AGENDA
- Review and Approval of Minutes from Previous
Meeting - December 13, 2001 - Overview of Policy Development and Consultation Process
- Statement of Priorities and Auto Reform
B. Dudzinski / A. Bythell - New Quarterly MARS Statistics Reports
B. Dudzinski - AISI Update
M. Orlander - Smith v. Cooperators - Supreme Court Decision
M. Delahaye - Amendment to Bill 59 Disclosure Statement
M. Delahaye - Multiple Mediations
A. Fox - Position Paper
- $500 Fee
M. Rubenstein - Paralegals & the FSCO
M. Rubenstein - Insurer Committee
M. Rubenstein - Other Business
11-1. List of Mediators' Contact Numbers
Minutes of Meeting June 13, 2002
Attendees
Insurer Representatives:
Mary Wright Royal & SunAlliance
Mike De la Haye Wawanesa
Michael Rubenstein Kingsway
Adam Fox Belair Direct Insurance
FSCO-DRG: Margaret Orlander FSCO
Ann Bythell FSCO
Barbara Dudzinski FSCO
David Braund FSCO
The Dispute Resolution Group Companies Forum (Companies Forum)- includes representatives from auto insurance companies dealing with disputes before the Commission involving motor vehicle accident claims and statutory accident benefits. It consults with the Dispute Resolution Group of the Financial Services Commission of Ontario on issues relating to the dispute resolution system.
The scheduled meeting of the Companies Forum commenced at 10 A.M. on June 13th.
- Approval of Minutes
The minutes of the previous meeting were approved.
- Role of Companies Forum in Policy Development
Ann Bythell spoke to recent questions raised about the scope and function of the Companies Forum. She described the difference, for FSCO as a government agency, between policy determined in the political arena, and operational issues determined in the Commission to implement the political will expressed through legislation. Although Companies Forum can be used to discuss broad policy issues, and FSCO staff will ensure that areas of consensus are passed on through appropriate channels, the industry can find more direct ways to seek major changes in the law. By contrast, matters of operation are largely within the control of FSCO, and these are always open for discussion in the Forum.
A discussion of this distinction followed, in which the greatest attention was devoted to the mediation fee (see below). Some members are concerned that all of their policy concerns cannot be answered within the Forum.
- Mediation Fees
A member expressed strong concerns about fraudulent claims being brought to mediation, and the use of mediation assessments to leverage deals from insurers in inappropriate cases. Concern was also expressed about the use of multiple filings for mediations related to the same claim as a means of driving up insurer settlement offers.
Mary Wright confirmed that the DRG Companies Forum only became aware of the $500 mediation fee after it's implementation. The group had not provided feedback prior to the implementation of the fee.
Barbara Dudzinski expressed that there is active consideration within the industry and within the Government about whether the optimal assessment system to recover FSCO costs is through market share assessment or charges related to individual files . She said that, based on initial feedback, mediation fees were originally implemented, although it was understood that some companies would not be in support of this approach.
- Auto Insurance Reform
The status of this project was of great interest and generated extensive discussion about the pace of reform and key issues.
- SCC Decision in Smith and Cooperators
This is a decision of the Supreme Court of Canada, which determined that communication of refusal of benefits was not effective unless there was full insurer compliance with the notification requirements in effect at the time. It was pointed out that FSCO forms should be designed to ensure that insurers using them would be in full compliance with requirements of the Act. Margaret Orlander said that FSCO was aware of this problem and would be reviewing the relevant forms.
- Amendment to Bill 59 Disclosure Statement
It was proposed that entitlement to case management benefits should be information set out in the disclosure statement required for settlement purposes. Margaret Orlander noted that this suggestion had been made to Roberto Pegoraro and their group is looking into this.
- AISI Update (Standard Invoice)
The Standard Invoice was introduced as a FSCO authorized form in October, 2001. Since that date there have been numerous concerns expressed by both health care providers and insurers in the field. As well, concerns have been heard about administrative costs associated with completing the form and what insurers do with incomplete forms. Other issues include, consent surrounding the collection of information on the form, the eventual creation of a database to store this information and associated privacy issues.
Margaret Orlander reported that on May 17, 2002, FSCO convened a forum for insurers and representatives of health care provider associations. The forum resulted in the formation of a working group made up of IBC members, insurers and provider association reps who will look at revising the standard invoice, treatment plan and disability certificate forms. They will look at what information is needed and when and also how this information can best be provided. FSCO will then be presented with the draft-revised forms. Margaret said that it was agreed that there will be a FSCO staff member on the working group as well. The larger stakeholder group will meet again in July at a similar meeting to be convened by FSCO and will get an update as to the progress of the working group.
- Paralegals in the DR Process
Members discussed various problems that arise in the DR process through the representation, and the improper procedures adopted by some paralegals. Ann Bythell agreed that there are concerns about a small number of paralegals not supervised by law firms. At the Conference of Ontario Boards and Agencies to be co-chaired by her in November one of the subjects to be discussed is the issue of paralegals appearing before Ontario Tribunals. There was also mention of arbitration and appeal decisions, which have criticized paralegals and decided issues, which show a readiness to control the integrity of the process.
The FSCO was/is working on an operational process to provide claimants with a pckage that explained the implications of being represented by a non-lawyer. The IBC has subsequently indicated that they are waiting for this to come into place.
- New Quarterly Statistics Report
Barbara Dudzinski introduced the three new reports --one for each of mediation, arbitration and appeals – presenting comparative date for the last four completed quarters. The data presented is more extensive and is focused on the performance measures for each of these areas.
Barbara Dudzinski asked that members indicate whether these reports fulfill their requirements for information. FSCO is encouraging members to comment upon the details of the report, and for the purpose of analyzing whether the new reports need modifications, the old reports were provided for comparison.
Mediation Report
An example of the new data is a feature, which tracks the completeness of the filed mediation applications. This allows a better breakdown of the time for processing a mediation application, differentiating those that were complete when received, and those that required more extensive work. A significant amount of detail is provided about the reasons for closing files, and about the various results of the files. The number of Reports issued is included because this is the basis of the mediation assessment charge.
Arbitration Report and Appeal Report
These reports provide quarterly comparisons of applications received and processed. There is information both about decisions issued in the periods, and decisions outstanding at the end of each period. The point in the process highlights the settlement rates in Arbitration when it is achieved, and more information about the number of arbitration events held is shown than in the past. As in mediation, the figures for representation by law firms is known to be misstated because some firms have been inappropriately coded as law firms in the past, and this is being gradually corrected.
- Next Meetings
The next scheduled meetings of the Forum will be held on October 17 and December 5, 2002.
The meeting was adjourned.
Financial Services Commission of Ontario