If you are not satisfied with your claim most companies have an internal Dispute Resolution Process.  To start the process contact your insurer and ask to speak to their Ombudsman.  They will help explain what process they have in place for complaints and disputes.

Car Insurance - Accident Benefit Claims

Dispute Resolution Services (DRS) is the branch of the Financial Services Commission of Ontario (FSCO) that helps claimants and insurance companies (the parties) resolve accident benefits disputes. Their mandate is to provide timely, cost-effective and fair dispute resolution services for claimants and insurance companies. Their  services include mediation, arbitration, neutral evaluation, appeal, and variation and revocation.

A claimant or an insurance company can apply for mediation if they disagree about the claimant’s entitlement to accident benefits or the amount of benefits that should be paid. An impartial FSCO mediator will help the parties reach a mutually agreeable resolution of their dispute. Mediation at FSCO is a mandatory first step in dispute resolution.

If mediation fails to settle the dispute, there are three ways to have the dispute decided:

• The claimant can apply for arbitration with a FSCO arbitrator. Insurance companies are not allowed to apply for arbitration, but can raise new issues if the claimant applies for arbitration.
• Either party (the claimant or the insurance company) can start a civil proceeding (law suit) in the courts.
• If both parties agree, the dispute can be decided by a private arbitrator who is not employed by FSCO.

DRS does not make rules for private arbitrations or law suits.

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