Health Service Provider consultation summary report | Financial Services Regulatory Authority of Ontario

Feedback from the sector:

During the consultation period of October 10 to November 16, 2023, FSRA received 5 submissions from stakeholders in the Heath Service Provider sector, each of which provided feedback on FSRA’s proposed Statement of Priorities for fiscal year 2024-25. The submissions and FSRA’s responses are available on FSRA’s website.

FSRA thanks all stakeholders that took the time to comment. FSRA carefully considered all feedback before finalizing and publishing the 2024-2027 Annual Business Plan.

Contributors to public consultation – Health Service Provider sector:

The following stakeholders submitted comments on FSRA’s proposed SOP for fiscal 2024-25 for Health Service Provider items:

Organization	Stakeholder Representative
1. Innovative Case Management Inc.	Ellie Lapowich
2. Pursuit Health Management	John Barry
3. Neenah Navasero Neurorehabilitation	Simon Oomen-Hurst
4. Ontario Trial Lawyers Association (“OTLA”)	Matt Caron
5. FAIR Association of Victims for Accident Insurance Reform	Rhona DesRoches

Health care provider rate adjustment

Stakeholder	Summary of Feedback	FSRA’s Response
Innovative Case Management Neenah Navasero Neurorehabilitation Pursuit Health Management	Health Services Providers (“HSP”) were concerned with rising health care costs to treat motor vehicle accident victims. The rates established for HSPs should be reviewed and updated to reflect the current inflationary pressures in the economic climate. Furthermore, HSPs also expressed challenges with talent acquisition and retention in the sector.	FSRA was aware of challenges in the HSP sector. The Professional Services Guideline (“PSG”) established maximum amounts that automobile insurers are liable to pay to HSPs. However, insurers were not prohibited from paying above any maximum amount or hourly rate established in the Guideline. An adequate review of the PSG would require review of the Minor Injury Guideline (“MIG”) as well as the Insurance Act, Statutory Accident Benefit Schedule (“SABS”), and other associated regulations, which are under the purview of the Ministry of Finance (“MOF”). FSRA worked closely with MOF in Auto insurance sector and would support if the areas identified above are reviewed.

Stakeholder

Summary of Feedback

FSRA’s Response

Innovative Case Management
Neenah Navasero Neurorehabilitation
Pursuit Health Management

Health Services Providers (“HSP”) were concerned with rising health care costs to treat motor vehicle accident victims. The rates established for HSPs should be reviewed and updated to reflect the current inflationary pressures in the economic climate. Furthermore, HSPs also expressed challenges with talent acquisition and retention in the sector.

FSRA was aware of challenges in the HSP sector.

The Professional Services Guideline (“PSG”) established maximum amounts that automobile insurers are liable to pay to HSPs. However, insurers were not prohibited from paying above any maximum amount or hourly rate established in the Guideline.

An adequate review of the PSG would require review of the Minor Injury Guideline (“MIG”) as well as the Insurance Act, Statutory Accident Benefit Schedule (“SABS”), and other associated regulations, which are under the purview of the Ministry of Finance (“MOF”).

FSRA worked closely with MOF in Auto insurance sector and would support if the areas identified above are reviewed.

Transparency and fairness

Stakeholder	Summary of Feedback	FSRA’s Response
OTLA FAIR Association of Victims for Accident Insurance Reform	One stakeholder emphasized the need for transparency and consumer education in the auto insurance system, as well as addressing issues such as potential bias at the License Appeal Tribunal (“LAT”) and insurers’ conduct regarding attendant care. They also called for action to reduce excessive insurer profits and improve the regulation of auto insurance rates and underwriting. The stakeholder supported FSRA's initiatives to ensure fair treatment of customers and promote public confidence in the insurance sector. It urged FSRA to prioritize consumer protection and transparency in all aspects of regulation. One stakeholder expressed concerns about the LAT and complaints process. The stakeholder also expressed interest in enhanced protection for injured claimants, changes to HSP compensation and recovery focused care.	FSRA appreciated the stakeholder’s support for FSRA’s commitment to strengthening consumer protection and enhancing fairness in auto insurance. FSRA’s strategy for reforming the regulation of auto insurance rates and underwriting rules will make the oversight more dynamic, flexible, and transparent for Ontario’s consumers to ensure fair rates and underwriting. Part of this work will be focused on developing, consulting on, and issuing Fairness and Supervisory Guidance that will enhance consumer protection, along with initiatives to enhance transparency and support informed decision making including modernizing documents and implementing consumer experience benchmarking. FSRA appreciated the stakeholder’s concerns regarding the Licence Appeal Tribunal (“LAT”), however, FSRA does not have jurisdiction over the LAT. Disputes between the insurers and the insured are outside of FSRA’s purview unless they raise conduct or other regulatory issues.

Stakeholder

Summary of Feedback

FSRA’s Response

OTLA
FAIR Association of Victims for Accident Insurance Reform

One stakeholder emphasized the need for transparency and consumer education in the auto insurance system, as well as addressing issues such as potential bias at the License Appeal Tribunal (“LAT”) and insurers’ conduct regarding attendant care. They also called for action to reduce excessive insurer profits and improve the regulation of auto insurance rates and underwriting. The stakeholder supported FSRA's initiatives to ensure fair treatment of customers and promote public confidence in the insurance sector. It urged FSRA to prioritize consumer protection and transparency in all aspects of regulation.

One stakeholder expressed concerns about the LAT and complaints process. The stakeholder also expressed interest in enhanced protection for injured claimants, changes to HSP compensation and recovery focused care.

FSRA appreciated the stakeholder’s support for FSRA’s commitment to strengthening consumer protection and enhancing fairness in auto insurance.

FSRA’s strategy for reforming the regulation of auto insurance rates and underwriting rules will make the oversight more dynamic, flexible, and transparent for Ontario’s consumers to ensure fair rates and underwriting.

Part of this work will be focused on developing, consulting on, and issuing Fairness and Supervisory Guidance that will enhance consumer protection, along with initiatives to enhance transparency and support informed decision making including modernizing documents and implementing consumer experience benchmarking.

FSRA appreciated the stakeholder’s concerns regarding the Licence Appeal Tribunal (“LAT”), however, FSRA does not have jurisdiction over the LAT. Disputes between the insurers and the insured are outside of FSRA’s purview unless they raise conduct or other regulatory issues.