If an insurer doesn’t comply with the aforementioned requirements of s. 33 of the SABS 34/10, as well as the Insurance Act, supra, then you can allege that your insurer lacks good faith in processing your statutory accident benefits claim in a manner that is prescribed by the legislature. Remember that your insurer has a duty to act in good faith, which applies throughout its processing of your application for statutory accident benefits. Furthermore, your insurer’s practices are subject to the general supervision by the Chief Executive Office of the Financial Services Regulatory Authority of Ontario (FSRAO): Financial Services Regulatory Authority of Ontario Act, 2016, S.O. 2016, c. 37, Sched. 8, s. 6. Among the Chief Executive Officer’s broad powers in respect to the administration and enforcement of the Insurance Act, supra, is the power to investigate and sanction any conduct or behaviour of your insurer deemed to constitute an “unfair or deceptive act and practice” in accordance with section 440 of the Insurance Act, supra., which reads as follows:
UNFAIR OR DECEPTIVE ACTS OR PRACTICES
Chief Executive Officer may investigate
440 (1) The Chief Executive Officer may examine and investigate the affairs of every person engaged in the business of insurance in Ontario in order to determine whether such person has been, or is, engaged in any unfair or deceptive act or practice. R.S.O. 1990, c. I.8, s. 440; 2018, c. 8, Sched. 13, s. 22.
Unfair or deceptive acts and practices committed by your insurer are proscribed by section 439 of the Insurance Act, supra, which reads as follows:
Unfair or deceptive acts, etc., prohibited
439 No person shall engage in any unfair or deceptive act or practice. R.S.O. 1990, c. I.8, s. 439.
As a matter of fact, the Ontario Regulation 7/00: Unfair or Deceptive Acts or Practices, under the Insurance Act, supra, sets out a list of those proscribed unfair or deceptive acts or practices, where, amongst other things, it specifically includes paragraph 13 of section, which reads as follows: “Any examination or purported examination under oath that does not comply with the requirements under the Act or the regulations. O. Reg. 7/00, s. 1; O. Reg. 278/03, s. 1; O. Reg. 128/19, s. 2.”
Therefore, proceeding with an allegation of unfair or deceptive act or practice against your insurer and bringing it to the attention of the Chief Executive Officer of FSRAO to investigate, is – at the moment – the legislated route to address non-compliant EUOs.