With this Bulletin the Financial Services Commission of Ontario (FSCO) is releasing a revised Standard Benefit Statement, the use of which will become mandatory on September 1, 2014.
Standard Benefit Statement
Following further testing and development of the Standard Benefit Statement, which was released with Bulletin A-09/13 on December 20, 2013, a deficiency in the form has been identified.
In the small number of cases where policyholders purchase the $1 million optional benefit they would have policy limits of up to $1,100,000 available for the medical and rehabilitation benefit and up to $1,072,000 for the attendant care benefit, subject to an overall combined aggregate limit of $1,172,000 for the total amount payable. If the policyholder sustains a catastrophic injury the limits are increased to $2,000,000 for the medical and rehabilitation benefit and $2,000,000 for the attendant care benefit, up to a combined aggregate limit of $3,000,000.
The Standard Benefit Statement released in December 2013 does not display the aggregate remaining balance for these policyholders as the medical and rehabilitation benefits and attendant care benefits are listed separately.
An additional table has been added to the Standard Benefit Statement which provides information about the combined medical, rehabilitation and attendant care policy limit for those claimants who have purchased the $1 million optional benefit.
Effective Date of Revised Standard Benefit Statement
The revised Standard Benefit Statement replaces the version released with Bulletin A-09/13. Beginning September 1, 2014, insurers will be required to deliver the attached revised Standard Benefit Statement to accident benefit claimants.
All other conditions outlined in Bulletin A-09/13 regarding general formatting (e.g., font style, spacing, colours) and presentation remains the same.
The Statement form is available in Word and PDF format, in English and French, on FSCO's website at www.fsco.gov.on.ca.
The Statement is issued for the purposes of s.50 (3) (f) of the Statutory Accident Benefits Schedule – Effective September 1, 2010 (SABS).
Chief Executive Officer and
Superintendent of Financial Services
June 18, 2014