​New Licensing Requirements for Service Providers Billing Auto Insurers: 2014

Issue No 1, December 2013


ATTENTION: This information must be forwarded to senior officials of every business that submits invoices through Health Claims for Auto Insurance (HCAI) [New Window] for payment by insurers of Statutory Accident Benefits (Service Providers).

Does your business currently invoice auto insurers directly on an Auto Insurance Standard Invoice (OCF-21) through HCAI?

If so, as of the fall of 2014 the business will need to be licensed under the Insurance Act as a Service Provider with the Financial Services Commission of Ontario (FSCO) to continue receiving direct payments from insurers. If a service provider is not licensed by the relevant date in 2014, the service provider will have to bill claimants directly instead of auto insurers.

The application process is expected to begin in the spring of 2014.

In the 2013 Ontario Budget [New Window], following the Report of the Ontario Automobile Insurance Anti-Fraud Task Force [New Window], the government committed to take further action to tackle fraud in the auto insurance sector. Among other measures announced, the government signalled its intention to expand FSCO’s mandate to include licensing and regulating businesses that invoice auto insurers for Statutory Accident Benefits (Service Providers). These are typically health and rehabilitation clinics, or businesses engaged in providing assessments and examinations for auto insurers.

What will FSCO regulate?

FSCO will regulate the business and billing practices of Service Providers, i.e., businesses that invoice auto insurers for Statutory Accident Benefits. This licence will authorize Service Providers to receive direct payments from auto insurers for specific listed expenses.
Licences will be issued at the business entity level not the branch or facility level. This means that only one licence is needed to cover all of a business' facilities, branches or locations that invoice auto insurers for Statutory Accident Benefits.

Subscribe to FSCO's monthly Service Providers eNewsletter

FSCO will provide regular updates on the licensing framework and its requirements through a monthly newsletter. We thank HCAI for routing Issue 1 of FSCO’s Service Provider eNewsletter to their registered facilities, on FSCO’s behalf. If your business is registered with HCAI, subscribe now to receive licensing updates directly into your inbox, every month.

Questions? There's more information on FSCO's website.

Take a look at FSCO's FAQs for additional information.

What is FSCO?

FSCO is a regulatory agency of the Ministry of Finance who regulates certain financial services sectors conducting business in Ontario (read more). FSCO and HCAI work collaboratively on various initiatives to fight fraud in Ontario's auto insurance system.