For years, healthcare and legal professionals have witnessed the emotional toll that the auto insurance system can take on injured Ontarians. Navigating a claim is stressful enough — but what happens when a client’s rights are potentially violated, and the only way to raise a concern is to drag them back into the process they’ve fought so hard to move past?

That’s the reality many providers face when trying to report questionable insurer practices or payment issues to the Financial Services Regulatory Authority of Ontario (FSRA).

The Problem: A Well-Intentioned Process That Misses the Human Cost

Under current procedures, FSRA requires a Third-Party Consent Form before reviewing a complaint made on a client’s behalf. This means that even when the concern involves regulatory compliance, billing practices, or systemic delays, the injured person must sign off to allow FSRA to investigate.

On paper, this makes sense — it protects personal health information and ensures privacy under the Freedom of Information and Protection of Privacy Act (FIPPA).
But in practice, it often creates a painful barrier.

Many clients — especially those recovering from catastrophic injuries — experience significant anxiety when asked to revisit anything related to their claim. They may associate the process with months or years of fighting for care, dealing with adjusters, and defending their own credibility. For some, just receiving another insurance-related email can trigger stress responses or feelings of helplessness.

A Real Example

Consider “Mary,” a brain injury survivor whose care team provided essential, insurer-approved rehabilitation and attendant care services. Over time, the insurer failed to pay for these approved services, and the account balance grew alarmingly high. Despite repeated submissions and follow-ups, payments weren’t processed.

Mary’s rehabilitation provider and her lawyer grew increasingly concerned that the insurer might ultimately refuse to cover the mounting costs — leaving Mary personally responsible for tens of thousands of dollars. To protect her, the team made the difficult decision to pause services until the matter could be rectified.

Eventually, the outstanding invoices were paid, confirming that the services had indeed been approved all along. But when the provider requested interest on the overdue payments, the insurer refused — despite the clear provisions in the Statutory Accident Benefits Schedule (SABS) requiring interest on late payments.

That interest isn’t just about compensation. It’s a critical deterrent — one designed to discourage insurers from delaying payments and jeopardizing a client’s access to care. Without it, there’s little accountability for late payments, and providers are left absorbing the financial strain while clients risk losing essential services.

This is not an isolated case. Providers across Ontario have shared similar experiences, where delayed payments and the refusal to pay interest create ripple effects that ultimately harm the very people the system is meant to protect.

Why Interest Matters — and Who It Protects

There’s often a misconception that when a rehabilitation company seeks interest on unpaid invoices, it’s about generating extra revenue. In reality, interest is about fairness and continuity of care.

When insurers delay payment on approved services — sometimes for months — the rehabilitation provider carries that financial burden. Most continue to deliver care out of commitment to their clients, even as unpaid invoices accumulate. But that can quickly become unsustainable.

Interest, as outlined in the SABS, exists for a reason:

• It discourages insurers from delaying payment on legitimate, approved services.
• It compensates providers for the cost of carrying overdue accounts while still staffing and supporting the client’s care.
• Most importantly, it protects the client’s continuity of care — because if providers can’t afford to continue, clients are the ones who lose access to essential services.

When interest goes unpaid, it sends a message that delays come without consequence — and it’s the injured person who ultimately suffers when their care is disrupted.

A Smarter Way Forward

Accountability should not come at the expense of a client’s mental health.
There are practical, privacy-safe alternatives that would allow FSRA and similar oversight bodies to investigate concerns without requiring direct client involvement every time.

Some potential approaches include:

• Anonymized case reviews: Allowing providers to submit documentation with redacted client information where the focus is on insurer conduct, not individual identity.
• Insurer data audits: Leveraging HCAI or internal payment data to flag patterns of delayed or denied interest payments or service approvals.
• Provider-based reporting: Creating a structured, limited channel for licensed providers to report systemic issues that affect multiple clients without breaching confidentiality.

These measures would give FSRA the tools to identify trends and hold insurers accountable, while shielding vulnerable consumers from unnecessary distress.

Balancing Oversight and Compassion

The goal isn’t to remove oversight — it’s to make it more effective and humane. The vast majority of providers filing these complaints are not doing so out of self-interest but out of concern for fairness and system integrity. When legitimate issues can’t even be reviewed because a traumatized client can’t sign another form, the system fails everyone.

By modernizing the complaint process, FSRA has an opportunity to lead by example — showing that consumer protection and consumer well-being are not mutually exclusive.

A Call to Action

As advocates, we’re asking FSRA and policymakers to take a closer look at this gap. Let’s reimagine a complaint process that still safeguards privacy but recognizes the lived realities of those injured in motor vehicle collisions.

After all, true fairness isn’t just about what’s written in regulation — it’s about how it feels to the people it’s meant to protect.

#InjuryAdvocates #OntarioAutoReform #FSRA #FairCare #ConsumerProtection #Rehabilitation #Accountability