Mediation
Mediation helps resolve disputes between insurance companies and claimants (people claiming accident benefits). A mediator in the Dispute Resolution Services (DRS) branch of the Financial Services Commission of Ontario (FSCO) helps the parties reach a mutually agreeable solution to their dispute.
Mediation is an informal and confidential process. The discussions are not recorded, and the mediator cannot be compelled to give evidence about the mediation. FSCO mediators are neutral, do not take sides and do not give legal advice. Mediators guide and support the parties in attempting to resolve the dispute.
Mediation of accident benefits disputes is mandatory in Ontario and must be conducted through FSCO before the dispute can proceed to arbitration or court.
more on mediation
Arbitration
If mediation fails to settle the dispute, the claimant can apply to have the disputes decided by an arbitrator. Insurance companies are not allowed to apply for arbitration, but can raise new issues if the claimant applies for arbitration.
Arbitration is a procedure used to resolve disputes that has the informality of a Small Claims Court, but not its dollar ceiling, because the financial restrictions are determined by the limits stated in your insurance policy. Either you or your insurance company can initiate arbitration if it seems settlement negotiations have ground to a
halt.
Both sides of the dispute explain their positions to a neutral individual, identified as the arbitrator. The insurance company must pay any amount the Arbitrator determines as fair compensation, within the limits of the policy. Their decision is almost always final and you must accept it.
more on arbitration
Small Claims Court
In Ontario, the Small Claims Court is a branch of the Superior Court of Justice. It deals with civil disputes of a monetary value of up to $10,000 (Canadian).
Neither insurance companies, nor their adjusters, are going to sing, whistle, shout, or leap up and click their heels in glee when presented with a lawsuit. That's emphatically true when there's no doubt the legal action had nothing to do with liability but was brought only because of a dispute regarding value! Lawyers are going to get involved, costs will skyrocket and the claim file may be taken away from the adjuster, and given to somebody else to handle, which could mean a blemish on that adjuster's work record.
Since a claims adjuster wants to avoid all this, you might be able to loosen his purse strings by suggesting that if a fair offer isn't made by a certain date, you'll have no choice but to hire an attorney and file a lawsuit.
No adjuster in his right mind wants that to happen, especially in a case where there's no question that their insured is 100% responsible for the accident.
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