Insurer’s reserves “should almost never be ordered produced” in Ontario SABS cases: FSCO arbitrator

An insurer’s reserves “should almost never be ordered produced” in statutory accident benefits claims made under Ontario’s SABS legislation, an arbitrator for the Financial Services Commission of Ontario (FSCO) has found.
Reserves are estimated amounts assigned by an insurer to account for the total possible future payout of a person’s claims arising from an accident.
In Security National Insurance Company/Monnex Insurance Management Inc. and Wakeel Qazi, FSCO arbitrator David Evans notes that arbitrators have historically meandered back and forth on the question of whether or not an insurer should be disclosing information about its reserves in AB claims.
On the one hand, arbitrators have ruled that reserve information is relevant regarding an insurer’s investigation of a claim and should therefore be disclosed.
On the other, arbitrators have concluded, as was done in Ouimet and Wawanesa Mutual Insurance Company, that: “evidence about total claims serves little to advance an insured person’s claim for specific benefits, while offering potential to sidetrack the disability or treatment issues.”
Evans observed “the courts have generally taken the same position as set out in Ouimet,” namely that reserve information “does not have a semblance of relevance” for the purpose of determining a specific claim for accident benefits.
“I see no reason why arbitral case law should differ from the courts in this area,” Evans said. “I find that providing irrelevant information to an insured does not serve the purpose of consumer protection, or that the provisions of the SABS require their production.”