Accidental benefits claims disputes may continue despite Ontario auto insurance reforms

Published: December 13, 2017

Updated: July 24, 2018

Author: Luke Jones



The auto insurance changes announced in Ontario last week will probably not reduce disputes over accidental benefits claims, one insurance defense lawyer says. However, brokers and insurance companies mostly agree that the government’s plans are a step in the right direction.

New reforms to the auto insurance market were announced by Ontario Finance Minister Charles Sousa on December 5. Amanda Lennox, a partner with Laxton Glass LLP, says the reforms “appear unlikely to reduce accident benefits disputes and may actually increase them.”

Under the Ontario Fair Auto Insurance Plan, the government looked to some of the recommendations made by David Marshall. He became the advisor or auto insurance and pensions in February 2016. Provide advice and recommendations to governing and regulatory bodies in an effort to reduce auto insurance costs in Ontario, while the role also involves him overseeing the roll out of the Ontario Retirement Pension Plan (ORPP). He worked as a direct advisor to Ontario finance minister Charles Sousa.

Among the features of the Fair Auto Insurance Plan is a Serious Fraud Office (SFO), in an effort to clamp down on auto insurance fraud.

Sousa’s announcement also included a pledge for “standard treatment plans for common collision injuries such as sprains, strains and whiplash,” in an effort to remove cash settlements.

However, Lennox predicts disputes will remain:

“If the government limits cash settlements, which they allude to in the announcement, I predict more disputes, not less,” Lennox told Canadian Underwriter“It will become an all-or-nothing system in which insurers and claimants will have no choice but to take every dispute all the way to a decision, as there would be no way to compromise and settle based on a risk/reward basis.”