AB Mediation Backlog

35,000 cases and counting.  What happens when the dam bursts?

Under the current Ontario Insurance Act, if you have a dispute with an Insurer involving the payment of accident benefits under the SABS (Statutory Accident Benefits Schedule), you must file for mediation with the Dispute Resolution Practice Group (DRPG) at FSCO (Financial Services Commission Of Ontario). This mediation must take place before the claimant can proceed to the courts through a law suit or by arbitration (again to be filed with the Dispute Resolution Practice Group).

The Act provides that such mediation shall take place within 60 days of the filing date with FSCO.  FSCO have found themselves facing some staffing issues and an unusual volume of cases being presented which resulted in a backlog of about 35,000 mediations.

The Auditor General of Ontario commented on this situation and FSCO has posted an RFP for outside services to assist in aggressively attacking the backlog.  One of the problems may be, however, what happens when the case is not settled at mediation.  If only 60% settle, 40% of these or 14,000 new cases will appear before the courts or at arbitration within the next few years.  Are we ready?

A great article in the Law Times talks a bit more on this subject.

We can help Insurers to get ready for mediations, and coach on mediation best practices.

Let us know if we can help! 

Thanks for reading,

Jim Cameron

Understanding Accident Benefits: A Primer for Brokers & other Insurance Professionals

We’re excited to announce that we will be delivering an Intro. to AB workshop on May 2nd at the Insurance Institute in Toronto.

We would love to see you there!  Our last courses on this topic were a big hit.

This one-day course is meant for someone with little-to-no claims experience, and will give a general overview of what benefits are, and some claims handling procedures.

Check out the Institute’s website for more information and registration.

Mediation Assistance Program for Insurers

At Cameron & Associates, we are pleased to announce our new Mediation Assistance Program (M.A.P.) for Insurers.

Are you ready?

FSCO has recently initiated a project to clear the backlog of over 30,000 mediation requests.

Implications for insurers:

  • Your AB team will receive an influx of mediation scheduling requests
  • Your ADR team and claims handlers will experience a dramatic workload increase to prepare for mediations
  • Your senior claims handlers will be preparing for mediations, spending less time on active files

At Cameron & Associates, our M.A.P. team is ready and available now for claims handling while your team readies for mediations.  Our highly skilled Accident Benefits team provides on-site assistance to insurers on long and short-term contracts.

What our M.A.P. Team can do:

  • Full AB file handling from Med./Rehab. to Catastrophic Claims
  • Mediation brief preparation

Help with individual tasks within the AB department:

  • Respond to incoming forms & mail
  • Make initial calls & return calls on AB claims
  • Identify red flags indicating possible fraud
  • Reserve worksheets
  • Processing & requesting payments
  • Correspondence to claimants
  • HCAI notification clearance

Please let us know how our team can support you.

Brian Grieve, Operations Manager via phone: 416-350-7359 or email: *protected email*

Nicole Langley, Training & Business Development via phone: 416-306-2857 or email: *protected email*