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Dispute Resolution Services: Appeals

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oneAppeal of Arbitration Decisions
 
Either the claimant or the insurance company can appeal an arbitration decision, but only on a question of law.
 
Appeals are decided by the Director of Arbitrations or a Director’s Delegate, who are adjudicators at Financial Services Commission of Ontario (FSCO)’s Dispute Resolution Services (DRS), Appeals Unit.
 
Appeals are usually heard by way of written submissions and a short oral hearing. The parties are not usually allowed to bring new evidence. The Director of Arbitrations or Director’s Delegate issues a written decision with reasons.
 
The appeal process is explained in more detail in Part 4 of the Dispute Resolution Practice Code.
 
twoHow do I start an appeal?
 
To start an appeal, a claimant must send FSCO and the insurance company a completed Notice of Appeal - Form I within 30 days of the date of the arbitration decision, along with a cheque or money order made payable to the Minister of Finance for $250 and a Statement of Service - Form F.
 
The same rules apply to insurance companies, but the fees are different. An insurance company can start an appeal by sending FSCO and the claimant a completed Notice of Appeal - Form I within 30 days of the date of the arbitration decision, and a Statement of Service - Form F. Insurance companies pay $500 for each appeal in which they participate, plus an additional $250 for starting an appeal. They are billed through FSCO’s regular assessment process. Please visit Fees and Assessments for more detail.
 
Once DRS acknowledges the appeal, the other party has 20 days to serve and file a completed Response to Appeal - Form J, along with a Statement of Service - Form F.
 
 
threeWhat will it cost?
 
A claimant who appeals must pay a filing fee of $250. There is no filing fee for the claimant when the insurance company starts the appeal and the claimant responds, unless the claimant also appeals (this is called a cross-appeal).
 
You will likely incur some costs in preparing and presenting your appeal, for example, legal fees.
After deciding the appeal, the Director of Arbitrations or Director’s Delegate has power to:
 
  • order the insurance company to pay all or part of your appeal expenses,
  • order you to pay all or part of the insurance company’s appeal expenses, or
  • order no expenses, leaving it to each party to pay their own expenses.
The expenses decision is based on each party’s degree of success in the outcome of the appeal, any written offers to settle, whether novel issues were raised, the conduct of the parties and their representatives, and whether any aspect of the proceeding was improper, vexatious or unnecessary.
 
The rules about ordering expenses, and the amount that can be ordered, are explained in Section F Expenses regulation of the Dispute Resolution Practice Code.
 
 
fourDo I need a lawyer?
 
You do not need a lawyer for dispute resolution at FSCO. You can choose to represent yourself.
 
However, as disputes can become complicated, and appeals are restricted to questions of law, almost all claimants and insurance companies have lawyers representing them at appeal. You should consider consulting a lawyer or licensed paralegal.
 
If you need help finding a representative, the Law Society of Upper Canada offers a referral service. For more information, visit the Law Society of Upper Canada website, or call 1-900-565-4577. (There is a fee for this referral service).
 
You are entitled to have a friend or family member help you in an informal and unpaid manner, but only if the person receives no compensation directly or indirectly.
 
 
fiveWhat are my options after appeal?
 
Appeal decisions are final, and cannot be appealed.
 
Depending on the case, you may be able to apply for variation or revocation of the appeal decision by the Director of Arbitrations or Director’s Delegate.
 
You may be able to have a court review an appeal decision (judicial review). You should get legal advice before deciding to take this step.