Disputing Denied Accident Benefits at the FSRA: Mediation and Arbitration

Your Right to Dispute Denied Benefits

When an Ontario auto insurer denies, reduces, or terminates accident benefits, the claimant has the right to dispute that decision through the Financial Services Regulatory Authority of Ontario (FSRA). The dispute resolution system has two mandatory stages: mediation, followed by arbitration or court action if mediation fails.

Stage One — FSRA Mediation

Before commencing arbitration, most accident benefits disputes require mandatory FSRA mediation. The FSRA assigns a mediator who facilitates a structured settlement conference. Mediation is informal and non-binding. If it resolves the dispute, the matter ends. If it fails, the mediator issues a report confirming breakdown, opening the pathway to arbitration or court.

Stage Two — FSRA Arbitration

FSRA arbitration is a formal quasi-judicial hearing before a FSRA arbitrator. Rules of procedure govern document exchange, expert reports, witness examination, and conduct. Arbitrators can order benefits paid, award interest on delayed amounts, and award expenses against parties whose conduct warrants it. Decisions are binding but appealable to the Director’s Delegate and Divisional Court.

Electing Court Instead

A claimant may elect to bring their accident benefits dispute to the Ontario Superior Court of Justice rather than FSRA arbitration. Court is often preferable for high-value claims, disputes where punitive damages are sought, or where legal complexity favours court procedure. Your lawyer will advise which forum best serves your interests.