ONTARIO REGULATION made under the INSURANCE ACT Amending O. Reg. 7/00
(Unfair or Deceptive Acts or Practices)
DRAFT
Note: Ontario Regulation 7/00 has previously been amended. Those amendments
are listed in the Table of Regulations – Legislative History Overview
which can be found at www.e-laws.gov.on.ca.
1 (1) Paragraphs 1, 2, 3, 4 and 5 of subsection 3 (2) of Ontario Regulation
7/00 are revoked and the following substituted:
- Charging an amount in consideration for the provision of goods or services
to or for the benefit of a person who claims statutory accident benefits or
who otherwise claims payment under a contract of insurance, if the goods or
services are not provided.
- Soliciting or demanding a referral fee, directly or indirectly, by or from
a person who provides goods or services to or for the benefit of a person who
claims statutory accident benefits or who otherwise claims payment under a contract
of insurance.
- Acceptance of a referral fee, directly or indirectly, by or from a person
who provides goods or services to or for the benefit of a person who claims
statutory accident benefits or who otherwise claims payment under a contract
of insurance.
- The payment of a referral fee, directly or indirectly, to or by a person
who provides goods or services to or for the benefit of a person who claims
statutory accident benefits or who otherwise claims payment under a contract
of insurance.
- Charging an amount in consideration for the provision of goods or services
to or for the benefit of a person who claims statutory accident benefits or
who otherwise claims payment under a contract of insurance, where the amount
charged unreasonably exceeds the amount charged to other persons for similar
goods or services.
(2) Section 3 of the Regulation is amended by adding the following subsection:
(3) For the purposes of paragraphs 1 to 5 of subsection (2), a person who
provides goods or services includes,
- a person who provides towing services or who owns or operates a tow truck;
- a person engaged in the provision of vehicle repair services; and
- a person who provides facilities for the storage of automobiles.
2. The Regulation is amended by adding the following section:
5. For the purposes of the definition of “unfair or deceptive act or
practice” in section 438 of the Act, each of the following actions is
prescribed as an unfair or deceptive act or practice in relation to a claim
for statutory accident benefits under the Statutory Accident Benefits Schedule
– Accidents on or after November 1, 1996 as it reads after December 31,
2004, in this section referred to as the Schedule:
- The failure or refusal of an insurer to pay for goods or services or for
the cost of an assessment within the time prescribed for payment in the Schedule.
- The determination by an insurer that a person is not entitled to a statutory
accident benefit or that a person does not have a catastrophic impairment if
the insurer is required under the Schedule to obtain a report of an examination
under section 42 of the Schedule in respect of the person before making that
determination and the insurer makes the determination in the absence of the
report
- The making of a statement for the purposes of an adjustment or settlement
of a claim if the statement misrepresents or unfairly presents the findings
or conclusions of a person who conducted an examination under section 42 of
the Schedule.
- A requirement by an insurer that an insured person attend for an examination
under section 42 of the Schedule conducted by a person whom the insurer knows
or ought to know is not reasonably qualified by training and experience to conduct
the examination.
- A requirement by an insurer that an insured person attend for an examination
under section 42 of the Schedule that is not reasonably required for the purposes
authorized under the Schedule.
- The failure to obtain the written and signed consent of an insured person
in the approved form before a pre-claim examination under section 32.1 is conducted
in respect of the insured person.