this schedule. It provides a consistent framework across most insurers and simplifies tax reporting for medical expenses.

Certificate of Insurance

A certificate of insurance is an official document issued by an insurance company that summarizes the key details of your coverage. It serves as proof that you are insured and outlines the essential terms of your policy, including the type of coverage, effective dates, benefit limits, exclusions, and any dependents or beneficiaries listed under the plan.

Claim

A claim is a formal request you or your healthcare provider submit to your insurance company to receive reimbursement or direct payment for eligible medical or dental expenses covered under your plan. Submitting a claim provides the insurer with the necessary information - such as receipts, treatment details, and provider information - to verify the service and determine the amount payable according to your policy’s terms.

Claim Submission Deadline

The claim submission deadline is the final date by which an insured person must submit a claim to their insurance company for reimbursement of eligible expenses. After this date, the insurer is not obligated to pay the claim, even if the expense itself would have been covered. This deadline ensures timely processing, accurate recordkeeping, and proper financial reporting for both the insurer and the policyholder.

Claimant

A claimant is the person who submits a request for reimbursement or payment under an insurance policy. In health and dental insurance, the claimant is usually the insured individual who received the service, such as a medical treatment, prescription, or dental procedure. However, a claimant can also be a parent, spouse, or legal guardian submitting a claim on behalf of a covered dependent.

Have questions about your insurance coverage?

Our licensed advisors can help you understand your options and find the right plan for your needs.

Contact Us