November 19, 2015 - Issue No. 16
New street address? Closing a facility? New director or partner? The law says you must report business changes like these to FSCO within five days. And now it’s easier.
Go to your online FSCO account, Request a Change, and simply upload electronic copies of supporting documents, such as proof of identity or proof of address.
On site examinations: What we’re learning
FSCO continues with on-site examinations of licensed service providers. The examinations are helping FSCO to ensure the completeness and accuracy of licence applications and to educate providers on how to be compliant with the Insurance Act and regulations. As well, FSCO is identifying areas where service providers may need more guidance.
In the last 11 months, FSCO completed more than 500 examinations of licensed service providers – over 10 percent of the licensed service provider population. So far, the top three findings among entity types break down as follows.
Rate of occurrence
|Patient ID not verified||27% ||53% ||37% |
|No policies and procedures in place||28% ||32% ||35% |
|OCF forms left unsigned||25% ||16% ||32% |
Many of the findings FSCO examiners encountered could result in enforcement action such as administrative monetary penalties, suspension, or licence revocation. Although FSCO’s primary focus in these early months of regulation is on education, these levels of non-compliance are unacceptable and FSCO is considering a shift in its regulatory respones.
Service provider input
Many service providers have used the examination exercise as an opportunity to discuss their particular concerns with FSCO compliance officers. The most common issues involved insurance companies and late payment of OCF-21s, and inconsistent or unclear requests for statutory declarations with information to support invoices.
FSCO continues to track service provider feedback from the on-site visits and will use this information to plan future insurer examinations.
FSCO will publish a full report on this year’s the service provider examination findings.
Changes coming to standard auto insurance coverages
In this year's Budget, the Ontario government announced reforms to the automobile insurance system that will take effect June 1, 2016. Here are some of the changes of interest to service providers:
- For catastrophic impairments, the standard level for medical and rehab benefits will combine with attendant care benefits and have a total limit of $1 million.
- For non-catastrophic impairments, the standard level for medical and rehab benefits will combine with attendant care benefits and have a total limit of $65,000.
- For non-catastrophic impairments, the maximum duration of medical and rehab benefits will be reduced from 10 years to five years, except for children.
- The definition of catastrophic impairment will change to be consistent with up-to-date medical information and knowledge.
- Goods and services not explicitly listed in the Statutory Accident Benefits Schedule will be subject to insurer agreement that they are essential for the claimant.
- Auto insurance policyholders can continue to purchase increased optional coverage levels for both standard and catastrophic medical and rehab.
For more information about the Ontario auto insurance reforms go to:
The next eNewsletter will discuss the impact of the reforms and how they will change Ontario Claims Forms such as the OCF-18, OCF-21, and OCF-23.
Buying or selling a FSCO-licensed Service Provider business? Contact FSCO for more information on how to proceed.
Where to go for more information
Toll free: 1-800-668-0128