No. A-04/09
Property & Casualty
– Auto

Updated Professional Services Guideline and Pre-approved Framework Guideline

To the attention of all insurance companies
licensed to transact automobile insurance in Ontario

With this Bulletin, the Financial Services Commission of Ontario (FSCO) is releasing an updated Professional Services Guideline and an updated Pre-approved Framework (PAF) Guideline for Grade I and II Whiplash Associated Disorders (WAD I and WAD II). 

The updated guidelines incorporate a 2.3 per cent increase in fees based on the 2008 Consumer Price Index for expenses related to services rendered on or after August 1, 2009.

Authority

The Professional Services Guideline is issued by FSCO under subsection 268.3 (1) of the Insurance Act for the purposes of subsections 14 (4), 15 (6), 17 (2) and 24 (2) of the Statutory Accident Benefits Schedule - Accidents on or After November 1, 1996 (SABS).  The PAF Guideline is issued by the Superintendent under subsection 268.3 (1.1) of the Insurance Act.

Changes

The updated Professional Services Guideline released with this Bulletin increases the maximum hourly rates by 2.3 per cent for services rendered on or after August 1, 2009.  The effective date for the updated Professional Services Guideline is August 1, 2009.

The fees outlined in Appendix B and C of the PAF Guideline for WAD I and WAD II are also being increased by 2.3 per cent for services rendered on or after August 1, 2009. 

The updated PAF Guideline for WAD I and WAD II is effective August 1, 2009.  It will apply to all new Pre-approved Framework Treatment Confirmation Forms (OCF-23) that are submitted by a health practitioner on or after August 1, 2009, or when the insurer has waived the requirement for an OCF-23 on or after August 1, 2009. 

Expenses prior to August 1, 2009

The Superintendent’s Professional Services Guideline No. 01/08 continues to apply to expenses related to services rendered between July 1, 2008 and July 31, 2009, whether they are billed before or after August 1, 2009. Similarly, the Superintendent’s PAF Guideline for WAD I and II Injuries No. 02/08 continues to apply to goods and services rendered between July 1, 2008 and July 31, 2009.

Copies

The Professional Services Guideline and the PAF Guideline for Grade I and II Whiplash Associated Disorders are attached for your information and can also be downloaded from the FSCO website at www.fsco.gov.on.ca. The guidelines will also be published in a forthcoming edition of The Ontario Gazette.

Bob Christie
Chief Executive Officer and
Superintendent of Financial Services

July 13, 2009

Attachments:                       

• Pre-approved Framework Guideline for Grade I and II Whiplash Associated Disorders (PDF)
• Professional Services Guideline (PDF)