The Dispute Resolution Group – Companies Forum includes representatives from auto insurance companies dealing with disputes before the Commission involving motor vehicle accident claims and Statutory Accident Benefits. It consults with the Dispute Resolution Group of Financial Services Commission of Ontario on issues relating to the dispute resolution system.


Introduction of new members

Review and Approval of Minutes from March 12, 2009
No changes made.

Matters arising from the Minutes
No matters arising from the minutes.

Overview of 5 year Review Report by Margaret Orlander

• There is no hard evidence that there will be change.
• Ministry office says there will be some info in June.
• This is the first time for the 5 year review.
• FSCO requested submissions for the 5 year review and received over 90.
• Accident Benefit loss costs have increased since 2004 (assessments, caregiver benefits, attendant care).
• Key Recommendations (short term) – refer to online document (http://www.fsco.gov.on.ca/English/insurance/auto/5yr-review/5yrRevReport09.pdf) in Executive Summary (7-8 pages).
• Drafting expected by Fall 2009, effective date to be 2010.
• FSCO is trying to reduce overall complexity of SABS.
• Discussion of a $25K limit including the assessments – we currently have a $100K limit that doesn’t include assessments – maximum $2000 per assessment up to $25K.

Question? Won’t this just increase cost of assessments?

Defining Regulations

• Question? Is there any discussion about extending the deadline? Currently we have 3 business days.
• Comment paperwork involved in day-to-day work for the adjuster is excessive, the process needs to be streamlined – the adjuster is spending more time processing paperwork than adjusting files.
• Question? Any considerations on 1 year limitations on settlements? `
  No

HCAI

• Comment – change to language “shall” to “may” pay clinic directly (S.44).
• Comment – Section 65 doesn’t allow claimant to assign benefits to someone else.
• Discussion about documents with original signature as opposed to an electronic signature.
• Margaret will send doctor’s electronic version.

MARS update by Asfaw Seife

• Want to expand DRCD to clients. Currently only available to mediators and insurance companies but there are privacy and confidentiality issues to consider. Asked for claim numbers and issues to be added. Also looking at ways to eliminate faxback sheets.
• claim number is on DRCD only if claim number is provided to FSCO.
• We have more developments on smart forms.

Outreach Committee Update by Asfaw Seife

• April 21-22, 2009 to conduct face to face mediations/arbitration pre-hearings.
• Most cases settled.
• Didn’t have large numbers as hoped, because of timing, etc.
• More discussions are ongoing as to whether to expand in outlying areas.
• Comment biggest problem was scheduling, maybe solution is to have set times in GTA vs. outside of GTA.

DRS Statistics and Staffing

Mediation update by John Lobo (refer to handout)

Reviewed statistics provided by FSCO

• Comment  Mediation Settlement Blitz – didn’t go well…only used about 5 files. Suggested DRS send insurer file >1 year old “These are over a year old, do we want to settle them?”
• Sounds like something can be done…more discussion…open call for suggestions…
• Comment We have a concern with the backlog of mediations.  There is a concern with our ability to book within 60 days.
•  Comment batching from DRS is problematic…costing more because they have to go out to counsel.
• Question? In respect of the mediation backlog is there a possibility of using student law clerks that are supervised by the Director. Answer: There are labor implications (unionized).
• Question? Has FSCO received lots of complaints due to the backlog?  Answer:  not to the extent that you would expect based on the number of backlogged files.

Arbitration / Appeals update by Asfaw Seife (refer to handout)

Reviewed statistics provided by FSCO

• Appeals p. 13 Released decisions within 85 days have significantly improved.

Judicial Review Update by Asfaw Seife

Update since March 2009 –
Murugappa v. Aviva Canada (FSCO P06-00036, May 1, 2008)
 Hearing date set for June 18, 2009

Question a rise in judicial review? Would FSCO tell a claimant that they have no other avenues to pursue?

Answer: FSCO Arbitrators don’t have that authority.

Next Meeting Dates

September 10, 2009
December 10, 2009
March 11, 2010

Minutes by:  Sandy MacSpadyen, Direct IME