Optional Accident Benefits Case

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.

Thomson Rogers did a write-up on this case in their March issue of The Accident Benefits Reporter.

So, brokers, insurers & direct writers, continue to dot your i’s and cross your t’s!

 

Mediation Skills Workshop

We are excited to announce that we have expanded our “Mediation Assistance Program” to include a Mediation Skills Workshop.

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.

Topics discussed:

  • File & strategy preparation
  • Challenges in file management
  • Information on relevant regulations, practice notes & forms
  • Mediation process & goals
  • Mediation behaviour & etiquette
  • Communication skills
  • 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.

Contact Us

Nicole Langley, Training & Business Development:  or 416-306-2857

Brian Grieve, Vice President: or 416-350-7359

Toronto Commercial Arbitration Society Membership

We’re pleased to announce that the President of Cameron & Associates, Jim Cameron, has been accepted as a member of the Toronto Commercial Arbitration Society.

Jim is honoured to be part of such a great group of arbitrators.

From the Toronto Commercial Arbitration Society’s website:

TCAS mission statement

To promote and develop in Toronto a world centre for arbitration excellence to resolve international and domestic disputes by providing

  • qualified arbitrators,
  • exceptional facilities,
  • experienced counsel,
  • innovative research, and
  • a supportive legal environment regardless of the location of the parties or their systems of law.

And to promote the use of arbitration to resolve commercial disputes by

  • developing alliances with other arbitral organizations and centres of learning,
  • sponsoring international conferences featuring preeminent practitioners as speakers,
  • advocating supportive international and domestic legislation, and
  • providing a forum and network for the exchange of ideas on all aspects of international and domestic arbitration
  • promoting and understanding of available rules and arbitral institutions to facilitate commercial arbitration.

Congratulations, Jim!

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.