The Ontario Insurance Commission (OIC) has released the Third Edition of its Dispute Resolution Practice Code (Code). The Rules issued within the Code are made by the OIC's Director of Arbitration under the authority of section 21 of the Insurance Act and section 25.1 of the Statutory Powers Procedures Act.
The Code is the chief source of comprehensive and easy-to-read information on the procedures the OIC has set out for insurance companies, the public and their representatives, in the resolution of disputes over claims for statutory accident benefits. The Dispute Resolution services at the OIC include mediation, arbitration, appeals and variation/revocation. Neutral evaluation is available through arbitration at the OIC. The Rules of Procedure portion of the Code will apply to all new applications as well as existing cases in the dispute resolution process as of April 15, 1997.
The Third Edition refines and expands on the Second Edition, dated August 1, 1995, Update # 1 issued on June 1, 1996, and Update # 2 issued on November 1, 1996. The Third Edition reflects changes to Ontario's automobile insurance legislation with the introduction of the Automobile Insurance Rate Stability Act, 1996 (Bill 59), and incorporates improvements arising out of extensive consultations with industry and client stakeholders. It also draws on the experience gained by the OIC after conducting hundreds of mediations and arbitration hearings.
Key Changes in the Third Edition
Users should be aware of a number of important changes in the Third Edition of the Code.
To facilitate the transition from the Second Edition to the Third Edition, the format and organization of the Code has been kept the same.
Some of the highlights are reviewed below and more detailed summaries are provided in the attached appendices.
Extensive changes have been made to Section A - Rules of Procedure (Rules). There have been additions to the definitions and significant revisions to the Rules themselves. The Third Edition has 80 Rules of Procedure, up from 73 in the Second Edition. However, this section retains the same six subsections and titles. A summary of some of the key changes to the Rules of Procedure can be found in Attachment A -- Key Changes to the Rules of Procedure. Please keep in mind that this summary contains a selection of key changes, but is not a comprehensive description of all of the changes.
Note: the greater number of new Rules has also resulted in changes to the numbering of the Rules. For example, the Rule pertaining to an Application for Arbitration was Rule 24 in the Second Edition. In the Third Edition, the rule pertaining to an Application for Arbitration is Rule 25.
Section B - Commissioner's Guidelines, contains two new guidelines, two revised guidelines and two Bill 59 versions of existing guidelines. Three previously issued guidelines are now time-limited. These changes are detailed in OIC Bulletin No.A-12/96. A one-page excerpt from OIC Bulletin No. A-12/96 can be found in Attachment B -- Summary of Commissioner's Guidelines.
Section C - Practice Notes, contains two new Practice Notes, and three revised Practice Notes. The two new Practice Notes are Practice Note 5, "Mediator Referral to Neutral Evaluation," and Practice Note 9, "Process for Settling Disputes Between Automobile Insurance Companies (Reg. 283/95)". Practice Note 1, "Using Medical Evidence to Support Your Claim for Accident Benefits," and Practice Note 4, "Exchange of Documents," contain extensive revisions. Practice Note 8, "Adjournments," has also been revised.
Note: the addition of two new Practice Notes has resulted in changes to the numbering of the Practice Notes. For example, the Practice Note entitled "The Abitration Prehearing Discussion," was Practice Note 5 in the Second Edition, but is Practice Note 6 in the Third Edition. In addition, the title and numbering of Practice Note 6 in the Second Edition, "How to Summons a Witness to an Arbitration Hearing," has been changed in the Third Edition to Practice Note 7, "Attendance of a Witness to An Arbitration Hearing by Summons".
Of particular note is Section D - Fees and Assessments. It reflects changes to the OIC's insurer assessments for dispute resolution services at the OIC, as outlined in Ontario Regulation 107/97. The regulation reflects an insurer assessment of $1,000 for neutral evaluation, and, if the matter proceeds to arbitration at the OIC, a further assessment of $2,000. If the case proceeds directly to arbitration, the insurer assessment is $3,000 for an insurer named as a party to an arbitration proceeding. Please refer to OIC Bulletin No. A-3/97, issued on April 1, 1997, for more information on Regulation 107/97.
There are no changes to Section E - Settlement Regulation.
Section F - Expense Regulation, was amended to allow arbitrators to award expenses to insurers as well as claimants under provisions of Bill 59. Please refer to OIC Bulletin No. A-13/96, issued on October 31, 1996, for more information.
Section G - Forms, contains samples of all forms used by the OIC's dispute resolution services. Six existing forms have been modified and two new forms have been introduced as a result of Bill 59. An additional form required in the OIC dispute resolution process has also been introduced. Changes to these forms are detailed in OIC Bulletin No. A-13/96. A one-page excerpt from OIC Bulletin No. A-13/96 can be found in Attachment C -- New and Revised OIC Dispute Resolution Forms.
Note: since the release of OIC Bulletin No. A-13/96, minor changes have been made to the Notice of Appeal and the Response to Appeal, as well as the Application for Variation/Revocation and Response to the Application for Variation/Revocation forms. For example, the wording on the Application for Variation/Revocation and the Response to the Application for Variation/Revocation forms have been modified to inform applicants that the form can be used to oppose an application for variation or revocation filed by the other party to an arbitration or appeal order. The most current versions of these forms are included in the Third Edition of the Code.
Availability and Pricing of the Code
The Code has been sent to the Alternative Dispute Resolution (ADR) Co-ordinators of all insurance companies licensed to transact automobile insurance in Ontario.
Additional copies of the Code may be obtained from:
880 Bay Street
Telephone: (416) 326-5320 (within Toronto)
1-800-668-9938 (outside Toronto)
Fax: (416) 326-5317
The cost of the Code in either English or French is $15.00. A bilingual version costs $30.00.
Bulk Orders of Forms
Bulk orders of forms are available from printers such as:
35 Bertrand Avenue
A complete list of printers from whom bulk forms may be obtained is included in the Introduction of the Code.
CD ROM/ Website Access
A CD ROM version of the Code containing both English and French versions of the Code will be available from Publications Ontario in May 1997. The cost will be $15.00. Effective May 1, 1997, the Code will be posted on the OIC's website at http://www.gov.on.ca/OIC.
To improve consumer access, the Code will be sent to all public libraries, and may be found in legal publications which report on the OIC decisions.
If you have any comments about the new Code, please write to the Dispute Resolution Group at the OIC. Their mailing address is Dispute Resolution Group, Attention:
DR Code Co-ordinator, 5160 Yonge Street, Box 85, North York, Ontario, M2N 6L9. The fax number is (416) 590-7077.
April 10, 1997