Accident Benefits Dispute Resolution System

The Ministry of Finance recently released its final recommendations for changes to the Dispute Resolution System (DRS). Some of the highlights of the proposed changes are quite significant if they are implemented.

Mediations and Pre-Arbitration Hearings will become one, and will be referred to as an enhanced settlement meeting. An arbitrator will conduct the meeting and decide which of three streams the case will fall into if a settlement is not reached. Claimants will no longer have the option of pursuing an issue that fails at mediation with the Courts. A paper review will be conducted if the issues in dispute are about medical and rehabilitation benefits under $10,000 and for those involving minor injury determinations. Full hearings will be reserved for Catastrophic Impairment determinations, 24-hour attendant care issues or income replacement benefits beyond 104 weeks. Expedited hearings will take place for issues that fall outside of these two streams and will last for a day only.

The Director’s Delegate would be eliminated. All appeals will proceed directly to the Superior Court of Justice to be heard by a single Judge. A further recommendation is that Arbitration decisions will not be binding.

While this is a very brief overview of the highlights, these recommendations are meant to address the serious backlog and uncertainty with the SABs. If the changes have the intended effect, cases will move along far more quickly. The claimant must be ready to deal with a disputed issue from start to finish in a six-month time frame.

The recommendations are currently before the legislature under Bill 171. Time will tell whether these recommendations will be implemented, and whether they will improve the current backlog and provide greater certainty for insureds and insurers.

Howie, Sacks & Henry stays on top of Accident Benefits law. For more information on the recommended changes to the DRS, and questions generally regarding Accident Benefits, please contact Melissa Miller at mmiller@hshlawyers.com or (416) 847-1063 for further information on this case or others.


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