If your Ontario accident benefits claim has been denied and you've exhausted direct discussions with your insurer, the Financial Services Regulatory Authority of Ontario (FSRA) provides a formal dispute resolution process. For most people, mediation is the first formal step.
What Is FSRA Mediation?
FSRA mediation is a structured, confidential negotiation facilitated by a neutral mediator appointed by FSRA. The mediator does not decide the outcome — they help both sides reach a voluntary agreement. If no agreement is reached, the case can proceed to arbitration.
Key point: Mediation is non-binding. Either party can reject the outcome and proceed to arbitration.
Who Can Apply
Any accident benefits claimant whose insurer has denied, reduced, or terminated a benefit can apply for FSRA dispute resolution. You must apply within 2 years of the insurer's refusal. Applications are submitted through FSRA's online portal.
What to Expect at Mediation
- Both parties submit statements of claim and response before the session
- The session is typically conducted by video or phone (in-person is rare)
- The mediator meets with both sides — sometimes separately
- A mediation session typically runs 2–4 hours
- If an agreement is reached, it is documented and binding
- If no agreement is reached, FSRA issues a certificate allowing you to proceed to arbitration
What Disputes Can Be Mediated
- Denial of income replacement or non-earner benefits
- Disputes about medical and rehabilitation benefit amounts
- MIG classification disputes
- Denials based on independent medical examinations
- Catastrophic impairment designation disputes
- Attendant care disputes
Preparation Matters
The claimants who do best in mediation are those who have organized medical evidence, understand the basis for the insurer's denial, and have a clear picture of what benefits they are entitled to. Going in without preparation puts you at a significant disadvantage when the insurer has experienced adjusters on their side.
If you are heading toward a dispute — or already in one — a free review can help you understand what benefits are at stake and what position your situation may support.