ID
2021-008
Thank you for providing your feedback on FSRA’s Revised Proposed Unfair or Deceptive Acts or Practices Rule.
We appreciate the comments received to date. Your feedback will help to inform our final rule and approach.
The request for submissions is now closed.
The Financial Services Regulatory Authority of Ontario (FSRA) is continuing its work to strengthen consumer protection in the insurance sectors we regulate.
Following its first public consultation, FSRA is now releasing a second consultation with revisions to its Proposed Unfair or Deceptive Acts or Practices (UDAP) Rule.
The proposed rule will replace the existing UDAP Regulation and is aimed at making the supervision of insurance more transparent, dynamic, and flexible. It also focuses on the need for stronger consumer protections by clearly defining outcomes that are unfair or otherwise harmful to consumers
Full details of all the amendments made to the proposed rule are available at Notice of Changes and Request for Further Comment Proposed Rule 2020-002 Unfair or Deceptive Acts or Practices (UDAP)
FSRA’s summary and list of comments received from the first consultation are available FSRA’s First Proposed Insurance Rule Released for Public Consultation – the Unfair or Deceptive Acts or Practices (UDAP) Rule.
Please provide your comments no later than August 11, 2021 by selecting “Submit a comment or ask a question”.
Useful links:
- FSRA’s First Proposed Insurance Rule Released for Public Consultation – the Unfair or Deceptive Acts or Practices (UDAP)
- Unfair or Deceptive Acts or Practices Rule (UDAP) Consultation Summary Report
Before we begin, please make sure you do not include any personal or private financial information. If your inquiry does require this information be shared with us, please call us at 1-800-668-0128 or email us at [email protected] for instructions.
By submitting your content, you agree to have your materials posted on our engagement portal, used in reports and other materials prepared by Financial Services Regulatory Authority of Ontario (FSRA) that may be shared with the public. Content is moderated so that all posts are respectful and professional. The Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c.F.31, applies to all online content.
Sector | Comment | Date posted Sort ascending |
---|---|---|
Life and Health Insurance | [ 2021-008] Brendan Wycks - Canadian Association of Financial Institutions in Insurance (CAFII)
Re: Notice of Changes and Request for Further Comment -- Proposed Rule 2020-002: Unfair or Deceptive Acts or PracticesThe Canadian Association of Financial Institutions in Insurance (CAFII) thanks FSRA for the opportunity to comment on the changes recently made to the Authority’s Proposed Rule [2020-002]: Unfair or Deceptive Acts or Practices (UDAP). We appreciate FSRA’s efforts to engage industry stakeholders -- including our Association -- in a further, second phase consultation on the Proposed Rule. Our Association is supportive of the amendments, clarifying changes, and other adjustments which FSRA has made to the Proposed Rule, based on stakeholder feedback and other inputs. In particular, we thank FSRA for the helpful amendment made to the definition of “Incentives” found in clause 7(1) and clause 7(1)(i), as follows: 7(1) Payment, rebate, consideration, allowance, gift or thing of value being offered or provided, directly or indirectly, to an insured or person applying for insurance, (i) as an incentive or inducement for a person to take an action or make a decision that would encourage that person relating to buy a an insurance product which would not, considering the options generally available in the marketplace, be recommended as a suitable insurance product action or decision by a reasonable person licensed to sell such an insurance product, . . . We believe that the above-noted amendment adequately addresses the concern expressed in our submission of March 18, 2021 – under the heading “Issue of Noteworthy Concern For CAFII Members -- with respect to problematic issues arising from use of the term “suitable insurance product.” CAFII also appreciates the clarifying amendment that has been introduced to the definition of “contract of insurance” found in section 1(1)(v) -- to properly reference the life insurance and accident and sickness insurance definitions found in Ontario’s Insurance Act – which makes it clear that the Proposed Rule does capture creditor’s group insurance. Finally, CAFII acknowledges and accepts the fundamental decision that FSRA has made to pivot and to retain, at least for the time being, the current prohibition on the offering of incentives in the life and health insurance sector. We understand that that change was made in response to life and health insurance stakeholder concerns regarding potential consumer harms associated with removing the Regulation’s prohibition against incentives. We concur with FSRA’s determination that further stakeholder input and discussion are required in order to assess and address potential consumer risks in this area fully. Conclusion Thank you again for the opportunity to provide further input on FSRA’s revised Proposed Rule [2020-002]: Unfair or Deceptive Acts or Practices (UDAP). Should you require further information from CAFII or wish to meet with representatives from our Association on this or any other matter at any time, please contact Keith Martin, CAFII Co-Executive Director, at [email protected] or 647-460-7725. CAFII and its members remain committed to supporting FSRA in its critically important mission and mandate; and we look forward to continuing our involvement as key stakeholder contributors to the Authority’s ongoing success. Sincerely, Rob Dobbins Board Secretary and Chair, Executive Operations Committee About CAFII CAFII is a not-for-profit industry Association dedicated to the development of an open and flexible insurance marketplace. Our Association was established in 1997 to create a voice for financial institutions involved in selling insurance through a variety of distribution channels. Our members provide insurance through client contact centres, agents and brokers, travel agents, direct mail, branches of financial institutions, and the internet. CAFII believes consumers are best served when they have meaningful choice in the purchase of insurance products and services. Our members offer credit protection, travel, life, health, and property and casualty insurance across Canada. In particular, credit protection insurance and travel insurance are the product lines of primary focus for CAFII as our members’ common ground. CAFII's diverse membership enables our Association to take a broad view of the regulatory regime governing the insurance marketplace. We work with government and regulators (primarily provincial/territorial) to develop a legislative and regulatory framework for the insurance sector which helps ensure that Canadian consumers have access to insurance products that suit their needs. Our aim is to ensure that appropriate standards are in place for the distribution and marketing of all insurance products and services. CAFII’s members include the insurance arms of Canada’s major financial institutions – BMO Insurance; CIBC Insurance; Desjardins Insurance; National Bank Insurance; RBC Insurance; ScotiaLife Financial; and TD Insurance – along with major industry players Assurant; Canada Life Assurance; Canadian Premier Life Insurance Company; Canadian Tire Bank; CUMIS Services Incorporated; Manulife (The Manufacturers Life Insurance Company); Sun Life; and Valeyo. |
|
Auto Insurance | [ 2021-008] Elliott - Silverstein
Attached please find CAA Insurance's comments on FSRA's proposed rule on Unfair or Deceptive Acts or Practices. |
|
Property and Casualty and General Insurance | [ 2021-008] Kyle Burky - The Wawanesa Mutual Insurance Company
Please find attached the Wawanesa Mutual Insurance Company's submission on this consultation, dated August 11, 2021. Best regards, |
|
Life and Health Insurance | [ 2021-008] Kyle Burky - The Wawanesa Life Insurance Company
Please find attached the Wawanesa Life Insurance Company's submission on this consultation, dated August 11, 2021. Best regards, |
|
Property and Casualty and General Insurance | [ 2021-008] Scott Parry - Desjardins General Insurance Group (DGIG)
Good afternoon, On behalf of Desjardins General Insurance Group (DGIG) please find our comments on FSRA's proposed Unfair or Deceptive Acts or Practices (UDAP) rules. |
|
Auto Insurance | [ 2021-008] FAIR - FAIR Association of victims for Accident Insurance Reform
FAIR Association of Victims for Accident Insurance Reform 579A Lakeshore Rd. E., Box 39522, Mississauga, ON, L5G 4S6 [email protected] August 11, 2021 FAIR Submission to Financial Services Regulatory Authority (FSRA) Revised Proposed Unfair or Deceptive Acts or Practices (UDAP) rule FAIR (Fair Association of Victims for Accident Insurance Reform) is a grassroots not-for-profit organization of MVA (Motor Vehicle Accident) survivors who have struggled with the current auto insurance system in Ontario. We are the end users of the auto insurance product and we appreciate the opportunity to have our voices heard. Our comments are directed toward the auto insurance sector. We see no substantive changes to the existing UDAP regulations and it is noteworthy that many of the suggestions put forward by various stakeholders during the UDAP consultation earlier this year have been ignored. The most important aspect of regulation is the follow-through or sanction for an unfair or deceptive act. This step has simply been ignored by FSRA. This leaves a huge hole in protecting consumers. There are no examples offered for guidance to the individuals and entities that might be affected by a UDAP sanction and this is unacceptable. How are stakeholders or consumers to know what boundaries insurers should not cross if there is no information offered to them by the Regulator? The FSRA website states: “FSRA sets well-understood expectations for regulated persons through clear and organized guidance” but we see no evidence of clear or organized guidance beyond empty wording. [1] Ontarians expect ALL insurers, large and small, to be held to the same standard and subject to the same regulations and possible outcomes. We are not sure why this inequitable landscape, where the ‘big guys’ might get a break while smaller businesses could be disadvantaged, is being introduced. This unfair advantage for some, but not all, will create greater uncertainty. We support facilitating innovation and flexibility but that too must always come with oversight. We do not agree that the new principals-based approach to oversight of auto insurers will protect consumers when it is a low bar that requires companies to adhere only to the spirit rather than the letter of the regulation. It allows large corporations, whose profit margins rest on customer claim denials, a great deal of latitude and in doing so creates uncertainty for consumers who, like the insurers, will have no idea where the boundaries are. There is no proactive element to this latest version of UDAP (as in the past) and it is clear that action will only take place after the unfair or deceptive act. And it may be too difficult to enforce any sanction because, well, no one knows what the infractions actually are, what will trigger a sanction, or if the size and scope of a business will make a difference. Everyone, all stakeholders will be disadvantaged but especially injured consumers in an abstract regulatory guessing game at a time when their quality of life and rehabilitation is hanging in the balance. [2] How are claimants or consumers supposed to figure out what constitutes a UDAP if the stakeholders, who ought to know, don’t have a clue. Consumers of auto insurance operate from a place of deadlines, thresholds, and compliance – and all of it has clear consequences for them if they fall out of step. Insurers don’t come to Ontarians with ‘it would be good if you paid a premium’ so why is the regulator giving the industry more latitude to “embed controls within their operations to better regulate themselves”? [3] Insurers are profit driven not people focused and there is plenty of evidence of poor insurer behavior that make it clear this is a system in need of regulatory sanctions not self-regulation. There’s been no substantive attention paid to protecting consumer rights when it comes to their privacy. It is a precarious position that consumers find themselves in when it comes to insurers managing their personal information. There are no safe-guards mentioned in these regulations as we had hoped there would be. This issue has become of greater importance with growing pressure from insurers to sign on to telematics usage based premiums. Insurers are already gathering a huge amount of medical information with latitude to make use of that information as they see fit. This should be reviewed with a modern lens to gauge risk to vulnerable patients and the same goes for the driving information insurers gather with an eye to how that information is shared and used. Every day Ontario drivers are asked to produce their driver’s license at medical examinations so the facility can photocopy their personal information in a direct and clear violation of accepted standards set by the Privacy Commission of Ontario. [6] Then, when leaving the medical exam claimants are asked to sign coercive documents that speak to the quality of a medical exam report that hasn’t yet been written in an attempt to manipulate a trier-of-fact somewhere down the road. The latest manipulation is sending out surveys about claimant satisfaction during the course of a claim when the individual is already at the insurer’s mercy when seeking rehabilitation supports. All of these acts are deceptive and not in consumers best interests and all appear to lie outside what is listed in the O. Reg. 7/00: UNFAIR OR DECEPTIVE ACTS OR PRACTICES and the UDAP rule. [4] That needs to change. FAIR supports robust oversight of Ontario’s auto insurers and their affiliated partners to ensure consumer confidence through UDAP rules that protect consumers from unscrupulous behavior. Information and education in a transparent system is key to ensuring consumer confidence and to strengthen consumer protection in the insurance sectors FSRA regulates. [5] Thank you for your attention and for the opportunity to voice our concerns. We look forward to participating in future discussions. FAIR Association of Victims for Accident Insurance Reform [1] Transparent. FSRA sets well-understood expectations for regulated persons through clear and organized guidance. https://www.fsrao.ca/regulation/guidance/fsra-guidance-framework [2] ABISS Survey of Auto Insurance Claims Process for Individuals with Communication Disorders After Traumatic Brain Injury https://c431623c-45a3-4335-ad63-b0038f2a649a.filesusr.com/ugd/ec004f_4f5440867ecb47fd9c2344ecfe290658.pdf [3] Ontario’s regulator explains how principles-based regulation still has teeth https://www.canadianunderwriter.ca/insurance/ontarios-regulator-explains-move-from-rules-to-principles-1004170185/ [4] 3.(2)7. Requiring, requesting or permitting a person who claims statutory accident benefits or who otherwise claims payment under a contract of insurance to sign, before it has been completed in full, a claims form or other document that is required to be in a form approved by the Chief Executive Officer or any form or document that is specified in a Guideline applicable for the purposes of the Statutory Accident Benefits Schedule — Effective September 1, 2010. https://www.ontario.ca/laws/regulation/000007 [5] Residents’ Reference Panel on Automotive Insurance in Ontario to the Financial Services Regulatory Authority of Ontario (FSRA) https://www.fsrao.ca/media/2811/download [6] Protecting your driver’s licence For the most part, Privacy Commissioners have concluded that writing down the driver’s licence number from the card, or photocopying, “swiping” or otherwise reproducing the card itself, cannot be justified. The number may encode personal information, such as the licensee’s birth date, and the card contains a photograph, signature and other personal information that is more than what is actually needed for most business purposes. https://www.priv.gc.ca/en/privacy-topics/sins-and-drivers-licences/drivers-licences/protecting-your-driver-s-licence/ |
|
Property and Casualty and General Insurance | [ 2021-008] Geoffrey Beechey - Canadian Association of Direct Relationship Insurers (CADRI) |
|
Property and Casualty and General Insurance | [ 2021-008] George Hardy - The Co-operators |
|
Auto Insurance | [ 2021-008] John Taylor - Ontario Mutual Insurance Association |
|
Health Service Providers | [ 2021-008] David Dos Santos
Attached is the CSCE submission and response to proposed UDAP changes. |
|
Life and Health Insurance | [ 2021-008] Justin Glinski - Canadian Life and Health Insurance Association
Attached please find comments from CLHIA. |
|
Auto Insurance | [ 2021-008] Laurie Davis - Ontario Rehab Alliance |
|
Health Service Providers | [ 2021-008] Ron Kaplan - Ontario Psychological Association
It is our pleasure to provide a submission on behalf of the Ontario Psychological Association regarding the proposed changes to the UDAP rules. |
|
[ 2021-008] Josh Landau - Insurance Bureau of Canada
Please find attached IBC's submission for FSRA's second consultation on the Proposed Unfair or Deceptive Acts or Practices (UDAP) Rule.Thank you. |
||
Life and Health Insurance | [ 2021-008] Michael Scott - Advocis, the Financial Advisors Association of Canada
Dear Sirs/Mesdames,On behalf of Advocis, The Financial Advisors Association of Canada, please find attached a response to FSRA's consultation on the revised proposed rule regarding unfair or deceptive acts or practices (UDAP). Best Regards, Michael Scott Associate Director, Legal and Regulatory Affairs |
|
Life and Health Insurance | [ 2021-008] Susan Allemang - Independent Financial Brokers of Canada
The attached comment letter is sent on behalf of Nancy Allan, Executive Director, IFB. |
|
Life and Health Insurance | [ 2021-008] Michael Williams - Canadian Association of Independent Life Brokerage Agencies (CAILBA)
Please find attached CAILBA’s comments. |
|
Auto Insurance | [ 2021-008] Matt Caron - Ontario Trial Lawyers Association
Please find our submission attached. |
|
Health Service Providers | [ 2021-008] Healthcare - Advocate
I am writing to comment on the “Notice of Changes and Request for Further CommentProposed Rule 2020-002 Unfair or Deceptive Acts or Practices (UDAP)” The purpose of these comments is to advocate for the rights of automobile accident victims with non-minor injuries who seek funding for healthcare from their insurer. These accident victims with non-minor injuries are often subject to unfair delays and denials of funding for their healthcare and certain insurance companies are known to engage in these practices disproportionately compared to other companies. There has been a lack of prioritization of this stakeholder group that has persisted for many years: accident victims remain vulnerable to insurance company abuse. Organizations that purport to represent the interests of accident victims often focus almost exclusively on issues with Independent Medical Examinations and so fail to address the more pervasive and complex systemic problems in claims adjudication practices. To properly protect accident victims, FSRA needs to make those insurance companies that abuse the system accountable based upon actionable comparable evidence that needs to be actively collected by FSRA. Inadequate transparency and accountability for health claims adjudication makes the UDAP meaningless when it comes to regulating claims practices. Without effective and independent oversight by FSRA, the UDAP provisions under “5 Unfair Claims Practices” will continue to be empty words. Despite widespread accounts of healthcare funding problems, these provisions will fail to yield meaningful action to rein in those insurance companies who engage in unfair and deceptive claims practices. What do I mean by effective independent oversight and actionable evidence? It means FSRA needs to collect data to compare how effectively different insurance companies handle funding of healthcare for accident victims claiming non-minor injuries. • There should be surveys of healthcare facilities and healthcare providers to rate different insurers on how fair they are in terms of their healthcare funding practices. • FSRA should be examining the HCAI system in detail to leverage healthcare claims data for comparative purposes. What updates can be made to the HCAI system to enable FSRA to extract meaningful data from it in order to compare how fair, effective and efficient different companies are at handling claims for healthcare funding? Data should be collected to compare companies on: • What is the rate of denials or partial approvals by company? • How much of the healthcare “claims costs” are related to insurance company expenditures rather than the actual funding of healthcare? • What portion of claims require LAT procedures in order to resolve funding disputes? • How long does it take a company to settle its LAT disputes? • how often does the company engage in investigations and statutory declarations? • How effective is the company’s ombudsman at resolving health claims disputes? • Is it possible that certain insurers subject some ethnic groups or communities to unfair discriminatory claims practices that violate human rights legislation? At a higher level, what are the systemic problems that harm accident victims who need healthcare in Ontario? It is important to acknowledge that excessive bureaucracy, unwarranted complexity, opportunities for frivolous and vexatious insurance investigations, and outdated fee schedules deter healthcare providers from serving accident victims. This kind of pointless bureaucracy causes these victims to receive inadequate degrees healthcare and too late. In this way, there may be an element of unfair claims practices that actually baked into the regulations and we need to honestly examine systemic unfairness. Independent oversight would include analysis of the following probing questions: • How do regulated claims procedures to request and bill for healthcare compare to those of other provinces? • What kinds of forms do healthcare providers or facilities have to fill out in other provinces in order to request healthcare for an accident victim? • What are the procedures in other provinces to get approval for different levels and types of healthcare? • In other provinces, what signatures are needed on forms and at what point in the claims process? • What degree of automation is there for making a healthcare claim in other provinces? • What sort of insurance claims investigations and statutory declarations are permitted or endorsed by regulators in other provinces and how do these impact healthcare funding vs Ontario? • How do healthcare provider guideline fees in Ontario compare to those of other provinces? Why do the Ontario fees appear to be decades out of date in some cases, deterring healthcare providers from serving accident victims? • Have the regulations, procedures and guidelines intended to control fraud and insurance abuse really achieved their stated purpose? Are there simpler more proportional ways to effectively achieve those results? Are the regulations effective? Or is the regulation mainly functioning to enable insurance companies delay and deter funding for legitimate healthcare? FSRA needs to ensure its claims data collection and analysis practices are truly independent. The scope to analyse the data in different ways is vast and if the individuals analysing the data have careers that benefit by exaggerating the extent of fraud and trivializing the problems experienced by excessive denials and delays of legitimate healthcare claims, we will continue to re-victimize accident victims forever. I see no evidence that anyone involved in collecting and analyzing insurance claims data on behalf of FSRA or government policymakers is truly committed to act independent of the insurance industry. FSRA should do a critical examination of its own performance and what that means for accident victims. What do its regulations really achieve for accident victims who need healthcare? Has the UDAP had any beneficial impact on accident victims ever? |
|
Life and Health Insurance | [ 2021-008] Gerry Matlashewski
I am wondering why Banks have the right to sell Creditor, Life, Disability, and CI Insurance without following these proposed guidelines. Under the present system, the Banks don't really underwrite insurance until death, disability or covered CI event. It is only then that individuals who buy this insurance are told because of a medical condition that was not disclosed, they are not eligible for the coverage. This is not fair, because if they were properly underwritten, a lot of the issues that come up would be dealt with before the event not after. In Alberta, Bank employees who sell insurance must be licenced under the Alberta Insurance Act and are subject to the same rules that we must follow to be open, transparent and trustworthy |
|
Auto Insurance | [ 2021-008] Jacqueline Cribb - ABISS
ABISS would like to send you our recent letter which outlines the problem of the treatment of claimants in the insurance industry. I have also attached the response from Mr. Tim Bzowey, which we have recently received. Information about us, our mission and our stories can be found at abiss.ca. Thank you. |
Date posted | Sector | Question and response |
---|---|---|
Life and Health Insurance | Question: BELOW ARE OUR QUESTIONS ABOUT THE REVISED UDAP RULE WHICH REPLACES THE CURRENT UDAP REGULATION: FSRA response: Thank you for providing feedback on the revised Proposed Unfair or Deceptive Acts or Practices (UDAP) Rule, and for your previous correspondence regarding similar issues. The Proposed Rule continues to apply to all insurance sectors, including Life and Health Insurance, as does the current UDAP Regulation (Ontario Regulation 7/00). If approved, the Proposed Rule would replace the UDAP Regulation. The Proposed UDAP Rule is intended to improve the identification, deterrence and sanctioning of misconduct to better protect the public interest. This includes the unfair treatment of consumers, abusive claims practices and behaviour that is deliberately intended to mislead consumers. FSRA will take into account the issues you have raised with respect to Creditor’s Group Insurance and other insurance products that may be offered alongside the sale of another product or service as it sets its strategic priorities in the coming years. Thank you for your engagement on this important rule. |
|
Life and Health Insurance | Question: We understand that the new Unfair and Deceptive Acts or Practices (UDAP) Rule will also apply to the Life and Health (L&H) insurance sector. That will cause problems for certain products where there is only self-regulation by the industry and where the product itself is not renewed every year. For example, there are many problems with respect to “Authorized Insurance Products” that are sold by banks such as Creditors Group Insurance (CGI). We know that banks are required to comply with the CLHIA Guideline G7 regarding the sale of CGI products by a qualified bank employee at the point of sale meeting prior to consumers signing the insurance application or insurance agreement. FSRA response: Thank you for providing feedback on the revised Proposed Unfair or Deceptive Acts or Practices (UDAP) Rule, and for your previous correspondence regarding similar issues. The Proposed Rule continues to apply to all insurance sectors, including Life and Health Insurance, as does the current UDAP Regulation (Ontario Regulation 7/00). If approved, the Proposed Rule would replace the UDAP Regulation. The Proposed UDAP Rule is intended to improve the identification, deterrence and sanctioning of misconduct to better protect the public interest. This includes the unfair treatment of consumers, abusive claims practices and behaviour that is deliberately intended to mislead consumers. FSRA will take into account the issues you have raised with respect to Creditor’s Group Insurance and other insurance products that may be offered alongside the sale of another product or service as it sets its strategic priorities in the coming years. Thank you for your engagement on this important rule. |
|
Life and Health Insurance | Question: My understanding is that on December 8, 2020 section 15 of the Insurance Act was amended. The CEO of FSRA will now have authority under the Insurance Act to issue Exemption Orders. FSRA response: Thank you for providing feedback on the revised Proposed Unfair or Deceptive Acts or Practices (UDAP) Rule, and for your previous correspondence regarding similar issues. The Proposed Rule continues to apply to all insurance sectors, including Life and Health Insurance, as does the current UDAP Regulation (Ontario Regulation 7/00). If approved, the Proposed Rule would replace the UDAP Regulation. The Proposed UDAP Rule is intended to improve the identification, deterrence and sanctioning of misconduct to better protect the public interest. This includes the unfair treatment of consumers, abusive claims practices and behaviour that is deliberately intended to mislead consumers. FSRA will take into account the issues you have raised with respect to Creditor’s Group Insurance and other insurance products that may be offered alongside the sale of another product or service as it sets its strategic priorities in the coming years. Thank you for your engagement on this important rule. |