When a person’s own insurance company starts to deny him/her benefits, a personal injury lawyer’s assistance is critical. There is a government body called the Financial Services Commission of Ontario (FSCO) that governs all matters of insurance in this province including accidents benefits.
If your own insurer refuses to pay for a benefit that you feel entitled to and is supported by the medical evidence, you can make an application for mediation to FSCO. At this point, the FSCO will appoint a mediator and then a mediation is set up usually by teleconference (but not always) to try to resolve the issues between the parties. I bring many applications for mediations on a regular basis on behalf of clients and have successfully secured many many benefits for people.
If the mediation fails to resolve the issues between you and your insurance company then you have one of three choices to make. You can decide not to fight it and do nothing, you can bring an application for arbitration through the FSCO process or you can bring a claim in the Superior Court of Ontario. Which path you should take is made on a case by case basis. You will need legal representation to get through this process. I can help. (22)