On December 5th, The Auditor General released the 2011 report. Chapter dealt with Auto Insurance Regulatory Oversight.
PURPOSE: Our audit objective was to assess whether FSCO had adequate systems and procedures in place with respect to its auto insurance responsibilities to:
• ensure compliance with relevant legislation and its own policies established to protect the public interest and to enhance public confidence
in the auto insurance sector;
• administer the Motor Vehicle Accident Claims Fund in the public interest; and
• measure and report on the effectiveness of its regulatory oversight.
Considering that this was an audit I found it surprising that the Auditor General referred to “industry estimates” to report on the level of fraud.
It was interesting to note that there are significant backlogs in FSCO’s mediation services for claimants in dispute with insurers, with resolutions taking 10 to 12 months rather than the legislated 60 days.
Recommendations from the auditor to fix this issue:
1. Improve its information-gathering to help explain why almost half of all injury claimants seek mediation, as well as how disputes are resolved, and to identify possible systemic problems with its SABS benefits policies that can be changed or clarified to help prevent disputes;
Maybe they could start by reading the newspaper or talking to anyone in the industry. Clearly claimants do not feel that $3500 is a reasonable amount of coverage.
• establish an action plan and timetable for reducing its current and growing backlog to a point where it can provide mediation services in a timely manner in accordance with legislation and established service standards.
Maybe they could start by expediting some arbitration cases to provide some guidance on topics of dispute:
1. What kind of and when does medical information need to be provided provided in response to an OCF-18.
2. What is compelling evidence that a claimant will not fully recover within the MIG.