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:  *protected email* or 416-306-2857

Brian Grieve, Vice President: *protected email* 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.

Arbitration Advocacy Presentation

I attended the Arbitration Advocacy presentation by the Advocates Society on March 27th.

This was the first such session presented by the Advocates Society and included a review of the myriad legislation existing both in Canada and Internationally on Commercial Arbitrations. Experienced practitioners discussed cultural and legal system differences that were highlighted by some fascinating tales of intrigue and hijackings of witnesses. It did, as a questioner pointed out, reinforce the value of arbitration in international off shore contractual disputes instead of having to resort to the local courts.

Great session.  I recommend you keep an eye out for more like this.  If you have any questions, please call or email me directly: *protected email* or 416-350-5823

Thanks for reading,

Jim Cameron

 

New Vice President Announcement

Jim Cameron is pleased to announce the promotion of Brian Grieve to Vice President of Cameron & Associates Insurance Consultants.

Brian has been invaluable to us since joining Cameron in the role of Operations Manager. He is a key contributor to our past successes and will continue to monitor and manage our anticipated rapid growth in the exciting times ahead.

Congratulations, Brian!

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*