The Ontario Insurance Commission (OIC) wishes to draw your attention to a new Regulation that outlines a process for settling disputes between automobile insurance companies when it is unclear which company is liable to pay for benefits.
The new Regulation provides protection to injured accident victims who may be entitled to benefits and are caught in the middle of these disputes. Insurers that first receive an application for accident benefits will now be required to pay benefits pending the resolution of these disputes.
The Regulation was developed in consultation with the insurance industry. It came into force on May 27, 1995, as published in The Ontario Gazette.
Background
Section 268 of the Insurance Act sets out a priority ranking for determining which insurer is liable to pay for accident benefits in situations where more than one insurer may be liable to pay for benefits. However, difficulties have emerged in resolving these disputes between companies: some claimants who have been entitled to benefits have been subject to delays in payments.
The Regulation outlines a private arbitration process to resolve these inter-company disputes. This means that disputes which arise after the regulation comes into force will no longer be resolved through the dispute resolution system operated by the OIC.
Claimants will be notified of this process through the approved form entitled "Notice to Applicant of Dispute Between Insurers". In addition, claimants will also have the right to object to any transfers of their claim to another insurer.
We are also enclosing several charts, prepared by the Insurance Bureau of Canada (IBC), that interpret the priority ranking set out in section 268 of the Act. These charts originally appeared in the IBC's All Members General Bulletin No. 162, dated April 13, 1995. Insurers may find this chart helpful in determining the priority of automobile insurance policies.
Attachments
We are attaching, for your information, a photocopy of:
- Ontario Regulation 283/95 - Disputes Between Insurers.
- The approved form, "Notice To Applicant of Dispute Between Insurers".
- Each of the three (3) "Priority of Payments" charts prepared by the IBC.
To obtain the approved form
To receive a copy of the form "Notice to Applicant of Dispute Between Insurers" in French or English, please send your request by fax to the OIC at (416) 590-7070, Attention: Administrative Officer.
D. Blair Tully
Commissioner of Insurance
May 29, 1995