Each day we’re seeing more & more impacts on the claims process & findings due to the Ontario Statutory Accident Benefits Schedule change effective September 2010.
One of the implications for direct writers, agents & brokers is the additional optional benefits. Each company has developed a strategy on how to offer these benefits & how to track a client’s acceptance or decline of these benefits. The implications of how this is documented can have legal consequences, as demonstrated in the case Zefferino V. Monnex. The reason that this case ultimately failed is because the client did not prove that she would have purchased these benefits, had they been adequately explained to her.
In this one-day workshop, you will receive tips & coaching in Mediation Best Practices through examples, demonstrations & role-plays. We will help you to effectively prepare for & participate in mediations.
File & strategy preparation
Challenges in file management
Information on relevant regulations, practice notes & forms
Mediation process & goals
Mediation behaviour & etiquette
Settlement practice tips
Stay tuned for our next scheduled session, or let us know how we can tailor this workshop to meet your specific needs.
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?