Company Forum Minutes of Meeting - December 7, 2006

Insurer Representatives   FSCO – DRS
Mike De La Haye (chairperson)
Mina Coslo
Adam Fox
Thomas Phin
Vera Babig
Martine Vaz
Mary Wright
Shabnam Shamlay
David Alpert
Sharon Lennox
Cassandra Phillips
Trevor McCallum
Tom Walsh
Scott MacDonald
Bridget Donato
Becky Cameron

David Draper
John Lobo
Susan Sapin
Alex Fadel


Special Guest
Catherine Zingg



The meeting was called to order at 10:00am on December 7, 2006.

The minutes of the last meeting were approved, with one minor amendment.

Issues Addressed during the Opening/Statistical Presentation

Several insurers addressed their concerns around the mediation/ arbitration process, specifically the issue of the claimant not showing up and being present for the process because it results in a lot of wasted time for everyone concerned and is unfair as the Insurer is expected to attend or face consequences. FSCO will review this issue.

One possible solution discussed was the delisting of those representatives who are repeat offenders.

Another issue raised by the group is an increase in the number of facilities representing claimants for the purpose of invoice payments. In these circumstances the claimant in effect has two representatives.

Mediation Statistics and Issues - John Lobo

Mediation Intake- there is a slight increase over last year (132 files for 2006 for week ending December 1, 2006). There was an increase in November compared to August -October 2006.

Average Processing time: FSCO made some progress in bringing down processing time between initial open to assigning (20 calendar days in November compared to 24 calendar days in October. )

Admin Closures: No issues in dispute was the largest ‘closure’ category (73 of 108)

Settlement Rate (Nov 06):
Full settlement up to 42%
Partial settlement at 16%
Failure down to 42%

Arbitration Statistics
– Susan Sapin

There has been an increase in Arbitration applications over the past month, and an increase in the percentage of claimants represented when they file for Arbitration. There are 5 decisions currently in typing, which will bring down the age of outstanding decisions. For Processing, more cases were closed in the months of September, October, and November then were received.. More pre-hearings have been heard this year. 

199 decisions have been issued so far in 2006. 

Appeal Statistics - David Draper

There were a number of decisions recently released. A low number of appeals are coming in.

FSCO Matters:

Alex Fadel- Alex informed the group that the consultation paper regarding possible changes to the regulatory environment but they are waiting for the Court of Appeal decision regarding whether MVAC is considered an Insurer before they can proceed further. Alex noted that there were limited submissions/suggestions from the Insurers, and they are prepared to still accept comments/ feedback on the proposal.

David Draper- Operational Issues- Currently FSCO is reviewing the internal work flow and will be consulting with the Counsel forum and Insurers for feedback on efficiency improvements that can be made- most likely in a questionnaire format for Insurers to respond to. Asking for Insurers to respond electronically and from there FSCO may ask for further consultation. Insurers should expect the questionnaire in mid-December and FSCO would need a response by mid-January. Insurers have requested that FSCO send out the questionnaire in the early New Year, or at least a reminder, as this is a busy time of year for everyone. One suggestion made was use of an electronic calendar to book mediations.

Staffing- The Arbitration unit is fully staffed with 23 Arbitrators and 1 Mediator was brought in for contract for mediation purposes. Insurers requested that John provide us with a new phone list with the mediator names.

Website – More on-line forms are on the way. The search engine is being reviewed. 

Other Issues: 

  1. There was a concern addressed that Insurers have had some difficulty in working with some of the FSCO mediators, and wanted to stress to FSCO that mediation needs to be a fair and equitable process that accommodates both sides. The issue of booking beyond the 60 day deadline was also raised, and the need for all sides to be flexible for scheduling purposes. One idea raised was the possibility of drawing mediations from a pool of mediators based on availability rather than file assignment.
  2. Arbitrations- some of the form letters coming from FSCO following the initial Arbitration notice are not coming in with claim numbers or loss dates to the Insurer, making this correspondence difficult to track and match up. FSCO and the Insurer will investigate the issue to see where the problem is.
  3. Insurer Mediation List- A comment was made that FSCO’s pick list of who has binding authority to represent an insurer is not always current. It was suggested that FSCO contact the ADR coordinator at the company where there is an error before refusing to allow that person to participate in the mediation.
  4. Clinics pre-signing treatment plans and other forms- Insurers have come across situations where claimants have signed a number of blank forms so they do not even know what treatment has been submitted for Insurer consideration- would like FSCO to be aware of the position the insurer is taking. FSCO suggested that this issue be noted in the mediation response if the Insurer is raising it on a particular file.
  5. Definition of what is considered ‘experimental’. Is investigative experimental? FSCO pointed out that there is no link between the legislation and OHIP with respect to any definition in this regard and it needs to be reviewed on a case by case basis.

  6. Bill 14- Law Society is taking over the regulation of Paralegals but the time frame is uncertain- October 2007 is estimated. The definition of provision of legal services is quite broad and this is a concern- interpretation may be that ADR representatives for companies would need to be regulated.
  7. HCAI- the Pilot Project for HCAI is likely starting in January as the approval was just received. The Pilot at the selected companies will likely last 1 year and then HCAI will be rolled out to the Industry. Legislative changes did come through recently.

Next Meeting

The next meeting will be March 8, 2007 at 10:00am @ FSCO

The 2nd meeting of 2007 will be June 7, 2007 at 10:00am @ FSCO

Minutes - Becky Cameron