Insurance Act, R.S.O. 1990, c. I.8 (section subset)

Section 1§Sections Definitions

In this Act, except where inconsistent with the definition sections of any Part,

“accountant” means a person who is licensed under the Public Accounting Act, 2004; (“comptable”)

“actuary” means a Fellow of the Canadian Institute of Actuaries; (“actuaire”)

“adjuster” means a person who,

(a) on behalf of an insurer or an insured, for compensation, directly or indirectly solicits the right to negotiate the settlement of or investigate a loss or claim under a contract or a fidelity, surety or guaranty bond issued by an insurer, or investigates, adjusts or settles any such loss or claim, or

(b) holds himself, herself or itself out as an adjuster, investigator, consultant or adviser with respect to the settlement of such losses or claims,

but does not include,

(c) a barrister or solicitor acting in the usual course of the practice of law,

(d) a trustee or agent of the property insured,

(e) a salaried employee of a licensed insurer while acting on behalf of such insurer in the adjustment of losses,

(f) a person who is employed as an appraiser, engineer or other expert solely for the purpose of giving expert advice or evidence, or

(g) a person who acts as an adjuster of marine losses only; (“expert d’assurance”)

“agent” means a person who, for compensation, commission or any other thing of value,

(a) solicits insurance on behalf of an insurer who has appointed the person to act as the agent of such insurer or on behalf of the Facility Association under the Compulsory Automobile Insurance Act, or

(b) solicits insurance on behalf of an insurer or transmits, for a person other than himself, herself or itself, an application for, or a policy of insurance to or from such insurer, or offers or assumes to act in the negotiation of such insurance or in negotiating its continuance or renewal with such insurer,

and who is not a member of the Registered Insurance Brokers of Ontario; (“agent”)

“Authority” means the Financial Services Regulatory Authority of Ontario continued under subsection 2 (1) of the Financial Services Regulatory Authority of Ontario Act, 2016; (“Autorité”)

“Authority rule” means a rule made under subsection 121.0.1 (1); (“règle de l’Autorité”)

“automobile” includes a trolley bus and a self-propelled vehicle, and the trailers, accessories and equipment of automobiles, but does not include railway rolling stock that runs on rails, watercraft or aircraft; (“automobile”)

“broker” means an insurance broker within the meaning of the Registered Insurance Brokers Act; (“courtier”)

“cash-mutual corporation” means a corporation without share capital that is empowered to undertake insurance on both the cash plan and the mutual plan; (“société mutuelle au comptant”)

“chief agency” means the principal office or place of business in Ontario of any licensed insurer having its head office out of Ontario; (“agence principale”)

“Chief Executive Officer” means the Chief Executive Officer appointed under subsection 10 (2) of the Financial Services Regulatory Authority of Ontario Act, 2016; (“directeur général de l’Autorité”)

“Commission” means the former Financial Services Commission of Ontario that was established under the repealed Financial Services Commission of Ontario Act, 1997; (“Commission”)

“compensation association” means a body corporate or unincorporated association the purpose of which is to provide compensation to claimants and policyholders of insolvent insurers and that has been designated under the regulations as a compensation association; (“association d’indemnisation”)

“contract” means a contract of insurance, and includes a policy, certificate, interim receipt, renewal receipt, or writing evidencing the contract, whether sealed or not, and a binding oral agreement; (“contrat”)

“debt obligation” means a bond, debenture, note or other evidence of indebtedness, whether the debt is secured or unsecured; (“titre de créance”)

“due application” includes such information, evidence and material as the Chief Executive Officer requires to be furnished and the payment of the fees established by the Minister in respect of any application, certificate or document required or issued by virtue of this Act; (“demande régulière”)

“entity” includes a corporation, trust, partnership, fund, unincorporated association or organization, the Crown, a Crown agency, the government of a foreign country or of a political subdivision of a foreign country and any agency of that government; (“entité”)

“exchange” or “reciprocal insurance exchange” means a group of subscribers exchanging reciprocal contracts of indemnity or insurance with each other through the same attorney; (“bourse” ou “bourse d’assurance réciproque”)

“financial institution” means,

(a) an insurer that is incorporated or organized under the laws of Canada or of any province of Canada,

(b) a bank or authorized foreign bank within the meaning of section 2 of the Bank Act (Canada),

(c) a loan or trust corporation incorporated or organized under the laws of Canada or any province of Canada,

(d) an entity that,

(i) is incorporated or organized under the laws of Canada or of any province of Canada, and

(ii) primarily engages in dealing in securities, including portfolio management and investment counselling,

(e) a credit union or caisse populaire incorporated under the laws of any province of Canada or an association to which the Cooperative Credit Associations Act (Canada) applies,

(f) an entity that is prescribed or is a member of a class that is prescribed; (“institution financière”)

“foreign jurisdiction” means a jurisdiction other than Ontario; (“ressort étranger”)

“fraternal society” means a society, order or association incorporated for the purpose of making with its members only, and not for profit, contracts of life insurance or accident and sickness insurance in accordance with its constitution, by-laws and rules and this Act; (“société fraternelle”)

“governing executive authority” means the executive committee, executive board, management committee, grand executive committee or such other board, committee or body as is charged under the constitution and rules of a fraternal society with its general management between general meetings; (“organe de direction”)

“head office” means the place where the chief executive officer of an insurer transacts business; (“siège social”)

“insurance” means the undertaking by one person to indemnify another person against loss or liability for loss in respect of a certain risk or peril to which the object of the insurance may be exposed, or to pay a sum of money or other thing of value upon the happening of a certain event, and includes life insurance; (“assurance”)

“insurance fund” or “insurance funds”, as applied to a fraternal society or as applied to a corporation not incorporated exclusively for the transaction of insurance, includes all money, securities for money and assets appropriated by the rules of the society or corporation to the payment of insurance liabilities or appropriated for the management of the insurance branch or department or division of the society, or otherwise legally available for insurance liabilities, but does not include funds of a trade union appropriated to or applicable for the voluntary assistance of wage earners unemployed or upon strike; (“fonds d’assurance”)

“insurance money” means the amount payable by an insurer under a contract, and includes all benefits, surplus, profits, dividends, bonuses, and annuities payable under the contract; (“sommes assurées”)

“insurance on the cash plan” means any insurance that is not mutual insurance; (“assurance au comptant”)

“insurer” means the person who undertakes or agrees or offers to undertake a contract; (“assureur”)

“lodge” includes a primary subordinate division, by whatever name known, of a fraternal society; (“loge”)

Note: On a day to be named by proclamation of the Lieutenant Governor, section 1 of the Act is amended by adding the following definition: (See: 2024, c. 20, Sched. 10, s. 1)

“managing general agent” means a corporation or partnership or an entity belonging to a class prescribed by Authority rule that holds a managing general agent licence issued under Part XIV.1; (“agent général gestionnaire”)

“Minister” means the Minister of Finance; (“ministre”)

“motor vehicle liability policy” means a policy or part of a policy evidencing a contract insuring,

(a) the owner or driver of an automobile, or

(b) a person who is not the owner or driver thereof where the automobile is being used or operated by that person’s employee or agent or any other person on that person’s behalf,

against liability arising out of bodily injury to or the death of a person or loss or damage to property caused by an automobile or the use or operation thereof; (“police de responsabilité automobile”)

“mutual benefit society” means a mutual corporation formed for the purpose of providing insurance against sickness, disability or death for its members, or for these and any other purposes necessary or incidental thereto except life insurance, but does not include a pension fund or employees’ mutual benefit society incorporated under or subject to the Corporations Act; (“société de secours mutuel”)

“mutual corporation” means a corporation without share capital that is empowered to undertake mutual insurance exclusively; (“société mutuelle”)

“mutual insurance” means a contract of insurance in which the consideration is not fixed or certain at the time the contract is made and is to be determined at the termination of the contract or at fixed periods during the term of the contract according to the experience of the insurer in respect of all similar contracts, whether or not the maximum amount of such consideration is predetermined; (“assurance mutuelle”)

“non-owner’s policy” means a motor vehicle liability policy insuring a person solely in respect of the use or operation by that person or on that person’s behalf of an automobile that is not owned by that person; (“police de non-propriétaire”)

“officer” includes a trustee, director, manager, treasurer, secretary or member of the board or committee of management of an insurer and a person appointed by the insurer to sue and be sued in its behalf; (“dirigeant”)

“owner’s policy” means a motor vehicle liability policy insuring a person in respect of the ownership, use or operation of an automobile owned by that person and within the description or definition thereof in the policy and, if the contract so provides, in respect of the use or operation of any other automobile; (“police de propriétaire”)

“paid in”, when applied to the capital stock of an insurer or to any shares thereof, means the amount paid to the insurer on its shares, not including the premium, if any, paid thereon, whether such shares are or are not fully paid; (“versé”)

“paid up”, when applied to the capital stock of an insurer or to any shares thereof, means the capital stock or shares on which there remains no liability, actual or contingent, to the issuing insurer; (“libéré”)

“participating share” means a share of a corporation that carries the right to participate in the earnings of the corporation to an unlimited degree and to participate in a distribution of the remaining property of the corporation on dissolution; (“action participante”)

“policy” means the instrument evidencing a contract; (“police”)

“premium” means the single or periodical payment under a contract for insurance, and includes dues, assessments, administration fees paid for the administration or servicing of such contract, and other considerations; (“prime”)

“premium note” means an instrument given as consideration for insurance whereby the maker undertakes to pay such sum or sums as may be legally demanded by the insurer, but the aggregate of which sums does not exceed an amount specified in the instrument; (“billet de souscription”)

“property” includes profits, earnings and other pecuniary interests, and expenditure for rents, interest, taxes and other outgoings and charges and in respect of inability to occupy the insured premises, but only to the extent of express provision in the contract; (“biens”)

“rate”, in relation to automobile insurance, means all amounts payable under contracts of automobile insurance for an identified risk whether expressed in dollar terms or in some other manner and includes commissions, surcharges, fees, discounts, rebates and dividends; (“taux”)

“regulations” means the regulations made under this Act; (“règlements”)

“risk classification system”, in relation to automobile insurance, means the elements used for the purpose of classifying risks in the determination of rates for a coverage or category of automobile insurance, including the variables, criteria, rules and procedures used for that purpose; (“système de classement des risques”)

“security” means, when used to refer to a form of investment,

(a) a share of any class of shares of a corporation or a debt obligation of a corporation, and includes a warrant of a corporation, but does not include a deposit with a financial institution, any instrument evidencing a deposit with a financial institution or a policy, or

(b) any ownership interest in or debt obligation of an unincorporated entity, but does not include a policy; (“titre”or “valeur mobilière”)

“security interest” means an interest in or charge upon property by way of mortgage, hypothec, pledge or otherwise, to secure the payment of a debt or the performance of another obligation; (“sûreté”)

“spouse” means either of two persons who,

(a) are married to each other,

(b) have together entered into a marriage that is voidable or void, in good faith on the part of the person asserting a right under this Act, or

(c) are not married to each other and live together in a conjugal relationship outside marriage; (“conjoint”)

Note: On a day to be named by proclamation of the Lieutenant Governor, section 1 of the Act is amended by adding the following definition: (See: 2024, c. 20, Sched. 10, s. 1)

“sub-managing general agent” means a managing general agent that performs managing general agent activities pursuant to an agreement with another managing general agent or sub-managing general agent; (“sous-agent général gestionnaire”)

“Superintendent” means the former position of Superintendent of Financial Services under the repealed Financial Services Commission of Ontario Act, 1997. (“surintendent”)

“Tribunal” means the Financial Services Tribunal continued under the Financial Services Tribunal Act, 2017; (“Tribunal”)

“upon proof”, as applied to any matter connected with the licensing of an insurer or other person, means upon proof to the satisfaction of the Chief Executive Officer; (“sur preuve”)

“voting share” means a share of a corporation carrying voting rights under all circumstances or by reason of an event that has occurred and is continuing or by reason of a condition that has been fulfilled. (“action avec droit de vote”) R.S.O. 1990, c. I.8, s. 1; 1993, c. 10, s. 2; 1994, c. 11, s. 336; 1996, c. 21, s. 1; 1997, c. 19, s. 10 (1); 1997, c. 28, s. 64; 1999, c. 6, s. 31 (1); 1999, c. 12, Sched. I, s. 4 (1, 2); 2002, c. 18, Sched. H, s. 4 (1-4); 2004, c. 8, s. 46; 2004, c. 31, Sched. 20, s. 1; 2005, c. 5, s. 35 (1, 2); 2006, c. 33, Sched. O, s. 1; 2014, c. 9, Sched. 3, s. 1; 2017, c. 34, Sched. 17, s. 22; 2018, c. 8, Sched. 13, s. 1, 22; 2019, c. 14, Sched. 9, s. 1; 2020, c. 34, Sched. 7, s. 1; 2020, c. 36, Sched. 14, s. 8 (1).

Section 142§Sections

Repealed: 2019, c. 14, Sched. 9, s. 20.

Section 143§Sections Application of Part

(1) This Part applies to insurance against loss of or damage to property arising from the peril of fire in any contract made in Ontario except,

(a) insurance within the class of aircraft insurance;

(a.1) insurance within the class of automobile insurance;

(a.2) insurance within the class of boiler and machinery insurance;

(a.3) insurance (other than marine insurance) against loss of or damage to property,

(i) while in transit or during delay incidental to transit, or

(ii) where, in the opinion of the Chief Executive Officer, the risk is substantially a transit risk;

(a.4) insurance within the class of marine insurance;

(a.5) insurance against loss of or damage to plate, sheet or window glass, whether in place or in transit;

(a.6) insurance against loss of or damage to property through the breakage or leakage of sprinkler equipment or other fire protection system, or of pumps, water pipes or plumbing and its fixtures;

(a.7) insurance against loss or damage through theft, wrongful conversion, burglary, house-breaking, robbery or forgery;

(b) where the subject-matter of the insurance is rents, charges or loss of profits;

(c) where the peril of fire is an incidental peril to the coverage provided; or

(d) where the subject-matter of the insurance is property that is insured by an insurer or group of insurers primarily as a nuclear risk under a policy covering against loss of or damage to the property resulting from nuclear reaction or nuclear radiation and from other perils. R.S.O. 1990, c. I.8, s. 143 (1); 2002, c. 18, Sched. H, s. 4 (19); 2018, c. 8, Sched. 13, s. 22.

(2) Repealed: 2015, c. 20, Sched. 17, s. 2.

Section 144§Sections Extent of coverage by contract

(1) Subject to subsection (4) of this section and to clause 151 (a), in any contract to which this Part applies the contract shall be deemed to cover the insured property,

(a) against fire (whether resulting from explosion or otherwise) not occasioned by or happening through,

(i) in the case of goods, their undergoing any process involving the application of heat,

(ii) riot, civil commotion, war, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection or military power;

(b) against lightning, but excluding destruction or loss to electrical devices or appliances caused by lightning or other electrical currents unless fire originates outside the article itself and only for such destruction or damage as occurs from such fire;

(c) against explosion (not occasioned by or happening through any of the perils specified in subclause (a) (ii)) of natural, coal or manufactured gas in a building not forming part of a gas works, whether fire ensues therefrom or not. R.S.O. 1990, c. I.8, s. 144 (1).

Radioactive contamination

(2) Unless a contract to which this Part applies otherwise specifically provides, it does not cover the insured property against loss or damage caused by contamination by radio-active material directly or indirectly resulting from fire, lightning or explosion within the meaning of subsection (1). R.S.O. 1990, c. I.8, s. 144 (2).

Coverage where property removed

(3) Where property insured under a contract covering it at a specified location is necessarily removed to prevent loss or damage or further loss or damage thereto, that part of the insurance under the contract that exceeds the amount of the insurer’s liability for any loss incurred covers, for seven days only or for the unexpired term of the contract if less than seven days, the property removed and any property remaining in the original location in the proportions that the value of the property in each of the respective locations bears to the value of the property in them all. R.S.O. 1990, c. I.8, s. 144 (3).

Extended insurance

(4) Nothing in subsection (1) precludes an insurer giving more extended insurance against the perils mentioned therein, but in that case this Part does not apply to the extended insurance. R.S.O. 1990, c. I.8, s. 144 (4).

Power to extend meaning of “lightning” in livestock contracts

(5) An insurer licensed to carry on property insurance may include in its insurance contracts a clause or endorsement providing that, in the case of livestock insured against death or injury caused by fire or lightning, the word “lightning” is deemed to include other electrical currents. R.S.O. 1990, c. I.8, s. 144 (5); 2002, c. 18, Sched. H, s. 4 (20).

Section 145§Sections Renewal of contract

A contract may be renewed by the delivery of a renewal receipt identifying the policy by number, date or otherwise. R.S.O. 1990, c. I.8, s. 145; 1999, c. 12, Sched. I, s. 4 (16).

Section 146§Sections Form of contract

After an application for insurance is made, if it is in writing, any policy sent to the insured shall be deemed to be intended to be in accordance with the terms of the application, unless the insurer points out in writing the particulars wherein it differs from the application, in which case the insured may, within two weeks from the receipt of the notification, reject the policy. R.S.O. 1990, c. I.8, s. 146.

Section 147§Sections Mortgagees and other payees

(1) Where the loss, if any, under a contract has, with the consent of the insurer, been made payable to a person other than the insured, the insurer shall not cancel or alter the policy to the prejudice of that person without notice to that person. R.S.O. 1990, c. I.8, s. 147 (1).

Form of notice

(2) Subject to subsection (3), the length of and manner of giving the notice under subsection (1) is the same as notice of cancellation to the insured under the statutory conditions in the contract. R.S.O. 1990, c. I.8, s. 147 (2); 1997, c. 19, s. 10 (26).

Alternate notice

(3) If the loss under a contract has, with the consent of the insurer, been made payable to a person other than the insured, the insurer and the person may enter into a written agreement to provide for alternate notice. 1997, c. 19, s. 10 (27).

Section 148§Sections Statutory conditions

(1) The conditions set forth in this section shall be deemed to be part of every contract in force in Ontario and shall be printed in English or French in every policy with the heading “Statutory Conditions” or “Conditions légales”, as may be appropriate, and no variation or omission of or addition to any statutory condition is binding on the insured.

Definition

(2) In this section,

“policy” does not include interim receipts or binders.

STATUTORY CONDITIONS

Misrepresentation

1. If a person applying for insurance falsely describes the property to the prejudice of the insurer, or misrepresents or fraudulently omits to communicate any circumstance that is material to be made known to the insurer in order to enable it to judge of the risk to be undertaken, the contract is void as to any property in relation to which the misrepresentation or omission is material.

Property of Others

2. Unless otherwise specifically stated in the contract, the insurer is not liable for loss or damage to property owned by any person other than the insured, unless the interest of the insured therein is stated in the contract.

Change of Interest

3. The insurer is liable for loss or damage occurring after an authorized assignment under the Bankruptcy and Insolvency Act (Canada) or change of title by succession, by operation of law, or by death.

Material Change

4. Any change material to the risk and within the control and knowledge of the insured avoids the contract as to the part affected thereby, unless the change is promptly notified in writing to the insurer or its local agent, and the insurer when so notified may return the unearned portion, if any, of the premium paid and cancel the contract, or may notify the insured in writing that, if the insured desires the contract to continue in force, the insured must, within fifteen days of the receipt of the notice, pay to the insurer an additional premium, and in default of such payment the contract is no longer in force and the insurer shall return the unearned portion, if any, of the premium paid.

Termination

5. (1) This contract may be terminated,

(a) by the insurer giving to the insured,

(i) 15 days notice of termination by registered mail, or

(ii) five days written notice of termination,

(A) personally delivered,

(B) delivered by prepaid courier, if there is a record by the person who delivered it that the notice has been delivered, or

(C) delivered by electronic means, if the insured consents to delivery by electronic means; or

(b) by the insured at any time on request.

(2) Where this contract is terminated by the insurer,

(a) the insurer shall refund the excess of premium actually paid by the insured over the proportionate premium for the expired time, but, in no event, shall the proportionate premium for the expired time be deemed to be less than any minimum retained premium specified; and

(b) the refund shall accompany the notice unless the premium is subject to adjustment or determination as to amount, in which case the refund shall be made as soon as practicable.

(3) Where this contract is terminated by the insured, the insurer shall refund as soon as practicable the excess of premium actually paid by the insured over the short rate premium for the expired time, but in no event shall the short rate premium for the expired time be deemed to be less than any minimum retained premium specified.

(4) The refund may be made by money, postal or express company money order or cheque payable at par.

(5) The 15 days mentioned in subclause (1) (a) (i) of this condition commences to run on the day following the receipt of the registered letter at the post office to which it is addressed.

(6) The five days mentioned in subclause (1) (a) (ii) of this condition commences to run on,

(a) in respect of delivery by prepaid courier, the day after the day there is a record by the person who delivered it that the notice has been delivered; and

(b) in respect of delivery by electronic means, the day after the day the notice is sent.

Requirements After Loss

6. (1) Upon the occurrence of any loss of or damage to the insured property, the insured shall, if the loss or damage is covered by the contract, in addition to observing the requirements of conditions 9, 10 and 11,

(a) forthwith give notice thereof in writing to the insurer;

(b) deliver as soon as practicable to the insurer a proof of loss verified by a statutory declaration,

(i) giving a complete inventory of the destroyed and damaged property and showing in detail quantities, costs, actual cash value and particulars of amount of loss claimed,

(ii) stating when and how the loss occurred, and if caused by fire or explosion due to ignition, how the fire or explosion originated, so far as the insured knows or believes,

(iii) stating that the loss did not occur through any wilful act or neglect or the procurement, means or connivance of the insured,

(iv) showing the amount of other insurances and the names of other insurers,

(v) showing the interest of the insured and of all others in the property with particulars of all liens, encumbrances and other charges upon the property,

(vi) showing any changes in title, use, occupation, location, possession or exposures of the property since the issue of the contract,

(vii) showing the place where the property insured was at the time of loss;

(c) if required, give a complete inventory of undamaged property and showing in detail quantities, cost, actual cash value;

(d) if required and if practicable, produce books of account, warehouse receipts and stock lists, and furnish invoices and other vouchers verified by statutory declaration, and furnish a copy of the written portion of any other contract.

(2) The evidence furnished under clauses (1) (c) and (d) of this condition shall not be considered proofs of loss within the meaning of conditions 12 and 13.

Fraud

7. Any fraud or wilfully false statement in a statutory declaration in relation to any of the above particulars, vitiates the claim of the person making the declaration.

Who may give notice and proof

8. Notice of loss may be given and proof of loss may be made by the agent of the insured named in the contract in case of absence or inability of the insured to give the notice or make the proof, and absence or inability being satisfactorily accounted for, or in the like case, or if the insured refuses to do so, by a person to whom any part of the insurance money is payable.

Salvage

9. (1) The insured, in the event of any loss or damage to any property insured under the contract, shall take all reasonable steps to prevent further damage to such property so damaged and to prevent damage to other property insured hereunder including, if necessary, its removal to prevent damage or further damage thereto.

(2) The insurer shall contribute proportionately towards any reasonable and proper expenses in connection with steps taken by the insured and required under subcondition (1) of this condition according to the respective interests of the parties.

Entry, Control, Abandonment

10. After loss or damage to insured property, the insurer has an immediate right of access and entry by accredited agents sufficient to enable them to survey and examine the property, and to make an estimate of the loss or damage, and, after the insured has secured the property, a further right of access and entry sufficient to enable them to make appraisement or particular estimate of the loss or damage, but the insurer is not entitled to the control or possession of the insured property, and without the consent of the insurer there can be no abandonment to it of insured property.

Appraisal

11. In the event of disagreement as to the value of the property insured, the property saved or the amount of the loss, those questions shall be determined by appraisal as provided under the Insurance Act before there can be any recovery under this contract whether the right to recover on the contract is disputed or not, and independently of all other questions. There shall be no right to an appraisal until a specific demand therefor is made in writing and until after proof of loss has been delivered.

When Loss Payable

12. The loss is payable within sixty days after completion of the proof of loss, unless the contract provides for a shorter period.

Replacement

13. (1) The insurer, instead of making payment, may repair, rebuild, or replace the property damaged or lost, giving written notice of its intention so to do within thirty days after receipt of the proofs of loss.

(2) In that event the insurer shall commence to so repair, rebuild, or replace the property within forty-five days after receipt of the proofs of loss, and shall thereafter proceed with all due diligence to the completion thereof.

Action

14. Every action or proceeding against the insurer for the recovery of a claim under or by virtue of this contract is absolutely barred unless commenced within one year next after the loss or damage occurs.

Notice

15. (1) Written notice may be given to the insurer in the following ways:

1. It may be personally delivered at the chief agency or head office of the insurer in the Province.

2. It may be sent by registered mail to the chief agency or head office of the insurer in the Province.

3. It may be delivered by electronic means.

(2) Written notice may be given to the insured named in the contract in the following ways:

1. It may be personally delivered.

2. It may be delivered by prepaid courier to the latest address of the insured on the records of the insurer if there is a record by the person who has delivered it that the notice has been delivered.

3. It may be sent by registered mail to the latest address of the insured on the records of the insurer.

4. It may be delivered by electronic means if the insured consents to delivery by electronic means.

(3) In this condition, the expression “registered” means registered in or outside Canada.

R.S.O. 1990, c. I.8, s. 148; 2016, c. 5, Sched. 14, s. 3; 2019, c. 7, Sched. 33, s. 5 (1); 2020, c. 36, Sched. 22, s. 3; 2021, c. 40, Sched. 14, s. 3; 2024, c. 20, Sched. 10, s. 6.

Section 149§Sections Limitation of liability clause

A contract containing,

(a) a deductible clause;

(b) a co-insurance, average or similar clause; or

(c) a clause limiting recovery by the insured to a specified percentage of the value of any property insured at the time of loss, whether or not that clause is conditional or unconditional,

shall have printed or stamped upon its face in red ink or bold type the words “The policy contains a clause that may limit the amount payable”, or the French equivalent failing which the clause is not binding upon the insured. R.S.O. 1990, c. I.8, s. 149; 1997, c. 19, s. 10 (28).

Section 150§Sections Rateable contribution

(1) Where on the happening of any loss or damage to property insured there is in force more than one contract covering the same interest, each of the insurers under the respective contracts is liable to the insured for its rateable proportion of the loss, unless it is otherwise expressly agreed in writing between the insurers.

Effect of policy may not be postponed

(2) For the purpose of subsection (1), a contract shall be deemed to be in force despite any term thereof that the policy will not cover, come into force, attach or become insurance with respect to the property until after full or partial payment of any loss under any other policy.

Certain restrictions valid

(3) Nothing in subsection (1) affects the validity of any divisions of the sum insured into separate items, or any limits of insurance on specified property, or any clause referred to in section 149 or any contract condition limiting or prohibiting the having or placing of other insurance.

Ascertainment of rateable proportions

(4) Nothing in subsection (1) affects the operation of any deductible clause and,

(a) where one contract contains a deductible, the proportion of the insurer under that contract shall be first ascertained without regard to the clause and then the clause shall be applied only to affect the amount of recovery under that contract; and

(b) where more than one contract contains a deductible, the proportions of the insurers under those contracts shall be first ascertained without regard to the deductible clauses and then the highest deductible shall be pro rated among the insurers with deductibles and these pro rated amounts shall affect the amount of recovery under those contracts.

Idem

(5) Nothing in subsection (4) shall be construed to have the effect of increasing the proportional contribution of an insurer under a contract that is not subject to a deductible clause.

Insurance on identified articles

(6) Despite subsection (1), insurance on identified articles is a first loss insurance as against all other insurance. R.S.O. 1990, c. I.8, s. 150.

Section 151§Sections Special stipulations

Where a contract,

(a) excludes any loss that would otherwise fall within the coverage prescribed by section 144; or

(b) contains any stipulation, condition or warranty that is or may be material to the risk including, but not restricted to, a provision in respect to the use, condition, location or maintenance of the insured property,

the exclusion, stipulation, condition or warranty is not binding upon the insured, if it is held to be unjust or unreasonable by the court before which a question relating thereto is tried. R.S.O. 1990, c. I.8, s. 151.

Section 152§Sections Subrogation

(1) The insurer, upon making a payment or assuming liability therefor under a contract to which this Part applies, is subrogated to all rights of recovery of the insured against any person, and may bring action in the name of the insured to enforce such rights. R.S.O. 1990, c. I.8, s. 152 (1); 2002, c. 18, Sched. H, s. 4 (21).

Where amount recovered is not sufficient to indemnify

(2) Where the net amount recovered, after deducting the costs of recovery, is not sufficient to provide a complete indemnity for the loss or damage suffered, that amount shall be divided between the insurer and the insured in the proportions in which the loss or damage has been borne by them respectively. R.S.O. 1990, c. I.8, s. 152 (2).

Section 153§Sections General reinsurance agreement

An insurer that is a member of the Fire Mutuals Guarantee Fund shall enter into and remain a party to a general reinsurance agreement with a mutual insurance corporation incorporated under subsection 148 (3) of the Corporations Act. 1999, c. 12, Sched. I, s. 4 (17).

Section 154-168§Sections

Repealed: 1999, c. 12, Sched. I, s. 4 (17).

Section 169§Sections Fire Mutuals Guarantee Fund

(1) The agreement establishing the Fire Mutuals Guarantee Fund is continued and may be amended with the approval of the Chief Executive Officer. 1999, c. 12, Sched. I, s. 4 (18); 2018, c. 8, Sched. 13, s. 22.

Members

(2) The following persons may be members of the Fund, with the approval of the Chief Executive Officer:

1. Mutual insurance corporations including those that are incorporated under subsection 148 (3) of the Corporations Act.

2. Joint stock insurance companies, all the shares of which are owned by one or more mutual insurance corporations that are members of the Fund. 1999, c. 12, Sched. I, s. 4 (18); 2018, c. 8, Sched. 13, s. 22.

Purposes

(3) The Fund has the following purposes, and such additional purposes as may be set out in the agreement:

1. To pay the insurance claims and repay the unearned premiums of policyholders who are members of the Fund, if a member is unable to meet its obligations.

2. To pay the insurance claims of third parties against policyholders who are members of the Fund, if a member is unable to meet its obligations. 1999, c. 12, Sched. I, s. 4 (18).

Same

(3.1) With the approval of the Chief Executive Officer, the assets of the Fund may be used for the purposes of the Fund. 1999, c. 12, Sched. I, s. 4 (18); 2018, c. 8, Sched. 13, s. 22.

Powers

(3.2) If the Fund is authorized to do so by the agreement, the Fund may,

(a) assess its members in respect of any payments that the Fund has authorized in respect of a member who is unable to meet its obligations; and

(b) until the assessments are paid, borrow money or establish lines of credit for the purposes of making payments in respect of the member who is unable to meet its obligations. 1999, c. 12, Sched. I, s. 4 (18).

Administration

(3.3) The assets of the Fund shall be held in trust by a trust corporation registered under the Loan and Trust Corporations Act. 1999, c. 12, Sched. I, s. 4 (18).

Assets of Fund

(4) The assets of the Fund shall,

(a) be maintained at no less than a book value of $1,000,000 including the value of any assessments made to restore the book value of $1,000,000, or such further amount as may be specified from time to time by the Chief Executive Officer;

(b) be maintained or increased by assessments on parties to the agreement on the basis set out in the agreement referred to in subsection (1);

(c) Repealed: 2006, c. 33, Sched. O, s. 8 (1).

(d) be invested and valued in accordance with the regulations. R.S.O. 1990, c. I.8, s. 169 (4); 1999, c. 12, Sched. I, s. 4 (19); 2006, c. 33, Sched. O, s. 8; 2018, c. 8, Sched. 13, s. 22.

Relief from assessment

(5) No assessment referred to in clause (3.2) (a) or (4) (b) shall be paid by an insurer if its effect would be to reduce the surplus of that insurer below the minimum amount specified by the Chief Executive Officer, and such a waiver of an assessment shall not be cause for the insurer’s expulsion from the Fund. R.S.O. 1990, c. I.8, s. 169 (5); 1999, c. 12, Sched. I, s. 4 (20); 2018, c. 8, Sched. 13, s. 22.

Interest of Chief Executive Officer in Fund

(6) The Chief Executive Officer shall be deemed to have an interest in the Fund as representative of all persons who may be claimants against insurers that are parties to the agreement and the trustees shall from time to time furnish the Chief Executive Officer with such information and accounts with respect to the Fund as the Chief Executive Officer may require. R.S.O. 1990, c. I.8, s. 169 (6); 2018, c. 8, Sched. 13, s. 22.

Cessation of membership

(7) The Chief Executive Officer may permit an insurer to cease to be a member of the Fund and may impose such terms and conditions respecting the cessation as the Chief Executive Officer considers appropriate. 1999, c. 12, Sched. I, s. 4 (21); 2018, c. 8, Sched. 13, s. 22.

Withdrawal of approval

(7.1) The Chief Executive Officer may withdraw his or her approval under subsection (2) when an insurer is in default of payment of its assessment under the agreement. 1999, c. 12, Sched. I, s. 4 (21); 2018, c. 8, Sched. 13, s. 22.

(8) Repealed: 2019, c. 14, Sched. 9, s. 20.

Application of Act

(9) All parties to the agreement and their officers and directors shall be deemed to be persons engaged in the business of insurance for the purposes of this Act and the regulations and any contravention of the trust agreement constitutes an offence. R.S.O. 1990, c. I.8, s. 169 (9).

Passing of accounts

(10) An account filed with the Chief Executive Officer under subsection (6), except so far as mistake or fraud is shown, is binding and conclusive upon all interested persons as to all matters shown in the account and the trustees’ administration thereof, unless the Chief Executive Officer, within six months of the date upon which the account is filed with him or her, requires in writing that such account be filed and passed before a judge of the Superior Court of Justice. R.S.O. 1990, c. I.8, s. 169 (10); 2006, c. 19, Sched. C, s. 1 (1); 2018, c. 8, Sched. 13, s. 22.

Idem

(11) The provisions of the Estates Act and the rules made thereunder and of the Trustee Act with respect to the passing of accounts of the trustees apply, with necessary modifications, to the passing of accounts under subsection (10). R.S.O. 1990, c. I.8, s. 169 (11).

Section 170§Sections

Repealed: 1999, c. 12, Sched. I, s. 4 (22).

Section 178§Sections Insurable interest required

(1) Subject to subsection (2), where at the time a contract would otherwise take effect the insured has no insurable interest, the contract is void. R.S.O. 1990, c. I.8, s. 178 (1).

Exceptions

(2) A contract is not void for lack of insurable interest,

(a) if it is a contract of group insurance; or

(b) if the person whose life is insured has consented in writing to the insurance being placed on his or her life. R.S.O. 1990, c. I.8, s. 178 (2).

Consent of minor

(3) Where the person whose life is insured is under the age of sixteen years, consent to insurance being placed on the person’s life may be given by one of his or her parents or by a person standing in the role of parent to him or her. R.S.O. 1990, c. I.8, s. 178 (3); 2021, c. 4, Sched. 11, s. 19.

Section 179§Sections Insurable interest, defined

Without restricting the meaning of “insurable interest”, a person, in this section called the “primary person”, has an insurable interest,

(a) in the case of a primary person who is a natural person, in his or her own life and in the lives of,

(i) the primary person’s child or grandchild,

(ii) the primary person’s spouse,

(iii) a person on whom the primary person is wholly or partly dependent for, or from whom the primary person is receiving, support or education,

(iv) the primary person’s employee, and

(v) a person in the duration of whose life the primary person has a pecuniary interest; and

(b) in the case of a primary person that is not a natural person, in the lives of,

(i) a director, officer or employee of the primary person, and

(ii) a person in the duration of whose life the primary person has a pecuniary interest. 2012, c. 8, Sched. 23, s. 14.

Section 179.1§Sections Termination of contract by court

Application to court

(1) A person may make an application to the court if,

(a) the person’s life is insured under a contract;

(b) the person is not the insured under the contract; and

(c) the person reasonably believes that the person’s life or health might be endangered by the insurance on his or her life continuing under that contract. 2012, c. 8, Sched. 23, s. 15.

Court order

(2) Upon an application being made under subsection (1), the court may make any order it considers just in the circumstances, including,

(a) an order that the insurance on that person’s life under the contract be terminated in accordance with the terms of the contract other than any terms respecting notice of termination; and

(b) an order that the amount of insurance under the contract on that person’s life be reduced. 2012, c. 8, Sched. 23, s. 15.

Notice

(3) An application under subsection (1) must be made on at least 30 days notice to the insured, the beneficiary, the insurer and any other person the court considers to have an interest in the contract. 2012, c. 8, Sched. 23, s. 15.

Same

(4) Despite subsection (3), if the court considers it just to do so, it may dispense with the notice to a person other than,

(a) the insurer; or

(b) if the contract is a contract of group insurance or of creditor’s group insurance, the insured. 2020, c. 34, Sched. 7, s. 4.

Who is bound by order

(5) An order made under subsection (2) binds any person having an interest in the contract. 2012, c. 8, Sched. 23, s. 15.

Section 224§Sections Interpretation, Part VI

(1) In this Part,

“automobile” includes,

(a) a motor vehicle required under any Act to be insured under a motor vehicle liability policy, and

(b) a vehicle prescribed by regulation to be an automobile; (“automobile”)

“contract” means a contract of automobile insurance that,

(a) is undertaken by an insurer that is licensed to undertake automobile insurance in Ontario, or

(b) is evidenced by a policy issued in another province or territory of Canada, the United States of America or a jurisdiction designated in the Statutory Accident Benefits Schedule by an insurer that has filed an undertaking under section 226.1; (“contrat”)

“excluded driver” means a person named as an excluded driver in an endorsement under section 249; (“conducteur exclu”)

“fault determination rules” means the rules prescribed under paragraph 21 of subsection 121 (1); (“règles de détermination de la responsabilité”)

“health care” includes all goods and services for which payment is provided by the medical, rehabilitation and attendant care benefits provided for in the Statutory Accident Benefits Schedule; (“soins de santé”)

“insured” means a person insured by a contract whether named or not and includes every person who is entitled to statutory accident benefits under the contract whether or not described therein as an insured person; (“assuré”)

“listed expenses” means, in connection with statutory accident benefits, the amounts payable that, under section 288.1, are listed expenses; (“frais désignés”)

“occupant”, in respect of an automobile, means,

(a) the driver,

(b) a passenger, whether being carried in or on the automobile,

(c) a person getting into or on or getting out of or off the automobile; (“personne transportée”)

“public transit” means,

(a) any service for which a fare is charged for transporting the public by automobiles operated by or on behalf of a municipality or a local board as defined in the Municipal Affairs Act, or under an agreement between a municipality and a person, firm or corporation, but does not include special transportation facilities for persons with disabilities or transportation by special purpose facilities such as school buses or ambulances, and

(b) any service prescribed by regulation to be public transit, in the circumstances and subject to the terms, conditions, provisions, exclusions and limits prescribed by the regulation,

but does not include any service prescribed by regulation not to be public transit, in the circumstances and subject to the terms, conditions, provisions, exclusions and limits prescribed by the regulation; (“transport en commun”)

“public transit vehicle” means an automobile while being used for public transit; (“véhicule de transport en commun”)

“service provider’s licence” means a licence issued under section 288.5; (“permis de fournisseur de services”)

“spouse” means either of two persons who,

(a) are married to each other,

(b) have together entered into a marriage that is voidable or void, in good faith on the part of the person asserting a right under this Act, or

(c) have lived together in a conjugal relationship outside marriage,

(i) continuously for a period of not less than three years, or

(ii) in a relationship of some permanence, if they are the parents of a child; (“conjoint”)

“statutory accident benefits” means the benefits set out in the regulations made under paragraphs 9 and 10 of subsection 121 (1); (“indemnités d’accident légales”)

“Statutory Accident Benefits Schedule” means the regulations made under paragraphs 9 and 10 of subsection 121 (1). (“Annexe sur les indemnités d’accident légales”) R.S.O. 1990, c. I.8, s. 224 (1); 1993, c. 10, s. 1; 1996, c. 21, s. 15; 1999, c. 6, s. 31 (4); 2002, c. 22, s. 115; 2005, c. 5, s. 35 (5-8); 2011, c. 9, Sched. 21, s. 2; 2013, c. 2, Sched. 8, s. 12; 2016, c. 23, s. 55 (1).

(2)-(5) Repealed: 2020, c. 34, Sched. 7, s. 6 (1).

Additional benefits

(6) An insurer, with the approval of the Chief Executive Officer, may offer optional benefits in excess of the benefits that must be provided under the Statutory Accident Benefits Schedule. R.S.O. 1990, c. I.8, s. 224 (6); 1993, c. 10, s. 1; 1997, c. 28, s. 109; 2018, c. 8, Sched. 13, s. 22.

Idem

(7) Optional benefits offered under subsection (6) shall be deemed to be statutory accident benefits and the Statutory Accident Benefits Schedule applies to them with necessary modifications. R.S.O. 1990, c. I.8, s. 224 (7); 1993, c. 10, s. 1.

Transition

(8) The following provisions, as they read immediately before the day section 8 of Schedule 7 to the Better for People, Smarter for Business Act, 2020 came into force, continue to apply to proceedings commenced before that day:

1. Section 266.

2. Section 267.

3. Section 267.1.

4. Subsection 267.5 (1). 2020, c. 34, Sched. 7, s. 6 (2).

Same

(9) Sections 266 to 267.1, as they read immediately before the day section 8 of Schedule 7 to the Better for People, Smarter for Business Act, 2020 came into force, continue to apply to new proceedings for loss or damage from bodily injury or death arising from the use or operation, before November 1, 1996, of an automobile in Canada, the United States of America or a jurisdiction designated in the Statutory Accident Benefits Schedule, during the applicable periods as provided for in those sections. 2020, c. 34, Sched. 7, s. 6 (2).

Section 234§Sections Statutory conditions

(1) The conditions prescribed by the regulations made under paragraph 15.1 of subsection 121 (1) are statutory conditions and shall be deemed to be part of every contract to which they apply and shall be printed in English or French in every policy to which they apply with the heading “Statutory Conditions” or “Conditions légales”, as may be appropriate.

Variation

(2) No variation or omission of or addition to a statutory condition is binding on the insured.

Exceptions

(3) Except as otherwise provided in the contract, the statutory conditions referred to in subsection (1) do not apply to the insurance required by section 265 or 268.

Definition

(4) In subsection (1),

“policy” does not include an interim receipt or binder. 1993, c. 10, s. 17.

Section 237§Sections Limitation on termination

(1) If so required by the regulations and unless the insurer has complied therewith, an insurer shall not decline to issue or terminate or refuse to renew a contract in respect of such coverages and endorsements as may be set out in the regulations or decline to issue, terminate or refuse to renew any contract or refuse to provide or continue any coverage or endorsement on any ground set out in the regulations. R.S.O. 1990, c. I.8, s. 237 (1).

Information

(2) The Chief Executive Officer may require insurers, agents and brokers to provide such information, material and evidence as the Chief Executive Officer considers necessary to determine compliance with subsection (1). R.S.O. 1990, c. I.8, s. 237 (2); 1997, c. 28, s. 111; 2018, c. 8, Sched. 13, s. 22.

Exemption

(3) An insurer may apply to the Chief Executive Officer for an exemption from subsection (1). R.S.O. 1990, c. I.8, s. 237 (3); 1997, c. 28, s. 111; 2018, c. 8, Sched. 13, s. 22.

Idem

(4) An application for an exemption from compliance with subsection (1) shall be in a form approved by the Chief Executive Officer and shall be filed together with such information, materials and evidence as the Chief Executive Officer considers necessary. R.S.O. 1990, c. I.8, s. 237 (4); 1997, c. 28, s. 111; 2018, c. 8, Sched. 13, s. 22.

Idem

(5) The Chief Executive Officer may exempt an insurer in whole or in part from compliance with subsection (1) if, in the opinion of the Chief Executive Officer, compliance with the regulations would impair the solvency of the insurer or would cause the insurer to be in contravention of this Act or the regulations. R.S.O. 1990, c. I.8, s. 237 (5); 1997, c. 28, s. 111; 2018, c. 8, Sched. 13, s. 22.

Non-application

(6) Subsection (1) does not apply in respect of a contract if any payment in respect of premiums payable under the contract or under any ancillary agreement is overdue or if,

(a) the insured has given false particulars of the described automobile to the prejudice of the insurer;

(b) the insured has knowingly misrepresented or failed to disclose in an application for insurance any fact required to be stated therein. R.S.O. 1990, c. I.8, s. 237 (6).

Section 238§Sections Grounds to terminate

(1) An insurer shall not decline to issue, terminate or refuse to renew a contract or refuse to provide or continue a coverage or endorsement, except on a ground filed with the Chief Executive Officer under this section. 1993, c. 10, s. 19; 1997, c. 28, s. 111; 2018, c. 8, Sched. 13, s. 22.

Filing of grounds

(2) An insurer shall file with the Chief Executive Officer the grounds on which the insurer intends to decline to issue, terminate or refuse to renew a contract or refuse to provide or continue a coverage or endorsement. 1993, c. 10, s. 19; 1997, c. 28, s. 111; 2018, c. 8, Sched. 13, s. 22.

Material to be furnished

(3) The grounds shall be filed in a form approved by the Chief Executive Officer and shall be filed together with such information, material and evidence as the Chief Executive Officer may specify. 1993, c. 10, s. 19; 1997, c. 28, s. 111; 2018, c. 8, Sched. 13, s. 22.

Request for additional information

(3.1) The Chief Executive Officer may require that the insurer provide such additional information, material and evidence as the Chief Executive Officer may specify in order to make a decision with respect to a filed ground. 2010, c. 26, Sched. 9, s. 1 (1); 2018, c. 8, Sched. 13, s. 22.

Prohibition from using ground

(4) The Chief Executive Officer shall notify the insurer orally or otherwise that the insurer is prohibited from using one or more of the grounds filed under subsection (2) if the Chief Executive Officer is of the opinion that the ground,

(a) is subjective;

(b) is arbitrary;

(c) bears little or no relationship to the risk to be borne by the insurer in respect of an insured; or

(d) is contrary to public policy. 2010, c. 26, Sched. 9, s. 1 (2); 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (4) of the Act is repealed and the following substituted: (See: 2017, c. 34, Sched. 21, s. 19 (1))

Prohibition from using ground

(4) The Superintendent shall notify the insurer orally or otherwise that the insurer is prohibited from using one or more of the grounds filed under subsection (2) if the Superintendent is of the opinion that the ground is not just and reasonable, having considered the criteria set out in the Authority rules. 2017, c. 34, Sched. 21, s. 19 (1).

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (4) of the Act, as re-enacted by section 19 of Schedule 21 to the Stronger, Fairer Ontario Act (Budget Measures), 2017, is amended by striking out “Superintendent” wherever it appears and substituting in each case “Chief Executive Officer”. (See: 2018, c. 8, Sched. 13, s. 10)

When insurer may use ground

(4.1) Unless the Chief Executive Officer notifies the insurer that the insurer is prohibited from using a ground, the insurer may use the ground 30 days after the later of,

(a) the day the insurer files the ground under subsection (2); or

(b) the day the additional information, material or evidence requested is provided, if the Chief Executive Officer requires the insurer to provide additional information, material or evidence under subsection (3.1). 2010, c. 26, Sched. 9, s. 1 (2); 2018, c. 8, Sched. 13, s. 22.

Notice

(5) If the Chief Executive Officer notifies an insurer orally that the insurer is prohibited from using a ground, the Chief Executive Officer shall promptly mail a written notice to the insurer confirming that fact. 1993, c. 10, s. 19; 1997, c. 28, s. 111; 2018, c. 8, Sched. 13, s. 22.

Appeal to Tribunal

(6) If the Chief Executive Officer notifies an insurer that the insurer is prohibited from using a ground, the insurer may within 15 days appeal the decision to the Tribunal. 1997, c. 28, s. 112; 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (6) of the Act is repealed and the following substituted: (See: 2017, c. 34, Sched. 21, s. 19 (2))

Decision final

(6) A decision of the Superintendent is final for all purposes. 2017, c. 34, Sched. 21, s. 19 (2).

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (6) of the Act, as re-enacted by section 19 of Schedule 21 to the Stronger, Fairer Ontario Act (Budget Measures), 2017, is amended by striking out “Superintendent” and substituting “Chief Executive Officer”. (See: 2018, c. 8, Sched. 13, s. 10)

Prohibition by Tribunal

(7) After the hearing, the Tribunal shall prohibit the insurer from using the ground if the Tribunal finds that the ground comes within any of clauses (4) (a), (b), (c) and (d). 1997, c. 28, s. 112.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (7) of the Act is repealed and the following substituted: (See: 2017, c. 34, Sched. 21, s. 19 (2))

Definition

(7) In this section,

“insurer” includes the Facility Association. 2017, c. 34, Sched. 21, s. 19 (2).

Reconsideration

(8) The Chief Executive Officer may, at any time, give notice in writing to an insurer that,

(a) he or she is of the opinion that a ground that has been filed under this section or the manner in which it is applied comes within any of clauses (4) (a), (b), (c) and (d); and

(b) he or she intends to prohibit the use of the ground or to prohibit the use of the ground in a specified manner. 1997, c. 28, s. 112; 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (8) of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 19 (2))

Request for hearing

(9) Within 15 days after receiving the notice, the insurer may request in writing that the Tribunal hold a hearing before the Chief Executive Officer takes any action described in the notice. 1997, c. 28, s. 112; 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (9) of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 19 (2))

Hearing

(10) If, within the time period allowed, the insurer requests a hearing, the Tribunal shall hold a hearing. 1997, c. 28, s. 112.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (10) of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 19 (2))

No request for hearing

(11) If, within the time period allowed, the insurer does not request a hearing, the Chief Executive Officer may take any action described in the notice. 1997, c. 28, s. 112; 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (11) of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 19 (2))

Powers of Tribunal

(12) At a hearing, if the Tribunal finds that the ground or the manner in which it applies comes within any of clauses (4) (a), (b), (c) and (d), the Tribunal shall prohibit the insurer from using the ground or from using it in a specified manner. 1997, c. 28, s. 112.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (12) of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 19 (2))

Information to provide

(13) The Chief Executive Officer or the Tribunal may require insurers, agents and brokers to provide the information, material and evidence that the Chief Executive Officer or Tribunal, as the case requires, considers necessary for the purposes of this section. 1997, c. 28, s. 112; 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 238 (13) of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 19 (2))

Section 238.1§Sections Affiliated automobile insurers, concurrent filing

(1) The Chief Executive Officer may require that affiliated insurers who write automobile insurance in Ontario file their grounds under section 238 concurrently. 2010, c. 26, Sched. 9, s. 2; 2018, c. 8, Sched. 13, s. 22.

Insurer’s application, consideration of affiliate’s grounds

(2) The Chief Executive Officer may consider the grounds filed by the affiliates of an insurer when deciding on the grounds filed by the insurer. 2010, c. 26, Sched. 9, s. 2; 2018, c. 8, Sched. 13, s. 22.

Interpretation

(3) For the purpose of this section, an insurer is considered to be affiliated with another insurer if one of them is the subsidiary of the other or both are subsidiaries of the same body corporate or each of them is controlled by the same person. 2010, c. 26, Sched. 9, s. 2.

Section 251§Sections Minimum liability under policy

(1) Every contract evidenced by a motor vehicle liability policy insures, in respect of any one accident, to the limit of at least $200,000, exclusive of interest and costs, against liability resulting from bodily injury to or the death of one or more persons and loss of or damage to property.

Priorities

(2) The contract shall be interpreted to mean that where, by reason of any one accident, liability results from bodily injury or death and from loss of or damage to property,

(a) claims against the insured arising out of bodily injury or death have priority to the extent of $190,000 over claims arising out of loss of or damage to property; and

(b) claims against the insured arising out of loss of or damage to property have priority to the extent of $10,000 over claims arising out of bodily injury or death.

Minimum limits where separate limits designated

(3) The insurer may, instead of specifying a limit in the policy for an inclusive amount, specify a limit of liability of at least $200,000, exclusive of interest and costs, against liability resulting from bodily injury to or the death of one or more persons and a limit of liability of at least $200,000, exclusive of interest and costs, against liability for loss of or damage to property.

Variation of limits

(4) Nothing in this Part precludes an insurer, with respect to a limit or limits in excess of those specified in subsection (1) or (3), from increasing or reducing the limit or limits specified in the contract with respect to the use or operation of the automobile by a named person, but no reduction is effective for a limit less than that required under subsection (1) or (3). R.S.O. 1990, c. I.8, s. 251.

Section 263§Sections Accidents involving two or more insured automobiles

(1) This section applies if,

(a) an automobile or its contents, or both, suffers damage arising directly or indirectly from the use or operation in Ontario of one or more other automobiles;

(b) the automobile that suffers the damage or in respect of which the contents suffer damage is insured under a contract evidenced by a motor vehicle liability policy issued by an insurer that is licensed to undertake automobile insurance in Ontario or that has filed with the Chief Executive Officer, in the form provided by the Chief Executive Officer, an undertaking to be bound by this section; and

(c) at least one other automobile involved in the accident is insured under a contract evidenced by a motor vehicle liability policy issued by an insurer that is licensed to undertake automobile insurance in Ontario or that has filed with the Chief Executive Officer, in the form provided by the Chief Executive Officer, an undertaking to be bound by this section. 1993, c. 10, s. 21 (1); 1997, c. 28, s. 113; 2018, c. 8, Sched. 13, s. 22.

Exempt automobiles, undertaking to be bound

(1.1) This section applies, with necessary modifications, in respect of an automobile the owner, operator or lessee of which is exempt from the requirement to be insured under the Compulsory Automobile Insurance Act, if the organization that is financially responsible for the damages resulting from the accident involving the automobile files with the Chief Executive Officer an undertaking to be bound by this section. 1997, c. 19, s. 10 (29); 1997, c. 28, s. 114 (2); 2018, c. 8, Sched. 13, s. 22.

Damage recovery from insured’s insurer

(2) If this section applies, an insured is entitled to recover for the damages to the insured’s automobile and its contents and for loss of use from the insured’s insurer under the coverage described in subsection 239 (1) as though the insured were a third party. R.S.O. 1990, c. I.8, s. 263 (2).

Same, application of s. 233

(2.1) Despite subsection (6), section 233 applies to claims made under subsection (2). 2020, c. 36, Sched. 22, s. 7 (1).

Same, election not to recover

(2.2) An insured may elect, in accordance with the regulations, not to recover damages from the insured’s insurer under subsection (2). 2021, c. 40, Sched. 14, s. 4.

Same

(2.3) Despite subsection (6), if an insured makes an election under subsection (2.2),

(a) in addition to the restrictions set out in subsection (5), the insured has no right of action under subsection (2) against the insured’s insurer for damages to the insured’s automobile or its contents, or for loss of use; and

(b) the insured’s insurer shall not issue or offer collision or upset coverage, as referred to in the standard policy forms approved by the Chief Executive Officer under subsection 227 (5), to the insured. 2021, c. 40, Sched. 14, s. 4.

Fault-based recovery

(3) Recovery under subsection (2) shall be based on the degree of fault of the insurer’s insured as determined under the fault determination rules. R.S.O. 1990, c. I.8, s. 263 (3).

Dispute resolution

(4) An insured may bring an action against the insurer if the insured is not satisfied that the degree of fault established under the fault determination rules accurately reflects the actual degree of fault or the insured is not satisfied with a proposed settlement and the matters in issue shall be determined in accordance with the ordinary rules of law. R.S.O. 1990, c. I.8, s. 263 (4).

Restrictions on other recovery

(5) If this section applies,

(a) an insured has no right of action against any person involved in the incident other than the insured’s insurer for damages to the insured’s automobile or its contents or for loss of use;

(a.1) an insured has no right of action against a person under an agreement, other than a contract of automobile insurance, in respect of damages to the insured’s automobile or its contents or loss of use, except to the extent that the person is at fault or negligent in respect of those damages or that loss;

(b) an insurer, except as permitted by the regulations, has no right of indemnification from or subrogation against any person for payments made to its insured under this section. R.S.O. 1990, c. I.8, s. 263 (5); 1996, c. 21, s. 24 (1).

Agreement for partial payment

(5.1) Nothing in this Part precludes an insurer, in a contract belonging to a class prescribed by the regulations, from agreeing with an insured that, in the event that a claim is made by the insured under this section, the insurer shall pay only,

(a) an agreed portion of the amount that the insured would otherwise be entitled to recover; or

(b) the amount that the insured would otherwise be entitled to recover, reduced by a sum specified in the agreement. 1993, c. 10, s. 21 (2).

Application of subs. (5.1)

(5.2) Subsection (5.1) does not apply unless, before the insurer enters into the contract referred to in that subsection, the insurer offers to enter into another contract with the prospective insured that does not contain the agreement referred to in that subsection but is identical to the contract referred to in subsection (5.1) in all other respects except for the amount of the premium. 1993, c. 10, s. 21 (2).

Mandatory deductible

(5.2.1) In the circumstances prescribed by the regulations, a contract belonging to a class prescribed for the purpose of subsection (5.1) shall provide that, in the event that a claim is made by the insured under this section, the insurer shall pay only the amount that the insured would otherwise be entitled to recover, reduced by a sum specified in the contract. 1996, c. 21, s. 24 (2).

Application of subs. (5.2)

(5.2.2) Subsection (5.2) does not apply to a contract that contains a provision required by subsection (5.2.1). 1996, c. 21, s. 24 (2).

Stamping required

(5.3) If a contract contains an agreement referred to in subsection (5.1) or a provision required by subsection (5.2.1), the policy shall have printed or stamped on its face in conspicuous type the words “This policy contains a partial payment of recovery clause for property damage” in English or “La présente police comporte une clause de recouvrement partiel en cas de dommages matériels” in French, as may be appropriate. 1993, c. 10, s. 21 (2); 1996, c. 21, s. 24 (3).

Other coverages not affected

(6) This section does not affect an insured’s right to recover in respect of any physical damage coverage in respect of the insured automobile. R.S.O. 1990, c. I.8, s. 263 (6).

Non-application

(7) This section does not apply to damages to those contents of an automobile that are being carried for reward. R.S.O. 1990, c. I.8, s. 263 (7).

Idem

(8) This section does not apply if the damage occurred before the 22nd day of June, 1990. R.S.O. 1990, c. I.8, s. 263 (8).

Idem

(9) This section does not apply if both automobiles are owned by the same person. R.S.O. 1990, c. I.8, s. 263 (9).

Idem

(10) This section does not apply to damage to an automobile owned by the insured or to its contents if the damage is caused by the insured while driving another automobile. R.S.O. 1990, c. I.8, s. 263 (10).

Section 264§Sections

Repealed: 1996, c. 21, s. 25.

Section 265§Sections Uninsured automobile coverage

(1) Every contract evidenced by a motor vehicle liability policy shall provide for payment of all sums that,

(a) a person insured under the contract is legally entitled to recover from the owner or driver of an uninsured automobile or unidentified automobile as damages for bodily injuries resulting from an accident involving an automobile;

(b) any person is legally entitled to recover from the owner or driver of an uninsured automobile or unidentified automobile as damages for bodily injury to or the death of a person insured under the contract resulting from an accident involving an automobile; and

(c) a person insured under the contract is legally entitled to recover from the identified owner or driver of an uninsured automobile as damages for accidental damage to the insured automobile or its contents, or to both the insured automobile and its contents, resulting from an accident involving an automobile,

subject to the terms, conditions, provisions, exclusions and limits as are prescribed by the regulations. R.S.O. 1990, c. I.8, s. 265 (1).

Definitions

(2) For the purposes of this section,

“insured automobile” means the automobile as defined or described under the contract; (“automobile assurée”)

“owner” includes, in respect of an accident occurring on or after the day this definition comes into force, a person who is a lessee for the purposes of section 192 of the Highway Traffic Act; (“propriétaire”)

“person insured under the contract” means,

(a) in respect of a claim for damage to the insured automobile, the owner of the automobile,

(b) in respect of a claim for damage to the contents of the insured automobile, the owner of the contents,

(c) in respect of a claim for bodily injuries or death,

(i) any person while an occupant of the insured automobile,

(ii) the insured and his or her spouse and any dependent relative of either,

(A) while an occupant of an uninsured automobile, or

(B) while not the occupant of an automobile or of railway rolling stock that runs on rails, who is struck by an uninsured or unidentified automobile,

(iii) if the insured is a corporation, unincorporated association or partnership, any director, officer, employee or partner of the insured for whose regular use the insured automobile is furnished, and his or her spouse and any dependent relative of the person or the spouse,

(A) while an occupant of an uninsured automobile, or

(B) while not the occupant of an automobile or of railway rolling stock that runs on rails, who is struck by an uninsured or unidentified automobile,

where such director, officer, employee or partner or his or her spouse is not the owner of an automobile insured under a contract; (“personne assurée aux termes du contrat”)

“unidentified automobile” means an automobile with respect to which the identity of either the owner or driver cannot be ascertained; (“automobile non identifiée”)

“uninsured automobile” means an automobile with respect to which neither the owner nor driver thereof has applicable and collectible bodily injury liability and property damage liability insurance for its ownership, use or operation, but does not include an automobile owned by or registered in the name of the insured or his or her spouse. (“automobile non assurée”) R.S.O. 1990, c. I.8, s. 265 (2); 1999, c. 6, s. 31 (7, 8); 2005, c. 5, s. 35 (11, 12); 2005, c. 31, Sched. 12, s. 2; 2016, c. 23, s. 55 (2, 3).

Exclusion from coverage

(3) Despite the definition of “person insured under the contract” in subsection (2), a person who sustains loss or damage while the insured automobile is being used or operated by an excluded driver shall be deemed not to be a person insured under the contract in which the excluded driver is named, except as provided in the Statutory Accident Benefits Schedule. R.S.O. 1990, c. I.8, s. 265 (3); 1993, c. 10, s. 1.

Idem

(4) Where a dependent relative referred to in clause (c) of the definition of “person insured under the contract” in subsection (2),

(a) is the owner of an automobile insured under a contract; or

(b) sustains bodily injuries or dies as the result of accident while the occupant of his or her own uninsured automobile,

such relative shall be deemed not to be a dependent relative for the purposes of this section. R.S.O. 1990, c. I.8, s. 265 (4); 2016, c. 23, s. 55 (4).

Regulations

(5) The Lieutenant Governor in Council may make regulations,

(a) prescribing, amending or altering the terms, conditions, provisions, exclusions and limits with respect to payments under subsection (1);

(b) deeming any term, condition, provision, exclusion or limit as prescribed, amended or altered by a regulation made under clause (a) to be included in any motor vehicle liability policy made or renewed on or after the effective date of the regulation and in any motor vehicle liability policy that is subsisting on the effective date of the regulation;

(c) requiring that terms, conditions, provisions, exclusions and limits, as prescribed, amended or altered by a regulation made under clause (a), be attached to or included in every motor vehicle liability policy as a schedule in or to the policy. R.S.O. 1990, c. I.8, s. 265 (5).

Subrogation

(6) Where an amount is paid under subsection (1), the insurer is subrogated to the rights of the person to whom such amount is paid and the insurer may maintain an action in its name or in the name of such person against any other person or persons responsible for the use or operation of the uninsured or unidentified automobile. R.S.O. 1990, c. I.8, s. 265 (6).

Restriction on recovery

(7) No person has a right of action against any other person in respect of damage to an uninsured automobile or its contents arising directly or indirectly from the use or operation of an automobile if at the time of the damage the uninsured automobile was required by any Act to be insured under a contract evidenced by a motor vehicle liability policy. R.S.O. 1990, c. I.8, s. 265 (7).

Release

(8) A release under section 274 does not enure to the benefit of any person against whom the insurer may subrogate under subsection (6). R.S.O. 1990, c. I.8, s. 265 (8).

Application

(9) This section applies to all contracts evidenced by motor vehicle liability policies made or renewed on or after the 1st day of March, 1980, and all contracts evidenced by motor vehicle liability policies that were subsisting on the 1st day of March, 1980, shall be deemed to provide for the payments referred to in subsection (1) in respect of an accident arising out of the use or operation of an automobile occurring on or after that date. R.S.O. 1990, c. I.8, s. 265 (9).

Section 266§Sections

Repealed: 2020, c. 34, Sched. 7, s. 8.

Section 267§Sections

Repealed: 2020, c. 34, Sched. 7, s. 8.

Section 267.1§Sections

Repealed: 2020, c. 34, Sched. 7, s. 8.

Section 267.2§Sections Publication of deductible amounts

(1) Before the 1st day of January in each year after 1994, the Chief Executive Officer shall determine in accordance with this section and publish on the website of the Authority,

(a) the non-pecuniary loss deductible to be used under subparagraph i of paragraph 3 of subsection 267.1 (8) as it read immediately before the day section 8 of Schedule 7 to the Better for People, Smarter for Business Act, 2020 came into force in respect of awards of damages made in the year that begins on the 1st day of January; and

(b) the Family Law Act deductible to be used under subparagraph ii of paragraph 3 of subsection 267.1 (8) as it read immediately before the day section 8 of Schedule 7 to the Better for People, Smarter for Business Act, 2020 came into force in respect of awards of damages made in the year that begins on the 1st day of January. 1993, c. 10, s. 25; 1997, c. 28, s. 115; 2018, c. 8, Sched. 13, s. 22; 2019, c. 14, Sched. 9, s. 10; 2020, c. 34, Sched. 7, s. 9.

Rules for determination

(2) The following rules apply to the determination of the non-pecuniary loss deductible and the Family Law Act deductible:

1. The non-pecuniary loss deductible for 1993 and 1994 is $10,000.

2. The Family Law Act deductible for 1993 and 1994 is $5,000.

3. The non-pecuniary loss deductible and the Family Law Act deductible for a year after 1994 shall be determined by adjusting the deductible for the previous year by the percentage change in the Consumer Price Index for Canada (All Items), as published by Statistics Canada under the authority of the Statistics Act (Canada), for the period from September in the year immediately preceding the previous year to September of the previous year.

4. Despite paragraph 3, if the Consumer Price Index information required by paragraph 3 to determine the deductibles for a year is not available by the 1st day of November in the previous year, or if in the Chief Executive Officer’s opinion the information published by Statistics Canada does not provide a reasonable reflection of changes in consumer prices, the Chief Executive Officer may determine the deductibles in a manner that the Chief Executive Officer considers will provide a reasonable reflection of changes in consumer prices. 1993, c. 10, s. 25; 1997, c. 28, s. 115; 2018, c. 8, Sched. 13, s. 22, 23.

Section 267.3§Sections Definitions, ss. 267.4 to 267.12

In sections 267.4 to 267.12,

“owner” includes an operator as defined in subsection 16 (1) of the Highway Traffic Act and a person who is a lessee for the purposes of section 192 of that Act; (“propriétaire”)

“protected defendant” means a person who is protected from liability by subsections 267.5 (1), (3) and (5). (“défendeur exclu”) 2005, c. 31, Sched. 12, s. 3.

Section 267.4§Sections Application of ss. 267.5 to 267.11, automobile use on or after Nov. 1, 1996

(1) Sections 267.5 to 267.11 apply only to proceedings for loss or damage from bodily injury or death arising from the use or operation, after November 1, 1996, of an automobile in Canada, the United States of America or a jurisdiction designated in the Statutory Accident Benefits Schedule. 1996, c. 21, s. 29; 2020, c. 34, Sched. 7, s. 10.

Effect of amendments

(2) Subsection (1) shall not be interpreted as requiring an amendment made to sections 267.5 to 267.11 to apply in respect of the use or operation, before the amendment came into force, of an automobile. 2002, c. 22, s. 119.

Section 267.5§Sections Protection from liability

Income loss and loss of earning capacity

(1) Despite any other Act and subject to subsections (6) and (6.1), the owner of an automobile, the occupants of an automobile and any person present at the incident are not liable in an action in Ontario for the following damages for income loss and loss of earning capacity from bodily injury or death arising directly or indirectly from the use or operation of the automobile:

1. Damages for income loss suffered in the seven days after the incident.

2. Damages for income loss suffered more than seven days after the incident and before the trial of the action in excess of 70 per cent of the amount of gross income that is lost during that period, as determined in accordance with the regulations.

3. Damages for loss of earning capacity suffered after the incident and before the trial of the action in excess of 70 per cent of the loss of earning capacity during that period, as determined in accordance with the regulations. 1996, c. 21, s. 29; 2010, c. 1, Sched. 11, s. 1 (1); 2011, c. 9, Sched. 21, s. 3 (1); 2020, c. 34, Sched. 7, s. 11.

Application

(2) Subsection (1) applies to all actions, including actions under subsection 61 (1) of the Family Law Act. 1996, c. 21, s. 29.

Protection from liability; health care expenses

(3) Despite any other Act and subject to subsections (6) and (6.1), the owner of an automobile, the occupants of an automobile and any person present at the incident are not liable in an action in Ontario for damages for expenses that have been incurred or will be incurred for health care resulting from bodily injury arising directly or indirectly from the use or operation of the automobile unless, as a result of the use or operation of the automobile, the injured person has died or has sustained,

(a) permanent serious disfigurement; or

(b) permanent serious impairment of an important physical, mental or psychological function. 2002, c. 22, s. 120 (1); 2011, c. 9, Sched. 21, s. 3 (2).

(4) Repealed: 2002, c. 22, s. 120 (2).

Non-pecuniary loss

(5) Despite any other Act and subject to subsections (6) and (6.1), the owner of an automobile, the occupants of an automobile and any person present at the incident are not liable in an action in Ontario for damages for non-pecuniary loss, including damages for non-pecuniary loss under clause 61 (2) (e) of the Family Law Act, from bodily injury or death arising directly or indirectly from the use or operation of the automobile, unless as a result of the use or operation of the automobile the injured person has died or has sustained,

(a) permanent serious disfigurement; or

(b) permanent serious impairment of an important physical, mental or psychological function. 1996, c. 21, s. 29; 2011, c. 9, Sched. 21, s. 3 (3).

Application of subss. (1), (3) and (5)

(6) Subsections (1), (3) and (5) do not protect a person from liability if the person is defended in the action by an insurer that is not licensed to undertake automobile insurance in Ontario unless the insurer has filed an undertaking under section 226.1. 1996, c. 21, s. 29.

Same, public transit vehicles

(6.1) In respect of an incident that occurs on or after the date this subsection comes into force, subsections (1), (3) and (5) do not protect the owner or driver of a public transit vehicle if it did not collide with another automobile or any other object in the incident. 2011, c. 9, Sched. 21, s. 3 (4).

Amount of damages for non-pecuniary loss

(7) Subject to subsections (5), (12), (13) and (15), in an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile, the court shall determine the amount of damages for non-pecuniary loss to be awarded against a protected defendant in accordance with the following rules:

1. The court shall first determine the amount of damages for non-pecuniary loss for which the protected defendant would be liable without regard to this Part.

2. The determination under paragraph 1 shall be made in the same manner as a determination of the amount of damages for non-pecuniary loss in an action to which this section does not apply and, in particular, without regard to,

i. the statutory accident benefits provided for under subsection 268 (1),

ii. the provisions of this section that protect protected defendants from liability for damages for pecuniary loss, and

iii. the provisions of paragraph 3.

3. Subject to subsections (8), (8.1) and (8.1.1), the amount of damages for non-pecuniary loss to be awarded against the protected defendant shall be determined by reducing the amount determined under paragraph 1 by,

i. in the case of damages for non-pecuniary loss other than damages for non-pecuniary loss under clause 61 (2) (e) of the Family Law Act, the greater of,

A. $15,000, and

B. the amount prescribed by the regulations, and

ii. in the case of damages for non-pecuniary loss under clause 61 (2) (e) of the Family Law Act, the greater of,

A. $7,500, and

B. the amount prescribed by the regulations.

4. If fault or negligence on the part of the person entitled to damages for non-pecuniary loss contributed to those damages, the award for damages shall be reduced under paragraph 3 before the damages are apportioned under section 3 of the Negligence Act. 1996, c. 21, s. 29; 2002, c. 22, s. 120 (3); 2010, c. 1, Sched. 11, s. 1 (2).

Application of subpar. 3 i of subs. (7)

(8) Subparagraph 3 i of subsection (7) does not apply if the amount of damages for non-pecuniary loss, other than damages for non-pecuniary loss under clause 61 (2) (e) of the Family Law Act, would exceed the amount determined in accordance with subsection (8.3) in the absence of that subparagraph. 2002, c. 22, s. 120 (4); 2015, c. 20, Sched. 17, s. 3 (1).

Application of subpar. 3 ii of subs. (7)

(8.1) Subparagraph 3 ii of subsection (7) does not apply if the amount of damages for non-pecuniary loss under clause 61 (2) (e) of the Family Law Act would exceed the amount determined in accordance with subsection (8.4) in the absence of that subparagraph. 2002, c. 22, s. 120 (4); 2015, c. 20, Sched. 17, s. 3 (2).

No reduction under par. 3 i or ii of subs. (7)

(8.1.1) Subparagraphs 3 i and ii of subsection (7) do not apply to damages awarded for non-pecuniary loss awarded in respect of a person who dies as a direct or indirect result of an incident that occurs after August 31, 2010. 2010, c. 1, Sched. 11, s. 1 (3).

Application of subss. (7)-(8.1.1)

(8.2) Subsections (7), (8), (8.1) and (8.1.1) apply in respect of each person who is entitled to damages for non-pecuniary loss. 2002, c. 22, s. 120 (4); 2010, c. 1, Sched. 11, s. 1 (4).

Amount in subs. (8)

(8.3) For the purposes of subsection (8), the amount shall be determined in accordance with the following rules:

1. Until December 31, 2015, the amount is $121,799.

2. On January 1, 2016, the amount set out in paragraph 1 shall be revised by adjusting the amount by the indexation percentage published under subsection 268.1 (1) for that year.

3. On the 1st day of January in every year after 2016, the amount that applied for the previous year shall be revised by adjusting the amount by the indexation percentage published under subsection 268.1 (1) for the year. 2015, c. 20, Sched. 17, s. 3 (3).

Amount in subs. (8.1)

(8.4) For the purposes of subsection (8.1), the amount shall be determined in accordance with the following rules:

1. Until December 31, 2015, the amount is $60,899.

2. On January 1, 2016, the amount set out in paragraph 1 shall be revised by adjusting the amount by the indexation percentage published under subsection 268.1 (1) for that year.

3. On the 1st day of January in every year after 2016, the amount that applied for the previous year shall be revised by adjusting the amount by the indexation percentage published under subsection 268.1 (1) for the year. 2015, c. 20, Sched. 17, s. 3 (3).

Publication of adjusted amounts

(8.5) For every year after 2015, at the time an indexation percentage is published under subsection 268.1 (1), the Chief Executive Officer shall publish on the website of the Authority the amounts to which the amounts determined in accordance with subsections (8.3) and (8.4) shall be revised, effective the 1st day of January. 2015, c. 20, Sched. 17, s. 3 (3); 2018, c. 8, Sched. 13, s. 22; 2019, c. 14, Sched. 9, s. 11.

Costs

(9) In an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile, the determination of a party’s entitlement to costs shall be made with regard to the effect of paragraph 3 of subsection (7) on the amount of damages, if any, awarded for non-pecuniary loss. 1996, c. 21, s. 29; 2015, c. 20, Sched. 17, s. 3 (4).

Liability of other persons

(10) Subsections (1), (3) and (5) do not relieve any person from liability other than a protected defendant. 1996, c. 21, s. 29.

Vicarious liability

(10.1) Despite any provision of this Part, a person vicariously liable for the fault or negligence of a protected defendant is not, in respect of the person’s vicarious liability, liable for any amount greater than the amount of damages for which the protected defendant is liable. 2002, c. 22, s. 120 (5).

(11) Repealed: 2002, c. 22, s. 120 (6).

Motion to determine if threshold met; non-pecuniary loss

(12) In an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile, a judge shall, on motion made before trial with the consent of the parties or in accordance with an order of a judge who conducts a pre-trial conference, determine for the purpose of subsections (3) and (5) whether, as a result of the use or operation of the automobile, the injured person has died or has sustained,

(a) permanent serious disfigurement; or

(b) permanent serious impairment of an important physical, mental or psychological function. 1996, c. 21, s. 29; 2002, c. 22, s. 120 (7).

Determination binding

(13) The determination of a judge on a motion under subsection (12) is binding on the parties at the trial. 1996, c. 21, s. 29; 2002, c. 22, s. 120 (8).

(14) Repealed: 2002, c. 22, s. 120 (9).

Determination at trial; non-pecuniary loss

(15) If no motion is made under subsection (12), the trial judge shall determine for the purpose of subsections (3) and (5) whether, as a result of the use or operation of the automobile, the injured person has died or has sustained,

(a) permanent serious disfigurement; or

(b) permanent serious impairment of an important physical, mental or psychological function. 1996, c. 21, s. 29; 2002, c. 22, s. 120 (10).

Section 267.6§Sections No action by uninsured owner or lessee

(1) Despite any other Act, a person is not entitled in an action in Ontario to recover any loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile if, at the time of the incident, the person was contravening subsection 2 (1) of the Compulsory Automobile Insurance Act in respect of that automobile.

Prosecution not necessary

(2) Subsection (1) applies whether or not the person was prosecuted for or convicted of an offence under the Compulsory Automobile Insurance Act. 1996, c. 21, s. 29.

Section 267.7§Sections Joint and several liability with other tortfeasors

(1) If, in an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile, one or more protected defendants and one or more other persons are found to be liable for damages,

(a) the other persons,

(i) are jointly and severally liable with the protected defendants for the damages for which the protected defendants are liable, having regard to section 267.5, and

(ii) are solely liable for any amount by which the amount mentioned in subclause (i) is less than the amount that the other persons would have been liable to make contribution and indemnify the protected defendants in respect of damages in the absence of section 267.5;

(b) the other persons are liable to make contribution and indemnify the protected defendants in respect of damages to the same extent as if section 267.5 did not apply, up to the amount for which the protected defendants are liable having regard to section 267.5; and

(c) the protected defendants are liable to make contribution and indemnify the other persons for the amount that the protected defendants are liable, having regard to section 267.5, reduced by the amount that the other persons are liable to make contribution and indemnify the protected defendants under clause (b).

Separate determinations

(2) Liability shall be determined under subsection (1) separately for each of the following categories of damages:

1. Damages for income loss and loss of earning capacity.

2. Damages for expenses that have been incurred or will be incurred for health care.

3. Damages for pecuniary loss, other than damages referred to in paragraphs 1 and 2.

4. Damages for non-pecuniary loss, including damages for non-pecuniary loss under clause 61 (2) (e) of the Family Law Act.

Determination of liability

(3) For the purposes of subsection (1), the liability of all persons involved in the incident from which the action arose shall be determined as though all persons wholly or partly responsible for the damages were parties to the action even though any of those persons is not actually a party. 1996, c. 21, s. 29.

Section 267.8§Sections Collateral benefits

Income loss and loss of earning capacity

(1) In an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile, the damages to which a plaintiff is entitled for income loss and loss of earning capacity shall be reduced by the following amounts:

1. All payments in respect of the incident that the plaintiff has received or that were available before the trial of the action for statutory accident benefits in respect of the income loss and loss of earning capacity.

2. All payments in respect of the incident that the plaintiff has received or that were available before the trial of the action for income loss or loss of earning capacity under the laws of any jurisdiction or under an income continuation benefit plan.

3. All payments in respect of the incident that the plaintiff has received before the trial of the action under a sick leave plan arising by reason of the plaintiff’s occupation or employment. 1996, c. 21, s. 29.

Exception

(2) No reduction shall be made under subsection (1) for payments in respect of income loss if the payments are in respect of income loss suffered in the seven days after the incident. 1996, c. 21, s. 29.

Priority with other tortfeasors

(3) If persons other than protected defendants are liable for damages for income loss or loss of earning capacity, the reduction required by subsection (1) shall first be applied to the damages for which the protected defendants and the other persons are jointly and severally liable under subclause 267.7 (1) (a) (i), and any excess shall be applied to the amount for which the other persons are solely liable under subclause 267.7 (1) (a) (ii). 1996, c. 21, s. 29.

Health care expenses

(4) In an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile, the damages to which a plaintiff is entitled for expenses that have been incurred or will be incurred for health care shall be reduced by the following amounts:

1. All payments in respect of the incident that the plaintiff has received or that were available before the trial of the action for statutory accident benefits in respect of the expenses for health care.

2. All payments in respect of the incident that the plaintiff has received before the trial of the action under any medical, surgical, dental, hospitalization, rehabilitation or long-term care plan or law. 1996, c. 21, s. 29.

Exception

(5) Paragraph 2 of subsection (4) does not apply to a payment made by the Ministry of Health and Long-Term Care if the action is brought under section 30 of the Health Insurance Act. 1996, c. 21, s. 29; 2006, c. 19, Sched. L, s. 11 (3).

Other pecuniary loss

(6) In an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile, the damages to which a plaintiff is entitled for pecuniary loss, other than the damages for income loss or loss of earning capacity and the damages for expenses that have been incurred or will be incurred for health care, shall be reduced by all payments in respect of the incident that the plaintiff has received or that were available before the trial of the action for statutory accident benefits in respect of pecuniary loss, other than income loss, loss of earning capacity and expenses for health care. 1996, c. 21, s. 29.

Non-pecuniary loss

(7) In an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile, the damages in respect of non-pecuniary loss to which a plaintiff is entitled shall not be reduced because of any payments or benefits that the plaintiff has received or is entitled to receive. 1996, c. 21, s. 29.

Contributory negligence

(8) The reductions required by subsections (1), (4) and (6) shall be made after any apportionment of damages required by section 3 of the Negligence Act. 1996, c. 21, s. 29.

Future collateral benefits

(9) A plaintiff who recovers damages for income loss, loss of earning capacity, expenses that have been or will be incurred for health care, or other pecuniary loss in an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile shall hold the following amounts in trust:

1. All payments in respect of the incident that the plaintiff receives after the trial of the action for statutory accident benefits in respect of income loss or loss of earning capacity.

2. All payments in respect of the incident that the plaintiff receives after the trial of the action for income loss or loss of earning capacity under the laws of any jurisdiction or under an income continuation benefit plan.

3. All payments in respect of the incident that the plaintiff receives after the trial of the action under a sick leave plan arising by reason of the plaintiff’s occupation or employment.

4. All payments in respect of the incident that the plaintiff receives after the trial of the action for statutory accident benefits in respect of expenses for health care.

5. All payments in respect of the incident that the plaintiff receives after the trial of the action under any medical, surgical, dental, hospitalization, rehabilitation or long-term care plan or law.

6. All payments in respect of the incident that the plaintiff receives after the trial of the action for statutory accident benefits in respect of pecuniary loss, other than income loss, loss of earning capacity and expenses for health care. 1996, c. 21, s. 29.

Payments from trust

(10) A plaintiff who holds money in trust under subsection (9) shall pay the money to the persons from whom damages were recovered in the action, in the proportions that those persons paid the damages. 1996, c. 21, s. 29.

Disputes

(11) Any dispute concerning a plaintiff’s liability to make payments under subsection (10) shall, on the request of a person who claims to be entitled to a payment under that subsection, be submitted to arbitration in accordance with the Arbitration Act, 1991. 1996, c. 21, s. 29.

Assignment of future collateral benefits

(12) The court that heard and determined the action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of the automobile, on motion, may order that, subject to any conditions the court considers just,

(a) the plaintiff who recovered damages in the action assign to the defendants or the defendants’ insurers all rights in respect of all payments to which the plaintiff who recovered damages is entitled in respect of the incident after the trial of the action,

(i) for statutory accident benefits in respect of income loss or loss of earning capacity,

(ii) for income loss or loss of earning capacity under the laws of any jurisdiction or under an income continuation benefit plan,

(iii) under a sick leave plan arising by reason of the plaintiff’s occupation or employment,

(iv) for statutory accident benefits in respect of expenses for health care,

(v) under any medical, surgical, dental, hospitalization, rehabilitation or long-term care plan or law, and

(vi) for statutory accident benefits in respect of pecuniary loss, other than income loss, loss of earning capacity and expenses for health care; and

(b) the plaintiff who recovered damages in the action co-operate with the defendants or the defendants’ insurers in any claim or proceeding brought by the defendants or the defendants’ insurers in respect of a payment assigned pursuant to clause (a). 1996, c. 21, s. 29.

Application of subs. (9)

(13) Subsection (9) no longer applies if an order is made under subsection (12). 1996, c. 21, s. 29.

Pension legislation

(14) In the event of a conflict, subsections (9) to (13) prevail over,

(a) sections 65, 66 and 67 of the Pension Benefits Act; and

(b) sections 10, 11 and 12 of the Pooled Registered Pension Plans Act, 2015. 2015, c. 9, s. 30.

Workplace Safety and Insurance Act, 1997

(15) Payments or benefits received or that were, are or may become available to a person under the Workplace Safety and Insurance Act, 1997 shall not be applied under subsection (1), (4) or (6) to reduce the damages awarded. 1996, c. 21, s. 29; 1997, c. 16, s. 9 (4).

(16) Repealed: 1997, c. 16, s. 9 (5).

Limitation on subrogation

(17) A person who has made a payment described in subsection (1), (4) or (6) is not subrogated to a right of recovery of the insured against another person in respect of that payment.

Exception

(18) Subsection (17) does not apply if,

(a) the Ministry of Health and Long-Term Care made the payment; and

(b) the right of recovery is against a person other than a person insured under a motor vehicle liability policy issued in Ontario. 1996, c. 21, s. 29; 2006, c. 19, Sched. L, s. 11 (3).

Workplace Safety and Insurance Board

(19) The Workplace Safety and Insurance Board is not subrogated to a right of recovery of the insured against another person in respect of a payment or benefit paid by the Workplace Safety and Insurance Board to the insured or in respect of a liability to make such payment or benefit. 1996, c. 21, s. 29; 1997, c. 16, s. 9 (6).

Determination of liability

(20) For the purposes of subsections (1), (3), (4) and (6), the damages payable by a person who is a party to the action shall be determined as though all persons wholly or partly responsible for the damages were parties to the action even though any of those persons is not actually a party.

Interpretation

(21) For the purpose of subsection (1), (4) or (6), a payment shall be deemed not to be available to a plaintiff if the plaintiff made an application for the payment and the application was denied.

Same

(22) Subsection (21) does not apply if the court is satisfied that the plaintiff impaired his or her entitlement to the payment by,

(a) failing to give any notice required by law of the application for the payment;

(b) failing to make himself or herself reasonably available for any examination that was requested by the person to whom the application was made and that was required by law; or

(c) settling in bad faith his or her entitlement to the payment to the detriment of a person found liable for damages in the action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of the automobile. 1996, c. 21, s. 29.

Section 267.9§Sections Proceedings by action

A proceeding for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile shall be brought only by way of an action. 1996, c. 21, s. 29.

Section 267.10§Sections Structured judgments

In the circumstances prescribed by the regulations, the court shall order that an award for damages in an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile shall be paid periodically on such terms as the court considers just. 1996, c. 21, s. 29.

Section 267.11§Sections No gross-up for income tax

(1) In an action for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of an automobile, an award against a protected defendant shall not include any amount to offset liability for income tax payable on income from investment of the award with respect to,

(a) damages for income loss or loss of earning capacity;

(b) damages that are payable periodically pursuant to an order of a court under section 267.10;

(c) any component of an award, other than an award for damages mentioned in clause (b), that the plaintiff and defendant agree the defendant shall pay on a periodic basis. 2002, c. 22, s. 123.

Application

(2) Clause (1) (a) does not apply to an award for income loss or loss of earning capacity under subsection 61 (1) of the Family Law Act. 2002, c. 22, s. 123.

Section 267.12§Sections Liability of lessors

(1) Despite any other provision in this Part, except subsections (4) and (5), in an action in Ontario for loss or damage from bodily injury or death arising directly or indirectly from the use or operation of a motor vehicle that is leased, the maximum amount for which the lessor or lessors of the motor vehicle are liable in respect of the same incident in their capacity as lessors of the motor vehicle is the amount determined under subsection (3) less any amounts,

(a) that are recovered for loss or damage from bodily injury or death under the third party liability provisions of contracts evidenced by motor vehicle liability policies issued to persons other than a lessor;

(b) that are in respect of the use or operation of the motor vehicle; and

(c) that are in respect of the same incident. 2005, c. 31, Sched. 12, s. 4.

Same

(2) For the purposes of subsection (1), the amounts referred to in clauses (1) (a), (b) and (c) include only amounts recovered under the coverages referred to in subsections 239 (1) and (3) and section 241 and exclude,

(a) any sum referred to in subsection 265 (1);

(b) any amount payable as damages by the Motor Vehicle Accident Claims Fund under the Motor Vehicle Accident Claims Act; and

(c) any other amounts determined in the manner prescribed by the regulations. 2005, c. 31, Sched. 12, s. 4.

Maximum amount

(3) The maximum amount for the purposes of subsection (1) is the greatest of,

(a) $1,000,000;

(b) the amount of third party liability insurance required by law to be carried in respect of the motor vehicle; and

(c) the amount determined in the manner prescribed by the regulations, if regulations are made prescribing the manner for determining an amount for the purposes of this clause. 2005, c. 31, Sched. 12, s. 4.

Exceptions

(4) Subsection (1) does not apply,

(a) in such circumstances as may be prescribed by the regulations or to such persons, classes of persons, motor vehicles or classes of motor vehicles as may be prescribed in the regulations, subject to such terms, conditions, provisions, exclusions and limits as may be prescribed by the regulations;

(b) in respect of amounts payable by a lessor other than by reason of the vicarious liability imposed under section 192 of the Highway Traffic Act; or

(c) in respect of a motor vehicle used as a taxicab, livery vehicle or limousine for hire unless the lessor or lessors of the motor vehicle and the lessee are dealing with each other at arm’s length. 2005, c. 31, Sched. 12, s. 4; 2019, c. 8, Sched. 2, s. 1.

Application of subs. (1)

(5) Subsection (1) applies only to proceedings for loss or damage from bodily injury or death arising from the use or operation of a motor vehicle on or after the day this section comes into force. 2005, c. 31, Sched. 12, s. 4.

Definitions

(6) In this section,

“lessor” means, in respect of a motor vehicle, a person who is leasing or renting the motor vehicle to another person for any period of time, and “leased” has a corresponding meaning; (“bailleur”)

“motor vehicle” has the same meaning as in subsection 1 (1) of the Highway Traffic Act. (“véhicule automobile”) 2005, c. 31, Sched. 12, s. 4.

Section 268§Sections Statutory accident benefits

(1) Every contract evidenced by a motor vehicle liability policy, including every such contract in force when the Statutory Accident Benefits Schedule is made or amended, shall be deemed to provide for the statutory accident benefits set out in the Schedule and any amendments to the Schedule, subject to the terms, conditions, provisions, exclusions and limits set out in that Schedule. 1993, c. 10, s. 26 (1).

Exception, public transit vehicles

(1.1) Despite subsection (1) and the Statutory Accident Benefits Schedule, no statutory accident benefits are payable in respect of an occupant of a public transit vehicle, in respect of an incident that occurs on or after the date this subsection comes into force, if the public transit vehicle did not collide with another automobile or any other object in the incident. 2011, c. 9, Sched. 21, s. 4.

(1.2), (1.3) Repealed: 1996, c. 21, s. 30 (1).

Indexation

(1.4) Subject to subsection (1.5) and to the terms, conditions, provisions, exclusions and limits established by the Statutory Accident Benefits Schedule, the Schedule shall provide that, in respect of incidents involving the use or operation, after December 31, 1993 and before November 1, 1996, of an automobile,

(a) every continuing periodic amount payable by an insurer as an income replacement benefit, education disability benefit, caregiver benefit or loss of earning capacity benefit in accordance with the Schedule shall be revised, effective the 1st day of January in every year after 1994, using the indexation percentage published under subsection 268.1 (1); and

(b) every monetary amount set out in the Schedule shall be revised, effective the 1st day of January in every year after 1994, by adjusting the amount by the indexation percentage published under subsection 268.1 (1). 1993, c. 10, s. 26 (1); 1996, c. 21, s. 30 (2); 2020, c. 34, Sched. 7, s. 12.

No decrease in payments

(1.5) A continuing periodic amount payable by an insurer in accordance with the Statutory Accident Benefits Schedule shall not be reduced by the operation of the indexation percentage referred to in subsection (1.4). 1993, c. 10, s. 26 (1).

Liability to pay

(2) The following rules apply for determining who is liable to pay statutory accident benefits:

1. In respect of an occupant of an automobile,

i. the occupant has recourse against the insurer of an automobile in respect of which the occupant is an insured,

ii. if recovery is unavailable under subparagraph i, the occupant has recourse against the insurer of the automobile in which he or she was an occupant,

iii. if recovery is unavailable under subparagraph i or ii, the occupant has recourse against the insurer of any other automobile involved in the incident from which the entitlement to statutory accident benefits arose,

iv. if recovery is unavailable under subparagraph i, ii or iii, the occupant has recourse against the Motor Vehicle Accident Claims Fund.

2. In respect of non-occupants,

i. the non-occupant has recourse against the insurer of an automobile in respect of which the non-occupant is an insured,

ii. if recovery is unavailable under subparagraph i, the non-occupant has recourse against the insurer of the automobile that struck the non-occupant,

iii. if recovery is unavailable under subparagraph i or ii, the non-occupant has recourse against the insurer of any automobile involved in the incident from which the entitlement to statutory accident benefits arose,

iv. if recovery is unavailable under subparagraph i, ii or iii, the non-occupant has recourse against the Motor Vehicle Accident Claims Fund. R.S.O. 1990, c. I.8, s. 268 (2); 1993, c. 10, s. 1; 1996, c. 21, s. 30 (3, 4).

Liability

(3) An insurer against whom a person has recourse for the payment of statutory accident benefits is liable to pay the benefits. R.S.O. 1990, c. I.8, s. 268 (3); 1993, c. 10, s. 1.

Choice of insurer

(4) If, under subparagraph i or iii of paragraph 1 or subparagraph i or iii of paragraph 2 of subsection (2), a person has recourse against more than one insurer for the payment of statutory accident benefits, the person, in his or her absolute discretion, may decide the insurer from which he or she will claim the benefits. R.S.O. 1990, c. I.8, s. 268 (4); 1993, c. 10, s. 1.

Same

(5) Despite subsection (4), if a person is a named insured under a contract evidenced by a motor vehicle liability policy or the person is the spouse or a dependant, as defined in the Statutory Accident Benefits Schedule, of a named insured, the person shall claim statutory accident benefits against the insurer under that policy. 1993, c. 10, s. 26 (2); 1999, c. 6, s. 31 (9); 2005, c. 5, s. 35 (13).

Same

(5.1) Subject to subsection (5.2), if there is more than one insurer against which a person may claim benefits under subsection (5), the person, in his or her discretion, may decide the insurer from which he or she will claim the benefits. 1993, c. 10, s. 26 (2).

Same

(5.2) If there is more than one insurer against which a person may claim benefits under subsection (5) and the person was, at the time of the incident, an occupant of an automobile in respect of which the person is the named insured or the spouse or a dependant of the named insured, the person shall claim statutory accident benefits against the insurer of the automobile in which the person was an occupant. 1993, c. 10, s. 26 (2); 1999, c. 6, s. 31 (10); 2005, c. 5, s. 35 (14).

Excess insurance

(6) Except as provided in the Statutory Accident Benefits Schedule, the insurance mentioned in subsection (1) is excess insurance to any other insurance not being automobile insurance of the same type indemnifying the injured person or in respect of a deceased person for the expenses. R.S.O. 1990, c. I.8, s. 268 (6); 2024, c. 20, Sched. 10, s. 9.

Idem

(7) The insurance mentioned in subsection (1) is excess insurance to any other insurance indemnifying the injured person or in respect of a deceased person for the expenses. R.S.O. 1990, c. I.8, s. 268 (7).

Payments pending dispute resolution

(8) Where the Statutory Accident Benefits Schedule provides that the insurer will pay a particular statutory accident benefit pending resolution of any dispute between the insurer and an insured, the insurer shall pay the benefit until the dispute is resolved. R.S.O. 1990, c. I.8, s. 268 (8); 1993, c. 10, s. 1.

Section 268.0.1§Sections Winding-up orders

(1) The making of a winding-up order in respect of an insurer under the Winding-up and Restructuring Act (Canada) shall not be taken into account in determining under section 268 whether the insurer is liable to pay statutory accident benefits. 2002, c. 22, s. 124.

Motor Vehicle Accident Claims Fund

(2) If an insurer in respect of which a winding-up order has been made under the Winding-up and Restructuring Act (Canada) is liable to pay statutory accident benefits, the benefits, including any benefits that were outstanding at the time the order was made, shall be paid out of the Motor Vehicle Accident Claims Fund. 2002, c. 22, s. 124.

Application

(3) This section applies to winding-up orders made after this section comes into force. 2002, c. 22, s. 124.

Section 268.1§Sections Publication of indexation percentage

(1) Before the 1st day of January in each year, the Chief Executive Officer shall determine in accordance with this section and publish on the website of the Authority the indexation percentage to be used effective the 1st day of January under subsections 267.5 (8.3), (8.4) and 268 (1.4). 1993, c. 10, s. 27; 1997, c. 28, s. 115; 2015, c. 20, Sched. 17, s. 4; 2018, c. 8, Sched. 13, s. 22; 2020, c. 34, Sched. 7, s. 13.

Rules for determination

(2) The following rules apply to the determination of the indexation percentage to be used under subsections 267.5 (8.3), (8.4) and 268 (1.4) effective the 1st day of January in a year:

1. The indexation percentage shall be the percentage change in the Consumer Price Index for Canada (All Items), as published by Statistics Canada under the authority of the Statistics Act (Canada), for the period from September in the year immediately preceding the previous year to September of the previous year.

2. Despite paragraph 1, if the Consumer Price Index information required by paragraph 1 to determine the indexation percentage is not available by the 1st day of November in the previous year, or if in the Chief Executive Officer’s opinion the information published by Statistics Canada does not provide a reasonable reflection of changes in consumer prices, the Chief Executive Officer may determine the indexation percentage in a manner that the Chief Executive Officer considers will provide a reasonable reflection of changes in consumer prices. 1993, c. 10, s. 27; 1997, c. 28, s. 115; 2015, c. 20, Sched. 17, s. 4; 2018, c. 8, Sched. 13, s. 22, 23.

Publication of monetary amounts in Schedule

(3) At the time an indexation percentage is published under subsection (1), the Chief Executive Officer shall publish on the website of the Authority the amounts to which the monetary amounts set out in the Statutory Accident Benefits Schedule shall be revised, effective the 1st day of January, in accordance with clause 268 (1.4) (b). 1993, c. 10, s. 27; 1997, c. 28, s. 115; 2018, c. 8, Sched. 13, s. 22; 2019, c. 14, Sched. 9, s. 12.

Section 268.2§Sections Rules of interpretation, Statutory Accident Benefits Schedule

The Statutory Accident Benefits Schedule shall be interpreted in accordance with the rules made under paragraph 10.2 of subsection 121 (1). 1993, c. 10, s. 27; 1996, c. 21, s. 31.

Section 268.3§Sections Guidelines, Statutory Accident Benefits Schedule

(1) The Chief Executive Officer may issue guidelines on the interpretation and operation of the Statutory Accident Benefits Schedule or any provision of that Schedule. 1993, c. 10, s. 27; 1997, c. 28, s. 116; 2018, c. 8, Sched. 13, s. 22.

Same

(1.1) The Chief Executive Officer may issue guidelines setting out the treatment, services, measures or goods applicable in respect of types of impairments for the purposes of payment of a medical or rehabilitation benefit provided under the Statutory Accident Benefits Schedule, and such guidelines may include conditions, restrictions and limits with respect to such treatment, services, measures or goods. 2002, c. 22, s. 125; 2018, c. 8, Sched. 13, s. 22.

Effect of guideline

(2) Subject to section 268.2, a guideline shall be considered in any determination involving the interpretation of the Statutory Accident Benefits Schedule. 1993, c. 10, s. 27.

Incorporation by reference

(2.1) Despite subsection (2), a guideline that is incorporated by reference into the Statutory Accident Benefits Schedule is binding. 2013, c. 2, Sched. 8, s. 13.

Effective date

(3) A guideline takes effect on the day it is published in The Ontario Gazette. 1993, c. 10, s. 27.

Section 268.4§Sections Immunity

No action or other proceeding for damages may be commenced against any person for an act done or omitted in good faith in conducting an assessment by a designated assessment centre under the Statutory Accident Benefits Schedule. 2002, c. 22, s. 126.

Section 392.1§Sections Definition

In this Part,

“licence for life insurance” means the class of licence described in paragraph 1 of subsection 392.2 (2). 2014, c. 9, Sched. 3, s. 15.

Section 392.2§Sections Insurance agent’s licence, scope of authority

(1) A person who holds a licence issued under this Part to act as an insurance agent in Ontario is authorized to act as such in accordance with the requirements of this Act, the regulations and the Authority rules and subject to the restrictions applicable to the class of licence issued to the person. 2014, c. 9, Sched. 3, s. 15; 2021, c. 8, Sched. 5, s. 2.

Classes of agent’s licence

(2) The following classes of licence authorizing a person to act as an insurance agent in Ontario may be issued under this Part:

1. Licence for life insurance and accident and sickness insurance.

2. Licence for accident and sickness insurance.

3. Licence for all classes of insurance other than life insurance. 2014, c. 9, Sched. 3, s. 15.

Same

(3) An agent’s licence is subject to such terms and conditions as may be prescribed for the applicable class of licence, such conditions as may be imposed by the Chief Executive Officer, and such requirements, including reporting requirements, as may be prescribed for that class of licence. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Authority of agent

(4) A class of licence described in paragraph 2 or 3 of subsection (2) authorizes an agent to act for one insurer only, and the insurer itself must be licensed under this Act to undertake the applicable class of insurance. 2014, c. 9, Sched. 3, s. 15.

Same

(5) The agent’s licence for a class of licence described in paragraph 2 or 3 of subsection (2) must specify the name of the insurer that has appointed the agent to act on its behalf. 2014, c. 9, Sched. 3, s. 15.

Offence

(6) Every person who acts as an insurance agent in Ontario without the licence required by this Part, or does so while the person’s licence is suspended, is guilty of an offence. 2014, c. 9, Sched. 3, s. 15.

Representation restricted

(7) An agent holding a class of licence described in paragraph 2 or 3 of subsection (2) shall not make any representation to the public, by advertisement or otherwise, that the agent is an agent of any insurer other than the one specified in the licence for the purposes of selling the classes of insurance specified in the licence. 2014, c. 9, Sched. 3, s. 15.

Insurance groups

(8) Despite subsection (7), an agent may be licensed to act as an agent for an affiliated group of insurers that, in the opinion of the Chief Executive Officer, are carrying on business as a common undertaking and that affiliated group of insurers is deemed to be an insurer for the purpose of determining the agent’s authority to act as an agent under this Act. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Same

(9) For the purposes of subsection (8), the following corporations and insurers are deemed to be an affiliated group of insurers carrying on business as a common undertaking:

1. Every mutual insurance corporation that participates in the Fire Mutuals Guarantee Fund.

2. Every insurer that is controlled by one or more mutual insurance corporations that participate in the Fire Mutuals Guarantee Fund as a result of investments made under Part XVII. 2014, c. 9, Sched. 3, s. 15.

Section 392.3§Sections Application for agent’s licence

(1) A person who wishes to apply for a licence authorizing him, her or it to act as an insurance agent in Ontario shall submit an application to the Chief Executive Officer in the manner required by the Chief Executive Officer and shall give the Chief Executive Officer such information, evidence and material as he or she may require and pay the applicable fee. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22; 2024, c. 20, Sched. 10, s. 26.

Same

(2) The applicant is also required to pay any outstanding administrative penalty imposed under Part XVIII.1. 2014, c. 9, Sched. 3, s. 15.

Notice of appointment of applicant

(3) Unless the regulations specify otherwise, the application must include a notice from an insurer, on a form approved by the Chief Executive Officer, certifying that the insurer has appointed the applicant to act as the insurer’s agent in Ontario. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 392.3 (3) of the Act is amended by striking out “the regulations” and substituting “the Authority rules”. (See: 2021, c. 8, Sched. 5, s. 3)

Declaration by applicant

(4) The application must include a declaration by the applicant, on a form approved by the Chief Executive Officer, respecting representations made in the application. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Withdrawal of application

(5) The applicant may withdraw the application at any time before the licence is issued, but if the Chief Executive Officer has taken a step under section 407.1 in connection with the application, the applicant cannot withdraw the application without the Chief Executive Officer’s permission. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22, 23.

Conditions

(6) If the Chief Executive Officer permits the applicant to withdraw the application, the Chief Executive Officer may impose conditions relating to the withdrawal. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Section 392.4§Sections Issuance, amendment and renewal of agent’s licence

(1) The Chief Executive Officer shall issue a licence to act as an insurance agent in Ontario to an applicant who applies in accordance with section 392.3 and who satisfies the prescribed requirements for the licence unless the Chief Executive Officer believes, on reasonable grounds, that the applicant is not suitable to be licensed having regard to such circumstances as may be prescribed and such other matters as the Chief Executive Officer considers appropriate. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Term of licence

(2) A licence authorizing a person to act as an insurance agent expires at such time as the regulations provide, unless the licence is revoked or suspended under this Part. 2014, c. 9, Sched. 3, s. 15.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 392.4 (2) of the Act is amended by striking out “the regulations” and substituting “the Authority rules”. (See: 2021, c. 8, Sched. 5, s. 4)

Proposal to refuse application

(3) If the Chief Executive Officer proposes to refuse to issue a licence to the applicant, the Chief Executive Officer shall take the steps required by section 407.1. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Proposal to impose conditions

(4) If the Chief Executive Officer proposes to issue the licence and, without the applicant’s consent, to impose conditions on the licence, the Chief Executive Officer shall take the steps required by section 407.1. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Amendment of licence

(5) The Chief Executive Officer may, at any time, amend an agent’s licence. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Proposal to amend

(6) If the Chief Executive Officer proposes to amend the licence without the agent’s consent, the Chief Executive Officer shall take the steps required by section 407.1. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Renewal of licence

(7) An agent who wishes to apply for renewal of his, her or its licence shall submit an application to the Chief Executive Officer in the manner required by the Chief Executive Officer and shall give the Chief Executive Officer such information, evidence and material as he or she may require and pay the applicable fee. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22; 2024, c. 20, Sched. 10, s. 26.

Same

(8) Subsections 392.3 (2) to (6) and subsections (1), (3) and (4) of this section apply, with necessary modifications, with respect to the application for renewal. 2014, c. 9, Sched. 3, s. 15.

Section 392.5§Sections Revocation or suspension of agent’s licence

(1) The Chief Executive Officer may revoke or suspend an agent’s licence to act as an insurance agent if the agent has failed to comply with this Act, the regulations, the Authority rules or a condition of the licence. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22; 2021, c. 8, Sched. 5, s. 5.

Same

(2) The Chief Executive Officer may revoke or suspend an agent’s licence if any prescribed grounds for revoking or suspending a licence, or for refusing to issue a licence, exist. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Proposal to revoke or suspend

(3) If the Chief Executive Officer proposes to revoke or suspend an agent’s licence under this section without the agent’s consent, the Chief Executive Officer shall take the steps required by section 407.1. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Expedited order to revoke or suspend

(4) The Chief Executive Officer may, by order, revoke or suspend an agent’s licence in any of the following circumstances, without taking the steps required by section 407.1:

1. The agent fails to pay a fee required under this Act or an administrative penalty imposed under Part XVIII.1.

2. Such other circumstances as may be prescribed. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Effect of suspension

(5) During a suspension, the agent is not authorized to act as an insurance agent in Ontario. 2014, c. 9, Sched. 3, s. 15.

Interim order suspending licence

(6) If, in the Chief Executive Officer’s opinion, the interests of the public may be adversely affected by any delay in the revocation or suspension of an agent’s licence as a result of the steps required by section 407.1, the Chief Executive Officer may, without notice, make an interim order suspending the licence and may do so before or after giving the notice required by section 407.1 with respect to the proposal to revoke or suspend the licence. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22, 23.

Effect of interim order

(7) An interim order suspending an agent’s licence takes effect immediately and remains in effect until the expiry of the period for requesting a hearing under section 407.1 about the Chief Executive Officer’s proposal to revoke or suspend the licence. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 23.

Same

(8) Despite subsection (7), if the Chief Executive Officer does not give the agent the notice required by section 407.1 within 21 days after the day on which the interim order is made, the interim order expires at the end of the 21-day period. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Extension of interim order

(9) If the agent requests a hearing about the Chief Executive Officer’s proposal to revoke or suspend the licence, the Chief Executive Officer may extend the interim order until the proposal is finally determined. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22, 23.

Revocation of order re: suspension

(10) The Chief Executive Officer may, at any time, revoke a suspension order or an interim order suspending an agent’s licence. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Reinstatement of licence

(11) If a licence is revoked for non-payment of a fee or administrative penalty described in paragraph 1 of subsection (4), the Chief Executive Officer may reinstate the licence upon payment of the fee or penalty. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Section 392.6§Sections Automatic suspension of agent’s licence

Notice by insurer

(1) An insurer shall forthwith give written notice to the Chief Executive Officer if the insurer has terminated the appointment of an agent to act on the insurer’s behalf, and the notice must indicate the reason for the termination. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Suspension

(2) The agent’s licence is suspended upon termination of his or her appointment by the insurer. 2014, c. 9, Sched. 3, s. 15.

End of suspension

(3) The suspension of the agent’s licence ends when an insurer notifies the Chief Executive Officer, on a form approved by the Chief Executive Officer, that the agent is appointed to act on its behalf and the applicable fee to amend the licence is paid. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Offence

(4) An insurer who fails to give the notice required by subsection (1) within 30 days after terminating the agent’s appointment is guilty of an offence. 2014, c. 9, Sched. 3, s. 15.

Exceptions

(5) This section does not apply in such circumstances as may be prescribed by regulation. 2014, c. 9, Sched. 3, s. 15.

Section 392.7§Sections Surrender of agent’s licence

(1) An agent may apply to the Chief Executive Officer for permission to surrender the agent’s licence. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Application

(2) The applicant shall submit the application to the Chief Executive Officer in the manner required by the Chief Executive Officer and shall give the Chief Executive Officer such information, evidence and material as he or she may require and pay the applicable fee. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22; 2024, c. 20, Sched. 10, s. 26.

Decision re: surrender

(3) The Chief Executive Officer shall allow the applicant to surrender the licence unless the Chief Executive Officer believes, on reasonable grounds, that the surrender of the licence is not in the public interest having regard to such criteria as may be prescribed and such other factors as the Chief Executive Officer considers appropriate. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Same

(4) If the Chief Executive Officer allows the surrender of the licence, the Chief Executive Officer may impose conditions relating to the surrender. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Proposal to refuse the application to surrender

(5) If the Chief Executive Officer proposes to refuse to allow the surrender of the licence, the Chief Executive Officer shall take the steps required by section 407.1. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Proposal to impose conditions

(6) If the Chief Executive Officer proposes to allow the surrender of the licence and, without the applicant’s consent, to impose conditions relating to the surrender, the Chief Executive Officer shall take the steps required by section 407.1. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22.

Section 392.8§Sections Regulations re: agent’s licences

(1) The Lieutenant Governor in Council may make regulations relating to licences authorizing a person to act as an insurance agent in Ontario,

(a) prescribing the matters that are required or permitted under sections 392.2 to 392.7 to be prescribed or to be done by regulation;

(b) prescribing requirements, qualifications and terms and conditions for the issuance or renewal of licences;

(c) providing for the holding of examinations for applicants for licences or for renewals of licences;

(d) classifying applicants for licences and restricting or prohibiting the licensing of any class of applicant;

(e) providing that subsection 392.3 (3) and subsections 392.6 (1) to (4) do not apply in circumstances specified in the regulations in respect of a licence for life insurance;

(f) prescribing the grounds upon which a licence may be revoked, suspended or not renewed;

(g) governing reports by insurers to the Chief Executive Officer on the suitability of an applicant or licensee to act as an agent;

(h) requiring insurers that appoint agents to act on their behalf to establish and maintain a system to screen each agent and supervise activities of each agent;

(i) prescribing, for each class of licence, standards of practice and duties of agents, including prescribing a code of ethics;

(j) governing the discipline of agents;

(k) regulating the method of handling premiums collected and requiring and regulating accounts and records to be maintained by agents;

(l) requiring agents to supply information and make returns to the Chief Executive Officer;

(m) requiring an agent to furnish a bond or other security and fixing the amount, form, requirements and terms thereof;

(n) requiring that agents who hold a licence for life insurance carry errors and omissions insurance, furnish a fidelity bond or belong to a compensation fund, and fixing the amount, form, requirements and terms thereof;

(o) regulating the replacement of an existing contract of life insurance by another contract of life insurance;

(p) prescribing the duties of insurers and agents in connection with the replacement of life insurance contracts;

(q) respecting any matter necessary or advisable to carry out effectively the intent and purpose of sections 392.2 to 392.7. 2014, c. 9, Sched. 3, s. 15; 2018, c. 8, Sched. 13, s. 22; 2019, c. 14, Sched. 9, s. 14.

(2) Repealed: 2019, c. 14, Sched. 9, s. 20.

Scope of regulations

(3) Regulations made under subsection (1) are in addition to the provisions of sections 392.2 to 392.7, even if the regulations concern a matter provided for in any of those sections. 2014, c. 9, Sched. 3, s. 15.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 392.8 of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 29)

Section 393§Sections

Repealed: 2019, c. 14, Sched. 9, s. 20.

Section 394§Sections Agent or broker deemed to be insurer’s agent

(1) An agent or broker shall, for the purpose of receiving any premium for a contract of insurance, be deemed to be the agent of the insurer despite any conditions or stipulations to the contrary.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 394 (1) of the Act is amended by striking out “or broker” and substituting “broker or managing general agent”. (See: 2024, c. 20, Sched. 10, s. 13)

Exception

(2) This section does not apply to life insurance. R.S.O. 1990, c. I.8, s. 394.

Section 395§Sections Fraudulent representations

An agent or broker who knowingly procures, by fraudulent representations, payment or the obligation for payment of any premium on an insurance policy is guilty of an offence. R.S.O. 1990, c. I.8, s. 395.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 395 of the Act is amended by striking out “or broker” and substituting “broker or managing general agent”. (See: 2024, c. 20, Sched. 10, s. 14)

Section 396§Sections Personal liability of agent for unlawful contracts

An agent or broker is personally liable to the insured on all contracts of insurance unlawfully made by or through the agent or broker directly or indirectly with any insurer not licensed to undertake insurance in Ontario in the same manner as if the agent or broker were the insurer. R.S.O. 1990, c. I.8, s. 396.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 396 of the Act is amended by striking out “or broker” wherever it appears and substituting in each case “broker or managing general agent”. (See: 2024, c. 20, Sched. 10, s. 15)

Section 397§Sections Licences of insurance adjusters

(1) The Chief Executive Officer may, upon the payment of the fee established by the Minister and of any outstanding administrative penalty imposed under Part XVIII.1, issue to any suitable person a licence to act as an adjustor, but a person licensed as an insurance agent under this Part or an insurance broker under the Registered Insurance Brokers Act shall not receive a licence to act as an insurance adjuster. 2019, c. 14, Sched. 9, s. 15.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 397 (1) of the Act is amended by striking out “fee established by the Minister” and substituting “applicable fee” and by striking out “an insurance agent under this Part” and substituting “an insurance agent under this Part, a managing general agent under Part XIV.1”. (See: 2024, c. 20, Sched. 10, s. 16)

Application to be filed with Chief Executive Officer

(2) The applicant for the licence shall file with the Chief Executive Officer an application on a form approved by the Chief Executive Officer and shall provide any other information, material and evidence that the Chief Executive Officer may require. 2011, c. 9, Sched. 21, s. 5; 2014, c. 9, Sched. 3, s. 17 (1); 2018, c. 8, Sched. 13, s. 22.

Licence to be in force one year

(3) If the Chief Executive Officer is satisfied with the statements and information required, the Chief Executive Officer shall issue the licence, which expires on the 30th day of June in each year unless sooner revoked or suspended. R.S.O. 1990, c. I.8, s. 397 (3); 2018, c. 8, Sched. 13, s. 22.

Withdrawal of application

(3.1) Subsections 392.3 (5) and (6) apply, with necessary modifications, with respect to the withdrawal of an application for a licence. 2014, c. 9, Sched. 3, s. 17 (2).

Refusal to issue licence, etc.

(3.2) Subsections 392.4 (3) and (4) apply, with necessary modifications, if the Chief Executive Officer proposes to refuse to issue a licence or proposes to impose conditions on the licence without the applicant’s consent. 2014, c. 9, Sched. 3, s. 17 (2); 2018, c. 8, Sched. 13, s. 22.

Amendment of licence

(3.3) Subsections 392.4 (5) and (6) apply, with necessary modifications, with respect to the amendment of an adjuster’s licence. 2014, c. 9, Sched. 3, s. 17 (2).

Renewal of licence

(4) An adjuster who wishes to apply for renewal of his, her or its licence shall submit an application to the Chief Executive Officer in the manner required by the Chief Executive Officer and shall give the Chief Executive Officer such information, evidence and material as he or she may require and pay the applicable fee. 2014, c. 9, Sched. 3, s. 17 (3); 2018, c. 8, Sched. 13, s. 22; 2024, c. 20, Sched. 10, s. 26.

Same

(5) Subsections 392.3 (2) and (4) to (6) and 392.4 (1), (3) and (4) apply, with necessary modifications, with respect to the application for renewal of an adjuster’s licence. 2014, c. 9, Sched. 3, s. 17 (3).

Revocation or suspension of licence

(6) Section 392.5 (revocation or suspension of agent’s licence) applies, with necessary modifications, with respect to the revocation or suspension of an adjuster’s licence. 2014, c. 9, Sched. 3, s. 17 (3).

Surrender of licence

(6.1) Section 392.7 (surrender of agent’s licence) applies, with necessary modifications, with respect to the surrender of an adjuster’s licence. 2014, c. 9, Sched. 3, s. 17 (3).

Offence

(7) A person who acts as an adjuster without such a licence or during a suspension of the person’s licence is guilty of an offence. R.S.O. 1990, c. I.8, s. 397 (7).

Section 398§Sections Prohibition against public adjusters of motor accident claims

(1) Subject to subsections (2) and (3), no person shall, on the person’s own behalf or on behalf of another person, directly or indirectly,

(a) solicit the right to negotiate, or negotiate or attempt to negotiate, for compensation, the settlement of a claim for loss or damage arising out of a motor vehicle accident resulting from bodily injury to or death of any person or damage to property on behalf of a claimant; or

(b) hold himself, herself or itself out as an adjuster, investigator, consultant or otherwise as an adviser, on behalf of any person having a claim against an insured or an insurer for which indemnity is provided by a motor vehicle liability policy, including a claim for Statutory Accident Benefits. R.S.O. 1990, c. I.8, s. 398 (1); 2002, c. 22, s. 130 (1, 2).

Exception

(2) This section does not apply to a barrister or solicitor acting in the usual course of the practice of law. R.S.O. 1990, c. I.8, s. 398 (2).

Non-application to prescribed persons

(3) Subsection (1) does not apply to a prescribed person or class of persons who comply with prescribed terms and conditions. 2002, c. 22, s. 130 (3).

Section 399§Sections Licences to partnerships

(1) A licence to act as an agent or an adjuster may be issued under section 392.4 or 397 to a partnership, except as otherwise provided in this section or in the regulations. 2014, c. 9, Sched. 3, s. 18 (1).

Statement to be filed by each partner

(2) The application for a licence shall include the name of each member of the partnership and shall include a request that the licence be issued in the name of the partnership, and the licence may be revoked or suspended as to one or more members of the partnership. 2012, c. 8, Sched. 23, s. 72; 2014, c. 9, Sched. 3, s. 18 (2).

(2.1) Repealed: 2014, c. 9, Sched. 3, s. 18 (3).

Termination of partnership

(3) If the partnership is terminated before the expiration of the licence, the partners shall forthwith give notice to the Chief Executive Officer. 1994, c. 11, s. 340; 2018, c. 8, Sched. 13, s. 22; 2019, c. 14, Sched. 9, s. 16.

Revocation

(3.1) If notice is given under subsection (3), the partnership’s licence shall be revoked. 1994, c. 11, s. 340.

Offence

(4) A member of a partnership licensed under this section who contravenes any of its provisions is guilty of an offence. R.S.O. 1990, c. I.8, s. 399 (4).

Section 400§Sections Licences to corporations

(1) A licence to act as an agent or an adjuster may be issued under section 392.4 or 397 to a corporation, except as otherwise provided in this section or in the regulations. 2014, c. 9, Sched. 3, s. 19 (1).

When licences not to be issued

(2) Licences as agents shall not be issued to a corporation if it appears to the Chief Executive Officer that the application is made for the purpose of acting as agent wholly or chiefly in the insurance of property owned by the corporation or by its shareholders or members, or in the placing of insurance for one person, firm, corporation, estate or family. 2001, c. 8, s. 43 (1); 2018, c. 8, Sched. 13, s. 22; 2019, c. 14, Sched. 9, s. 17.

(3)-(5) Repealed: 2001, c. 8, s. 43 (2).

Authority of corporation, etc.

(6) A corporation that holds a licence to act as an agent or adjuster, and every individual who is appointed to act as an agent or adjuster on behalf of and in the name of the corporation, is subject to the provisions of this Act that apply with respect to agents and adjusters. 2014, c. 9, Sched. 3, s. 19 (2).

Exception for certain employees

(7) Despite subsection (6), an employee of the corporation who does not receive commissions and who performs only office duties on behalf of the corporation in connection with the activities of an agent or adjuster may perform those duties under the authority of the corporation’s licence. 2014, c. 9, Sched. 3, s. 19 (2).

(8) Repealed: 2014, c. 9, Sched. 3, s. 19 (2).

Chief Executive Officer may require information

(9) If the principal business of a corporation licensed under this section is not the business of an insurance agent or adjuster, the Chief Executive Officer may require from such a corporation such information as he or she considers necessary in respect to the corporation, its officers and affairs and may make such examination of its books and affairs as he or she considers necessary for the purposes of this Act. R.S.O. 1990, c. I.8, s. 400 (9); 1994, c. 11, s. 341 (3); 2018, c. 8, Sched. 13, s. 22; 2019, c. 14, Sched. 9, s. 17.

Dissolution of corporation

(10) If a corporation licensed under this section is dissolved or its instrument of incorporation is revoked, the corporation shall forthwith give notice to the Chief Executive Officer. 1994, c. 11, s. 341 (4); 2018, c. 8, Sched. 13, s. 22; 2019, c. 14, Sched. 9, s. 17.

Revocation

(10.1) If notice is given under subsection (10), the corporation’s licence shall be revoked. 1994, c. 11, s. 341 (4).

Personal liability of officers

(11) An officer of the corporation who contravenes any of the provisions of this section is guilty of an offence and is personally liable therefor, although such contravention is committed in the name and on behalf of the corporation, and the corporation is liable for any such contravention the responsibility for which cannot be placed upon any such officer. R.S.O. 1990, c. I.8, s. 400 (11); 2014, c. 9, Sched. 3, s. 19 (3).

Section 401§Sections Acting as agent or adjuster without authority

A person who, not being duly licensed as an agent or adjuster, represents or holds himself, herself or itself out to the public as being such an agent or adjuster, or as being engaged in the insurance business by means of advertisements, cards, circulars, letterheads, signs, or other methods, or, being duly licensed as such agent or adjuster, advertises as aforesaid or carries on such business in any other name than that stated in the licence, is guilty of an offence. R.S.O. 1990, c. I.8, s. 401.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 401 of the Act is amended by striking out “agent or adjuster” wherever it appears and substituting in each case “agent, adjuster or managing general agent”. (See: 2024, c. 20, Sched. 10, s. 17)

Section 402§Sections Money held in trust by agent

Agent to be deemed to hold premium in trust for insurer

(1) An agent or broker who acts in negotiating, or renewing or continuing a contract of insurance, other than life insurance, with a licensed insurer, and who receives any money or substitute for money as a premium for such a contract from the insured, shall be deemed to hold such premium in trust for the insurer, and, if the agent or broker fails to pay the premium over to the insurer within fifteen days after written demand made upon the agent or broker therefor, less the commission of the agent or broker and any deductions to which, by the written consent of the company, the agent or broker is entitled, such failure is proof, in the absence of evidence to the contrary, that the agent or broker has used or applied the premium for a purpose other than paying it over to the insurer. R.S.O. 1990, c. I.8, s. 402 (1); 2024, c. 20, Sched. 10, s. 18 (1).

Note: On a day to be named by proclamation of the Lieutenant Governor, section 402 of the Act is amended by adding the following subsection: (See: 2024, c. 20, Sched. 10, s. 18 (2))

Same, managing general agent

(1.1) A managing general agent that receives any money or substitute for money as a premium from an agent pursuant to subsection (1) shall be deemed to hold such premium in trust for the insurer, and, if the managing general agent fails to pay the premium over to the insurer within 15 days after written demand made upon the managing general agent, less any commission of the managing general agent and any deductions to which, by the written consent of the company, the managing general agent is entitled, such failure is proof, in the absence of evidence to the contrary, that the managing general agent has used or applied the premium for a purpose other than paying it over to the insurer. 2024, c. 20, Sched. 10, s. 18 (2).

Agent to be deemed to hold money in trust for payee under policy

(2) An agent or broker who acts in negotiating or renewing or continuing a contract of insurance with a licensed insurer, and who receives any money or substitute for money for payment to a person in respect of the contract of insurance shall be deemed to hold such money in trust for the person entitled thereto, and, if the agent or broker fails to pay the money over to such person within fifteen days after written demand made upon the agent or broker therefor, less the commission of the agent or broker and any deductions to which the agent or broker is entitled, such failure is proof, in the absence of evidence to the contrary, that the agent or broker has used or applied the money for a purpose other than paying it over to the person entitled. R.S.O. 1990, c. I.8, s. 402 (2).

Note: On a day to be named by proclamation of the Lieutenant Governor, section 402 of the Act is amended by adding the following subsection: (See: 2024, c. 20, Sched. 10, s. 18 (3))

Same, managing general agent

(3) A managing general agent that receives any money or substitute for money for payment to a person in respect of the contract of insurance shall be deemed to hold such in trust for the person entitled thereto, and, if the managing general agent fails to pay the money over to such person within 15 days after written demand made upon the managing general agent, less any commission of the managing general agent and any deductions to which the managing general agent is entitled, such failure is proof, in the absence of evidence to the contrary, that the managing general agent has used or applied the money for a purpose other than paying it over to the person entitled. 2024, c. 20, Sched. 10, s. 18 (3).

Section 403§Sections No compensation to be paid by insurer not licensed

(1) No insurer, and no officer, employee or agent thereof, and no broker, shall directly or indirectly pay or allow, or agree to pay or allow, compensation or anything of value to any person for placing or negotiating insurance on lives, property or interests in Ontario, or negotiating the continuance or renewal thereof, or for attempting so to do, who, at the date thereof, is not an agent or broker and whoever contravenes this subsection is guilty of an offence. R.S.O. 1990, c. I.8, s. 403 (1); 1994, c. 11, s. 342; 2024, c. 20, Sched. 10, s. 19 (2).

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 403 (1) of the Act is amended by striking out “no broker” and substituting “no broker or managing general agent”. (See: 2024, c. 20, Sched. 10, s. 19 (1))

(2) Repealed: 1999, c. 12, Sched. I, s. 4 (58).

Note: On a day to be named by proclamation of the Lieutenant Governor, section 403 of the Act is amended by adding the following subsection: (See: 2024, c. 20, Sched. 10, s. 19 (3))

Same, managing general agent

(2) No insurer, and no officer, employee or agent thereof, and no broker or managing general agent, shall directly or indirectly pay or allow, or agree to pay or allow, compensation or anything of value to any person for acting or offering to act as a managing general agent, who, at the date thereof, is not a managing general agent, and whoever contravenes this subsection is guilty of an offence. 2024, c. 20, Sched. 10, s. 19 (3).

Exceptions

(3) Nothing in this section affects any payment by way of dividend, bonus, profit or savings that is provided for by the policy, or shall be construed so as to prevent an insurer compensating a salaried employee of its head office or a branch office in respect of insurance issued by the employing insurer upon the life of such employee or upon the employee’s property or interests in Ontario or so as to require that such employee shall be licensed as an agent under this Act to affect such insurance. R.S.O. 1990, c. I.8, s. 403 (3).

Section 404§Sections

Repealed: 1994, c. 11, s. 343.

Section 405§Sections

Repealed: 1994, c. 11, s. 343.

Section 406§Sections

Repealed: 1993, c. 10, s. 37.

Section 407§Sections Limited or conditional licence

A licence may be issued to an agent or adjuster subject to such limitations and conditions as the Chief Executive Officer may prescribe. R.S.O. 1990, c. I.8, s. 407; 1994, c. 11, s. 344; 2018, c. 8, Sched. 13, s. 22; 2019, c. 14, Sched. 9, s. 18.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 407 of the Act is amended by striking out “or adjuster” and substituting “adjuster or managing general agent”. (See: 2024, c. 20, Sched. 10, s. 20)

Section 407.1§Sections Chief Executive Officer’s proposal to refuse application, etc.

(1) This section applies if the Chief Executive Officer proposes to do any of the following things:

1. Refuse to issue a licence under this Part.

2. Issue a licence and, without the applicant’s consent, impose conditions.

3. Amend a licence without the licensee’s consent.

4. Refuse to renew a licence.

5. Renew a licence and, without the applicant’s consent, amend the conditions to which the licence is subject.

6. Revoke a licence without the licensee’s consent.

7. Suspend a licence without the licensee’s consent, except by an interim order authorized under this Part.

8. Refuse to allow the surrender of a licence.

9. Allow the surrender of a licence and, without the licensee’s consent, impose conditions relating to the surrender. 2014, c. 9, Sched. 3, s. 20; 2018, c. 8, Sched. 13, s. 22.

Notice of proposal

(2) The Chief Executive Officer shall give written notice of the proposal to the applicant or licensee, including the reasons for the proposal; the Chief Executive Officer shall also inform the applicant or licensee that he, she or it can request a hearing by the Tribunal about the proposal and shall advise the applicant or licensee about the process for requesting a hearing. 2014, c. 9, Sched. 3, s. 20; 2018, c. 8, Sched. 13, s. 22.

Hearing requested

(3) If the applicant or licensee requests a hearing in writing within 15 days after the notice under subsection (2) is given, the Tribunal shall hold a hearing. 2014, c. 9, Sched. 3, s. 20.

Order

(4) The Tribunal may, by order, direct the Chief Executive Officer to carry out the proposal, with or without changes, or substitute its opinion for that of the Chief Executive Officer, and the Tribunal may impose such conditions as it considers appropriate in the circumstances. 2014, c. 9, Sched. 3, s. 20; 2018, c. 8, Sched. 13, s. 22.

Appeal

(5) A party to a hearing held by the Tribunal may appeal the order of the Tribunal to the Divisional Court. 2014, c. 9, Sched. 3, s. 20.

Effect of appeal

(6) An order of the Tribunal takes effect immediately, but if the order is appealed, the Tribunal may grant a stay of the order until the appeal is finally determined. 2014, c. 9, Sched. 3, s. 20.

Hearing not requested

(7) If the applicant or licensee does not request a hearing, or does not make the request in accordance with subsection (3), the Chief Executive Officer may carry out the proposal. 2014, c. 9, Sched. 3, s. 20; 2018, c. 8, Sched. 13, s. 22.

Continued jurisdiction of Chief Executive Officer, Tribunal

(8) If, after the Chief Executive Officer gives notice under subsection (2),

(a) an applicant withdraws the application to which the proposal relates; or

(b) the licence to which the proposal relates is suspended or expires,

the Chief Executive Officer and the Tribunal retain continuing jurisdiction with respect to the proposal and may take any step and make any order that they could have made relating to the proposal, as if the application had not been withdrawn or as if the licence had not been suspended or had not expired, and the parties may appeal any order of the Tribunal. 2014, c. 9, Sched. 3, s. 20; 2018, c. 8, Sched. 13, s. 22.

Same

(9) The continuing jurisdiction of the Chief Executive Officer and the Tribunal under subsection (8) is terminated when the rights of the parties have been exhausted or have expired and when all proceedings relating to the proposal have concluded. 2014, c. 9, Sched. 3, s. 20; 2018, c. 8, Sched. 13, s. 22.

Section 407.2§Sections

Repealed: 2019, c. 14, Sched. 9, s. 20.

Section 408§Sections Meaning of “rating bureau”, Part XV

In this Part,

“rating bureau” means an association or body, incorporated or unincorporated, created or organized for the purpose of fixing or promulgating rates of premium payable upon contracts of insurance in Ontario, or the terms or conditions of such contracts, or for these and other purposes, or that assumes to fix or promulgate such rates, terms or conditions by agreement among the members thereof or otherwise. R.S.O. 1990, c. I.8, s. 408.

Section 409§Sections Duties of rating bureaus and insurers

Filing of constitution, by-laws, etc.

(1) A rating bureau shall, forthwith after adoption, file in the office of the Chief Executive Officer duly certified copies of its constitution, articles of association and by-laws, and a list of its members and their addresses, and thereafter shall file in the office of the Chief Executive Officer every amendment, revision or consolidation of its constitution, articles of association and by-laws, and notice of the admission of new members and the withdrawal of former members, within thirty days after the passing or adoption of such amendment, revision or consolidation, or after the admission or withdrawal of such members. R.S.O. 1990, c. I.8, s. 409 (1); 2018, c. 8, Sched. 13, s. 22.

Return of rates

(2) A rating bureau and a licensed insurer shall make a return under oath to the Chief Executive Officer in such form and at such times as the Chief Executive Officer may require, showing every schedule of rates fixed, made or charged by them, together with such further or other information concerning such rates as the Chief Executive Officer may require. R.S.O. 1990, c. I.8, s. 409 (2); 2018, c. 8, Sched. 13, s. 22.

Changes in rates

(3) A rating bureau and a licensed insurer shall give to the Chief Executive Officer at least ten days notice of any change in the schedules of rates or rules applicable thereto filed with the Chief Executive Officer under subsection (2), and shall file with the Chief Executive Officer amended schedules duly verified under oath showing particulars of all such changes before their effective date. R.S.O. 1990, c. I.8, s. 409 (3); 2018, c. 8, Sched. 13, s. 22.

Offence for deviation from filed rate

(4) A rating bureau or licensed insurer that, having filed its schedules of rates under this section, fixes, makes or charges a rate or receives a premium that deviates from the schedules of rates fixed and filed with the Chief Executive Officer for, and the rules applicable to, any risk or class of risks is guilty of an offence. R.S.O. 1990, c. I.8, s. 409 (4); 2018, c. 8, Sched. 13, s. 22.

Section 410§Sections Application re risk classification system, rates

(1) Every insurer shall apply to the Chief Executive Officer for approval of,

(a) the risk classification system it intends to use in determining the rates for each coverage and category of automobile insurance; and

(b) the rates it intends to use for each coverage and category of automobile insurance. 1996, c. 21, s. 44; 1997, c. 28, s. 125; 2018, c. 8, Sched. 13, s. 22.

Exception

(1.1) Subsection (1) does not apply with respect to the Personal Vehicles — Private Passenger Automobile category of automobile insurance while subsection 4 (1) of the Automobile Insurance Rate Stabilization Act, 2003 is in force. 2013, c. 2, Sched. 8, s. 26.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 410 (1.1) of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 30 (1))

Exception

(2) An insurer is not required to apply for approval of a risk classification system that the insurer is required to use under the regulations. 1996, c. 21, s. 44.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 410 (2) of the Act is amended by striking out “the regulations” at the end and substituting “the Authority rules”. (See: 2017, c. 34, Sched. 21, s. 30 (2))

Note: On a day to be named by proclamation of the Lieutenant Governor, section 410 of the Act is amended by adding the following subsection: (See: 2017, c. 34, Sched. 21, s. 30 (3))

Order requiring application for approval

(2.1) The Superintendent may order an insurer to apply to the Superintendent for approval of,

(a) the risk classification system it intends to use, as of the date specified in the order, in determining the rates for each coverage and category of automobile insurance; and

(b) the rates it intends to use, as of the date specified in the order, for each coverage and category of automobile insurance. 2017, c. 34, Sched. 21, s. 30 (3).

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 410 (2.1) of the Act is amended by striking out “Superintendent” wherever it appears and substituting in each case “Chief Executive Officer”. (See: 2018, c. 8, Sched. 13, s. 12)

Material to be furnished

(3) An application for approval of a risk classification system or rates shall be in a form approved by the Chief Executive Officer and shall be filed together with such information, material and evidence as the Chief Executive Officer may specify. 1996, c. 21, s. 44; 1997, c. 28, s. 125; 2018, c. 8, Sched. 13, s. 22.

Additional information

(4) The Chief Executive Officer may require an applicant to provide such information, material and evidence as the Chief Executive Officer considers necessary in addition to the information, material and evidence required to be provided in or with the application. 1996, c. 21, s. 44; 1997, c. 28, s. 125; 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 410 of the Act is amended by adding the following subsections: (See: 2017, c. 34, Sched. 21, s. 30 (4))

Superintendent’s powers

(4.1) After considering an application and any additional information, material or evidence relating to the application, the Superintendent may do one or more of the following:

1. Approve all or part of the application.

2. Refuse to approve all or part of the application.

3. Require the applicant to reduce or otherwise vary one or more of its current or proposed rates.

4. Require the applicant to vary one or more of the elements of its current or proposed risk classification systems. 2017, c. 34, Sched. 21, s. 30 (4).

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 410 (4.1) of the Act is amended by striking out “Superintendent” and substituting “Chief Executive Officer”. (See: 2018, c. 8, Sched. 13, s. 12)

Criteria for refusal to approve, etc.

(4.2) The Superintendent shall refuse to approve all or part of an application and may require the applicant to vary one or more of the elements of its current or proposed risk classification system or to reduce or vary one or more of its current or proposed rates if, in the Superintendent’s opinion, having considered the criteria set out in the Authority rules, the proposed risk classification system or proposed rate is not just and reasonable in the circumstances. 2017, c. 34, Sched. 21, s. 30 (4).

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 410 (4.2) of the Act is amended by striking out “Superintendent” and substituting “Chief Executive Officer”. (See: 2018, c. 8, Sched. 13, s. 12)

Decision final

(4.3) A decision of the Superintendent is final for all purposes. 2017, c. 34, Sched. 21, s. 30 (4).

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 410 (4.3) of the Act is amended by striking out “Superintendent” and substituting “Chief Executive Officer”. (See: 2018, c. 8, Sched. 13, s. 12)

Definition

(5) In this section,

“insurer” includes the Facility Association. 1996, c. 21, s. 44.

Section 411§Sections Approval of expedited applications, s. 410

(1) An applicant under section 410 may choose to have this section apply to the application if the application meets the following criteria:

1. The average of the proposed rates for each coverage and category of automobile insurance does not exceed the average of the existing rates by more than a percentage prescribed by the regulations for that class of applicant, coverage and category, and the proposed rates meet such other criteria as are prescribed by the regulations for the purposes of this section.

2. The proposed risk classification system for each coverage and category of automobile insurance does not contain elements prescribed by the regulations for the purposes of this section. 1996, c. 21, s. 44.

Deemed approval after 30 days

(2) An application to which this section applies shall be deemed to have been approved by the Chief Executive Officer 30 days after it is filed, unless the Chief Executive Officer within that 30-day period advises the applicant orally or otherwise that the Chief Executive Officer has not approved the application. 1996, c. 21, s. 44; 1997, c. 28, s. 125; 2018, c. 8, Sched. 13, s. 22.

Earlier approval

(3) The Chief Executive Officer may approve the application before the expiry of the 30-day period. 1996, c. 21, s. 44; 1997, c. 28, s. 125; 2018, c. 8, Sched. 13, s. 22.

Notice of failure to approve

(4) If the Chief Executive Officer notifies an insurer orally that he or she has not approved the application, the Chief Executive Officer shall promptly mail a written notice to the applicant confirming that fact. 1996, c. 21, s. 44; 1997, c. 28, s. 125; 2018, c. 8, Sched. 13, s. 22.

Effect of notice

(5) If the Chief Executive Officer notifies the insurer that he or she has not approved the application, the insurer may,

(a) submit a new application to the Chief Executive Officer; or

(b) resubmit the same application to the Chief Executive Officer, in which case section 412 applies to the application and this section does not apply. 1996, c. 21, s. 44; 1997, c. 28, s. 125; 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 411 of the Act is repealed and the following substituted: (See: 2017, c. 34, Sched. 21, s. 31)

Reconsideration by Superintendent

411 (1) The Superintendent may notify an insurer that the Superintendent intends to make an order with respect to the risk classification system or rate for a coverage or category of automobile insurance of the insurer if, in the Superintendent’s opinion, having considered the criteria set out in the Authority rules, the current risk classification system or current rate is not just and reasonable in the circumstances. 2017, c. 34, Sched. 21, s. 31.

Written submissions

(2) The Superintendent shall give the insurer an opportunity to make written submissions with respect to the matter. 2017, c. 34, Sched. 21, s. 31.

Orders

(3) After considering the written submissions, if any, the Superintendent may make the order described in the notice or may make a revised order. 2017, c. 34, Sched. 21, s. 31.

Order final

(4) An order of the Superintendent under subsection (3) is final for all purposes. 2017, c. 34, Sched. 21, s. 31.

Definition

(5) In this section,

“insurer” includes the Facility Association. 2017, c. 34, Sched. 21, s. 31.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 411 of the Act, as re-enacted by section 31 of Schedule 21 to the Stronger, Fairer Ontario Act (Budget Measures), 2017, is amended by striking out “Superintendent” wherever it appears and substituting in each case “Chief Executive Officer”. (See: 2018, c. 8, Sched. 13, s. 13)

Section 412§Sections Approval of other applications, s. 410

(1) An application under section 410 to which section 411 does not apply shall be deemed to have been approved by the Chief Executive Officer 60 days after it is filed, unless the Chief Executive Officer within that 60-day period advises the applicant orally or otherwise that the Chief Executive Officer has not approved the application. 1996, c. 21, s. 45; 1997, c. 28, s. 126 (1); 2018, c. 8, Sched. 13, s. 22.

Same

(2) The Chief Executive Officer may approve the application before the expiry of the 60-day period. 1996, c. 21, s. 45; 2002, c. 22, s. 131; 2018, c. 8, Sched. 13, s. 22.

Extension of time

(3) The Chief Executive Officer may extend the period for approval for a period not exceeding 60 days. 1996, c. 21, s. 45; 1997, c. 28, s. 126 (1); 2018, c. 8, Sched. 13, s. 22.

Notice of failure to approve

(4) If the Chief Executive Officer notifies an applicant orally that he or she has not approved an application, the Chief Executive Officer shall promptly mail a written notice to the applicant confirming that fact. 1996, c. 21, s. 45; 1997, c. 28, s. 126 (1); 2018, c. 8, Sched. 13, s. 22.

No approval

(5) The Chief Executive Officer shall not approve the application if a hearing is required by the regulations or if the Chief Executive Officer considers that it is in the public interest for the Tribunal to hold a hearing on the application. 1997, c. 28, s. 126 (2); 2018, c. 8, Sched. 13, s. 22.

Refusal to approve

(6) The Chief Executive Officer shall refuse to approve an application under section 410 if he or she considers that,

(a) the proposed risk classification system or rates are not just and reasonable in the circumstances;

(b) the proposed risk classification system is not reasonably predictive of risk or does not distinguish fairly between risks; or

(c) the proposed rates would impair the solvency of the applicant or are excessive in relation to the financial circumstances of the insurer. 1997, c. 28, s. 126 (2); 2018, c. 8, Sched. 13, s. 22.

Relevant information

(7) In deciding on an application under section 410, the Chief Executive Officer may take into account financial and other information and any other matters that directly or indirectly affect the applicant’s proposed rates or the applicant’s ability to underwrite insurance using the proposed risk classification system. 1997, c. 28, s. 126 (2); 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 412 of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 32)

Section 412.1§Sections Hearing

(1) If the Chief Executive Officer notifies an applicant under section 412 that he or she has not approved the application, the applicant may, within 15 days after receiving the notification, appeal in writing the decision to the Tribunal. 1997, c. 28, s. 127; 2018, c. 8, Sched. 13, s. 22.

Powers of Tribunal

(2) If the applicant appeals the Chief Executive Officer’s decision within the time period allowed, the Tribunal shall hold a hearing, at which the Tribunal may approve or refuse to approve the application or may vary the risk classification system or the rates, and the approval may be subject to the conditions or restrictions that the Tribunal considers appropriate in the circumstances. 1997, c. 28, s. 127; 2018, c. 8, Sched. 13, s. 23.

Additional information

(3) The Tribunal may require the applicant to provide the information, material and evidence that the Tribunal considers necessary in addition to the information, material and evidence that the applicant is required to provide in or with the application. 1997, c. 28, s. 127.

Criteria and relevant information

(4) Subsections 412 (6) and (7) apply with necessary modifications to a hearing held by the Tribunal under this section. 1997, c. 28, s. 127.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 412.1 of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 32)

Section 413§Sections Exemptions from approval process

(1) The Chief Executive Officer may exempt insurers, other than the Facility Association, from making an application under section 410 in respect of designated categories or coverages of automobile insurance. R.S.O. 1990, c. I.8, s. 413 (1); 1996, c. 21, s. 46 (1); 1997, c. 28, s. 128 (1); 2018, c. 8, Sched. 13, s. 22.

Filing

(2) An insurer shall file the risk classification systems and rates it intends to use for the exempted categories or coverages of automobile insurance in a form approved by the Chief Executive Officer. R.S.O. 1990, c. I.8, s. 413 (2); 1993, c. 10, s. 40 (1); 1997, c. 28, s. 128 (1); 2018, c. 8, Sched. 13, s. 22.

Effective date

(3) Subject to subsections (3.1) and (3.2), the insurer may use a risk classification system or rates filed under this section after the expiration of 30 days following the date they were filed, unless before the expiration of that period, the Chief Executive Officer advises the insurer orally or otherwise that the risk classification system or the rates filed by the insurer are not approved. 1997, c. 28, s. 128 (2); 2018, c. 8, Sched. 13, s. 22.

Extension of period

(3.1) Before the expiration of the thirty-day period referred to in subsection (3), the Chief Executive Officer may extend the period for a further period specified by the Chief Executive Officer of not more than thirty days. 1993, c. 10, s. 40 (2); 1997, c. 28, s. 128 (3); 2018, c. 8, Sched. 13, s. 22.

Abridgement of period

(3.2) The Chief Executive Officer may authorize the insurer to use a risk classification system or rates filed under this section before the expiration of the period referred to in subsection (3) or (3.1). 1993, c. 10, s. 40 (2); 1997, c. 28, s. 128 (3); 2018, c. 8, Sched. 13, s. 22.

Notice of failure to approve

(3.3) If the Chief Executive Officer notifies an insurer orally that a risk classification system or rates filed by the insurer are not approved, the Chief Executive Officer shall promptly mail a written notice to the insurer confirming that fact. 1997, c. 28, s. 128 (4); 2018, c. 8, Sched. 13, s. 22.

Appeal

(3.4) If the Chief Executive Officer notifies an insurer under subsection (3) or (3.3) that the risk classification system or rates are not approved, the insurer may, within 15 days after receiving the notification, appeal in writing the decision to the Tribunal. 1997, c. 28, s. 128 (4); 2018, c. 8, Sched. 13, s. 22.

Hearing by Tribunal

(3.4.1) If an insurer appeals the Chief Executive Officer’s decision within the 15-day period, the Tribunal shall hold a hearing. 2002, c. 22, s. 132 (1); 2018, c. 8, Sched. 13, s. 23.

Revocation of exemption

(4) If the Chief Executive Officer revokes an exemption, insurers are required to apply within thirty days after the revocation for approval under section 410 of the risk classification systems and rates it is using for the categories or coverages of automobile insurance affected by the revocation. R.S.O. 1990, c. I.8, s. 413 (4); 1993, c. 10, s. 40 (3); 1996, c. 21, s. 46 (3); 1997, c. 28, s. 128 (5); 2018, c. 8, Sched. 13, s. 22.

Idem

(5) An insurer may continue to use the risk classification systems and rates filed before the Chief Executive Officer revoked the exemption until the insurer’s application under subsection (4) is determined. R.S.O. 1990, c. I.8, s. 413 (5); 1993, c. 10, s. 40 (4); 1997, c. 28, s. 128 (5); 2018, c. 8, Sched. 13, s. 22.

Powers of the Chief Executive Officer, etc.

(6) For the purposes of this section, subsections 410 (4), 412 (6) and (7) and 412.1 (2), (3) and (4) apply, with necessary modifications, as if the insurer had made an application under section 410. 2002, c. 22, s. 132 (2).

Note: On a day to be named by proclamation of the Lieutenant Governor, section 413 of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 32)

Section 413.1§Sections Risk classification and rate determination regulations

(1) No insurer shall, as a result of the application of a regulation made under paragraph 36 or 36.1 of subsection 121 (1), increase or decrease the rate for a class of risks in respect of a coverage or category of automobile insurance by more than the maximum monetary amount or percentage prescribed under paragraph 36.2 of subsection 121 (1). 1993, c. 10, s. 41.

Application for phase-in of regulations

(2) If a regulation made under paragraph 36 or 36.1 of subsection 121 (1) would require an insurer to increase or decrease the rate for a class of risks in respect of a coverage or category of automobile insurance by more than the maximum monetary amount or percentage prescribed under paragraph 36.2 of subsection 121 (1), the insurer shall apply to the Chief Executive Officer for approval of a plan that will phase in the increase or decrease over a period specified in the application by exempting the insurer, in whole or in part, from the regulations made under paragraphs 36 to 36.2 of subsection 121 (1) for the specified period. 1993, c. 10, s. 41; 1997, c. 28, s. 129 (1); 2018, c. 8, Sched. 13, s. 22.

Material to be furnished

(3) The application shall be in a form approved by the Chief Executive Officer and shall be filed together with such information, material and evidence as the Chief Executive Officer may specify. 1993, c. 10, s. 41; 1997, c. 28, s. 129 (1); 2018, c. 8, Sched. 13, s. 22.

Additional information

(4) The Chief Executive Officer may require the applicant to provide such information, material and evidence as the Chief Executive Officer considers necessary in addition to the information, material and evidence required to be provided in or with the application. 1993, c. 10, s. 41; 1997, c. 28, s. 129 (1); 2018, c. 8, Sched. 13, s. 22.

Approval

(5) The application may be approved by the Chief Executive Officer only if, in the opinion of the Chief Executive Officer,

(a) the plan will permit the regulations under paragraphs 36 and 36.1 of subsection 121 (1) to apply to the applicant without any exemption at the end of the period specified in the application;

(b) the period of time during which an exemption will apply to the applicant is reasonable;

(c) the plan will cause a minimum of disruption in the automobile insurance market;

(d) the plan will not impair the solvency of the applicant; and

(e) the plan is in the public interest. 1993, c. 10, s. 41; 1997, c. 28, s. 129 (1); 2018, c. 8, Sched. 13, s. 22.

Variation

(6) The Chief Executive Officer may, with the consent of the applicant or after receiving written submissions, approve an application under subsection (5) subject to the variations and subject to the terms and conditions that the Chief Executive Officer considers appropriate. 1997, c. 28, s. 129 (2); 2018, c. 8, Sched. 13, s. 22.

Reconsideration

(7) The Chief Executive Officer may notify the insurer at any time that he or she intends to make an order with respect to a plan approved under subsection (5) if the Chief Executive Officer is of the opinion that any of the criteria specified in clauses (5) (a) to (e) may not be satisfied. 1997, c. 28, s. 129 (2); 2018, c. 8, Sched. 13, s. 22.

Request for hearing

(7.1) The insurer may, within 15 days after receiving the notice in subsection (7), request in writing that the Tribunal hold a hearing before the Chief Executive Officer makes the order described in the notice. 1997, c. 28, s. 129 (2); 2018, c. 8, Sched. 13, s. 22.

Hearing

(7.2) If the insurer requests a hearing within the time period allowed, the Tribunal shall hold a hearing. 1997, c. 28, s. 129 (2).

No request for hearing

(7.3) If the insurer does not request a hearing within the time period allowed, the Chief Executive Officer may make the order described in the notice. 1997, c. 28, s. 129 (2); 2018, c. 8, Sched. 13, s. 22.

Revocation or variation of approved plan

(8) Following a hearing under subsection (7.2) or section 412, the Tribunal may revoke the approval of a plan approved under subsection (5) or make the variations to the plan that the Tribunal considers appropriate. 1997, c. 28, s. 129 (2).

Definition

(9) In this section,

“insurer” includes the Facility Association. 1993, c. 10, s. 41.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 413.1 of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 32)

Section 414§Sections Affiliated automobile insurers

Concurrent filing, applications under s. 410, 413 or 413.1

(1) The Chief Executive Officer may require that affiliated insurers who write automobile insurance in Ontario file their applications under section 410, 413 or 413.1 concurrently. R.S.O. 1990, c. I.8, s. 414 (1); 1993, c. 10, s. 42 (1); 1996, c. 21, s. 47; 1997, c. 28, s. 130; 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 414 (1) of the Act is amended by striking out “413 or 413.1”. (See: 2017, c. 34, Sched. 21, s. 33)

Insurer’s application, consideration of affiliate’s systems and rates

(2) The Chief Executive Officer may consider the risk classification systems and the rates of the affiliates of an insurer when deciding upon the insurer’s application. R.S.O. 1990, c. I.8, s. 414 (2); 1993, c. 10, s. 42 (2); 1997, c. 28, s. 130; 2018, c. 8, Sched. 13, s. 22.

New affiliates

(2.1) If two or more insurers become affiliated, they shall notify the Chief Executive Officer within thirty days in the form approved by the Chief Executive Officer and the Chief Executive Officer may require the insurers to provide such additional information, material and evidence as the Chief Executive Officer considers necessary. 1993, c. 10, s. 42 (3); 1997, c. 28, s. 130; 2018, c. 8, Sched. 13, s. 22.

Interpretation

(3) For the purpose of this section, an insurer is considered to be affiliated with another insurer if one of them is the subsidiary of the other or both are subsidiaries of the same body corporate or each of them is controlled by the same person. R.S.O. 1990, c. I.8, s. 414 (3).

Section 415§Sections Reconsideration, systems and rates

(1) Despite any approval or exemption under section 411, 412, 412.1 or 413, the Chief Executive Officer may notify the insurer at any time that he or she intends to make an order with respect to any risk classification system or rates for any coverage or category of automobile insurance of an insurer if the Chief Executive Officer is of the opinion that,

(a) the risk classification system or rates are not just and reasonable in the circumstances;

(b) the risk classification system is not reasonably predictive of risk or does not distinguish fairly between risks; or

(c) the rates would impair the solvency of the insurer or are excessive in relation to the financial circumstances of the insurer. 1993, c. 10, s. 43; 1996, c. 21, s. 48 (1); 1997, c. 28, s. 131 (1); 2018, c. 8, Sched. 13, s. 22.

Request for hearing

(1.1) The insurer may, within 15 days after receiving the notice in subsection (1), request in writing that the Tribunal hold a hearing before the Chief Executive Officer takes any action described in the notice. 1997, c. 28, s. 131 (2); 2018, c. 8, Sched. 13, s. 22.

Hearing on request

(1.2) If the insurer requests a hearing within the time period allowed, the Tribunal shall hold a hearing. 1997, c. 28, s. 131 (2).

No request for hearing

(1.3) If the insurer does not request a hearing within the time period allowed, the Chief Executive Officer may make the order described in the notice. 1997, c. 28, s. 131 (2); 2018, c. 8, Sched. 13, s. 22.

Application under s. 410

(2) Instead of notifying the insurer under subsection (1), the Chief Executive Officer may require the insurer to make an application under section 410. 1997, c. 28, s. 131 (3); 2018, c. 8, Sched. 13, s. 22.

Application of s. 411

(2.1) Section 411 does not apply to an application that the Chief Executive Officer requires under subsection (2). 1997, c. 28, s. 131 (3); 2018, c. 8, Sched. 13, s. 22.

Variation

(3) Following a hearing held under subsection (1.2), the Tribunal may vary the risk classification system that the insurer may use or the rates that it may charge. 1997, c. 28, s. 131 (4).

Deemed approval

(4) For the purposes of section 417, a risk classification system and rates varied under subsection (3) shall be deemed to be a risk classification system and rates approved by the Tribunal. 1993, c. 10, s. 43; 1997, c. 28, s. 131 (5).

Definition

(5) In this section,

“insurer” includes the Facility Association. 1993, c. 10, s. 43.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 415 of the Act is repealed. (See: 2017, c. 34, Sched. 21, s. 34)

Section 416§Sections Ministerial policy, statements, systems and rates

(1) The Minister may issue policy statements on matters related to risk classification systems and automobile insurance rates. 1993, c. 10, s. 44.

When effective

(2) A policy statement takes effect on the day it is published in The Ontario Gazette. R.S.O. 1990, c. I.8, s. 416 (2).

Effect of statement

(3) The Chief Executive Officer and the Tribunal shall have regard to the policy statements issued under this section in making decisions under this Part. R.S.O. 1990, c. I.8, s. 416 (3); 1997, c. 28, s. 132; 2018, c. 8, Sched. 13, s. 22.

Section 417§Sections Automobile insurance, systems and rates

Risk classification systems

(1) No insurer shall use a risk classification system in classifying risks for a coverage or category of automobile insurance unless the system,

(a) is approved by the Chief Executive Officer or Tribunal as the case may be;

(b) is authorized under section 413; or

(c) is required under the regulations. 1993, c. 10, s. 45; 1997, c. 28, s. 133 (1); 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 417 (1) of the Act is repealed and the following substituted: (See: 2017, c. 34, Sched. 21, s. 35)

Automobile insurance, systems and rates

Risk classification systems

(1) No insurer shall use a rate for a coverage or category of automobile insurance or a risk classification system in classifying risks for a coverage or category of automobile insurance unless the rate or the system,

(a) is approved by the Superintendent; or

(b) is required under the Authority rules. 2017, c. 34, Sched. 21, s. 35.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 417 (1) of the Act, as re-enacted by section 35 of Schedule 21 to the Stronger, Fairer Ontario Act (Budget Measures), 2017, is amended by striking out “Superintendent” and substituting “Chief Executive Officer”. (See: 2018, c. 8, Sched. 13, s. 14)

Rates

(2) No insurer shall use a rate for a coverage or category of automobile insurance that is not approved by the Chief Executive Officer or Tribunal as the case may be or authorized under section 413. R.S.O. 1990, c. I.8, s. 417 (2); 1997, c. 28, s. 133 (2); 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 417 (2) of the Act is repealed and the following substituted: (See: 2017, c. 34, Sched. 21, s. 35)

Rates

(2) No insurer shall use a rate for a coverage or category of automobile insurance that is not approved by the Superintendent or required under the Authority rules. 2017, c. 34, Sched. 21, s. 35.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 417 (2) of the Act, as re-enacted by section 35 of Schedule 21 to the Stronger, Fairer Ontario Act (Budget Measures), 2017, is amended by striking out “Superintendent” and substituting “Chief Executive Officer”. (See: 2018, c. 8, Sched. 13, s. 14)

Definition

(3) In this section,

“insurer” includes the Facility Association. R.S.O. 1990, c. I.8, s. 417 (3).

Section 417.0.1§Sections Risk classification systems, emergency vehicles

(1) No insurer shall use a risk classification system in classifying risks for a coverage or category of automobile insurance that permits an insurer to consider for purposes of a contract of automobile insurance, other than a contract covering the emergency vehicle, an accident arising out of a person’s use or operation of an emergency vehicle while on duty. 2004, c. 11, s. 1.

Meaning of emergency vehicle

(2) Subsection (1) applies to the following emergency vehicles:

1. A fire department vehicle.

2. A police vehicle while used by a person in the lawful performance of his or her duties as a police officer.

3. An emergency response vehicle.

4. An ambulance. 2004, c. 11, s. 1; 2004, c. 31. Sched. 20, s. 12 (1).

Rates, accidents involving emergency vehicles

(3) No insurer shall use a rate for a coverage or category of automobile insurance that is contrary to subsection (1). 2004, c. 11, s. 1.

Limitation

(4) This section does not apply when a person is operating his or her personal automobile. 2004, c. 11, s. 1.

Definitions

(5) In this section,

“ambulance” means an ambulance as defined in subsection 1 (1) of the Ambulance Act; (“ambulance”)

“automobile” means an automobile within the meaning of Part VI; (“automobile”)

“contract of automobile insurance” means a contract of automobile insurance within the meaning of Part VI; (“contrat d’assurance-automobile”)

“emergency response vehicle” means a vehicle within the meaning of the Highway Traffic Act operated by an ambulance service, other than an ambulance, that is used to provide emergency response services, and that has been assigned an emergency response vehicle number by the Director of the Emergency Health Services Branch of the Ministry of Health and Long-Term Care; (“véhicule d’intervention en cas d’urgence”)

“fire department vehicle” includes an emergency crash extrication vehicle owned and operated by a rescue organization approved by the Minister in writing for the purposes of this Part and a vehicle designated in writing by the Fire Marshal of Ontario as a “fire department vehicle”; (“véhicule de pompiers”)

“insurer” includes the Facility Association; (“assureur”)

“Minister” means the Minister of Community Safety and Correctional Services or such other member of the Executive Council as may be assigned the administration of this Act under the Executive Council Act. (“ministre”) 2004, c. 11, s. 1; 2004, c. 31, Sched. 20, s. 12 (2).

Section 417.1§Sections

Repealed: 2013, c. 2, Sched. 8, s. 27.

Section 418§Sections Inquiry

(1) The Chief Executive Officer may inquire into any question that an insurer, insured or a rating bureau may bring before him or her with regard to insurance rates fixed by a rating bureau or charged by an insurer and also with regard to any other question arising out of the relationship or proposed relationship of the parties with reference to the insurance in question. R.S.O. 1990, c. I.8, s. 418 (1); 2018, c. 8, Sched. 13, s. 22.

Report

(2) The Chief Executive Officer shall not make an order pursuant to an inquiry under this section, but the result of the inquiry shall be reported in the Chief Executive Officer’s annual report. R.S.O. 1990, c. I.8, s. 418 (2); 2018, c. 8, Sched. 13, s. 22, 23.

Section 438§Sections Definitions, Part XVIII

For the purposes of this Part,

“person” includes an individual, corporation, association, partnership, organization, reciprocal or insurance exchange, member of the society known as Lloyd’s, fraternal society, mutual benefit society or syndicate; (“personne”)

“unfair or deceptive acts or practices” means any activity or failure to act that is prescribed by the Authority rules as an unfair or deceptive act or practice. (“actes ou pratiques malhonnêtes ou mensongers”) R.S.O. 1990, c. I.8, s. 438; 1993, c. 10, s. 48; 1999, c. 12, Sched. I, s. 4 (60, 61); 2018, c. 8, Sched. 13, s. 20.

Section 439§Sections Unfair or deceptive acts, etc., prohibited

No person shall engage in any unfair or deceptive act or practice. R.S.O. 1990, c. I.8, s. 439.

Section 440§Sections Chief Executive Officer may investigate

(1) The Chief Executive Officer may examine and investigate the affairs of every person engaged in the business of insurance in Ontario in order to determine whether such person has been, or is, engaged in any unfair or deceptive act or practice. R.S.O. 1990, c. I.8, s. 440; 2018, c. 8, Sched. 13, s. 22.

Same, former insurers, etc.

(2) The Chief Executive Officer may examine and investigate the affairs of every person who has been but is no longer engaged in the business of insurance in Ontario in order to determine whether the person has been, or is, engaged in any unfair or deceptive act or practice. 2013, c. 2, Sched. 8, s. 29 (1); 2018, c. 8, Sched. 13, s. 22.

Same, service provider’s licences

(3) The Chief Executive Officer may examine and investigate the affairs of every person who holds a service provider’s licence issued under Part VI, or who held such a licence, in order to determine whether the person has been, or is, engaged in any unfair or deceptive act or practice. 2013, c. 2, Sched. 8, s. 29 (2); 2018, c. 8, Sched. 13, s. 22.

Same, prescribed persons

(4) The Chief Executive Officer may examine and investigate the affairs of such other persons as may be prescribed, in such circumstances as may be prescribed, in order to determine whether the person has been, or is, engaged in any unfair or deceptive act or practice. 2013, c. 2, Sched. 8, s. 29 (3); 2018, c. 8, Sched. 13, s. 22.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 440 (4) of the Act is amended by striking out “prescribed” wherever it appears and substituting in each case “prescribed by the Authority rules”. (See: 2018, c. 8, Sched. 13, s. 21)

Same, other persons

(5) The Chief Executive Officer may examine and investigate the affairs of every other person who, in the opinion of the Chief Executive Officer, may have engaged in any unfair or deceptive act or practice in order to determine whether the person has been, or is, engaged in any unfair or deceptive act or practice. 2013, c. 2, Sched. 8, s. 29 (3); 2018, c. 8, Sched. 13, s. 22.

Section 441§Sections Action on examination or investigation

Chief Executive Officer’s report

(1) Upon examination or investigation, or upon any other evidence, the Chief Executive Officer shall make a report if he or she is of the opinion that a person has committed or is committing any act, or has pursued or is pursuing any course of conduct, that is an unfair or deceptive act or practice or might reasonably be expected to result in a state of affairs that would constitute an unfair or deceptive act or practice. 1997, c. 28, s. 144; 2018, c. 8, Sched. 13, s. 22.

Notice

(2) The Chief Executive Officer may give notice in writing, which shall include a copy of the report made under subsection (1), to the person that the Chief Executive Officer intends to order the person,

(a) to cease or refrain from doing any act or pursuing any course of conduct identified by the Chief Executive Officer;

(b) to cease engaging in the business of insurance or any aspect of the business of insurance specified by the Chief Executive Officer; or

(c) to perform the acts that, in the opinion of the Chief Executive Officer, are necessary to remedy the situation. 1997, c. 28, s. 144; 2018, c. 8, Sched. 13, s. 22.

Request for hearing

(3) Within 15 days after receiving the notice, a person may request in writing that the Tribunal hold a hearing before the Chief Executive Officer takes any action described in the notice. 1997, c. 28, s. 144; 2018, c. 8, Sched. 13, s. 22.

Interim order

(4) Despite subsection (3), if the Chief Executive Officer is of the opinion that the interests of the public may be prejudiced or adversely affected by any delay in the issuance of a permanent order, the Chief Executive Officer, without prior notice, may make an interim order as described in subsection (2) which shall take effect immediately on its making, and which shall become permanent on the 15th day after its making unless within that time the person requests a hearing before the Tribunal. 1997, c. 28, s. 144; 2018, c. 8, Sched. 13, s. 22.

Hearing

(5) If, within the time period allowed, the person requests a hearing, the Tribunal shall hold a hearing. 1997, c. 28, s. 144.

Extension of order

(6) If, within the time period allowed, the person requests a hearing and the Chief Executive Officer has made an interim order under subsection (4), the Chief Executive Officer may extend the interim order until the hearing is concluded and the order is confirmed, varied or revoked. 1997, c. 28, s. 144; 2018, c. 8, Sched. 13, s. 22.

No request for hearing

(7) If the person does not request a hearing within the time period allowed, the Chief Executive Officer may make an order in accordance with the notice given under subsection (2) which shall take effect on the date set out in the order. 1997, c. 28, s. 144; 2018, c. 8, Sched. 13, s. 22.

Hearing

(8) At a hearing, if the Tribunal is of the opinion that an order described in subsection (2) should be made, the Tribunal may make an order which shall take effect on the date set out in the order. 1997, c. 28, s. 144.

Modification

(9) The Chief Executive Officer may modify any order made under this section after giving the person named in the order an opportunity to make written submissions. 1997, c. 28, s. 144; 2018, c. 8, Sched. 13, s. 22.

Appeal

(10) The person named in an order modified by the Chief Executive Officer may appeal the order to the Tribunal. 1997, c. 28, s. 144; 2018, c. 8, Sched. 13, s. 22.

Revocation

(11) The Chief Executive Officer may revoke any order made under this section. 1997, c. 28, s. 144; 2018, c. 8, Sched. 13, s. 22.

Section 441.1§Sections Definitions

For the purposes of this Part,

“person” has the same meaning as in section 438; (“personne”)

“requirement established under this Act” means,

(a) a requirement imposed by a provision of this Act that is prescribed for the purpose of section 441.3 or 441.4 or by a provision of a regulation or an Authority rule that is prescribed for the purpose of either of those sections,

(b) a condition of a licence,

(c) a requirement imposed by order, or

(d) an obligation assumed by way of undertaking. (“exigence établie en vertu de la présente loi”) 2012, c. 8, Sched. 23, s. 75; 2021, c. 8, Sched. 5, s. 6.

Section 441.2§Sections Administrative penalties

(1) An administrative penalty may be imposed under section 441.3 or 441.4 for either of the following purposes:

1. To promote compliance with the requirements established under this Act.

2. To prevent a person from deriving, directly or indirectly, any economic benefit as a result of contravening or failing to comply with a requirement established under this Act. 2012, c. 8, Sched. 23, s. 75.

Same

(2) An administrative penalty may be imposed alone or in conjunction with any other regulatory measure provided by this Act, including an order under section 441, or the suspension, revocation or cancellation of a licence. 2012, c. 8, Sched. 23, s. 75.

Section 441.3§Sections General administrative penalties

(1) If the Chief Executive Officer is satisfied that a person is contravening or not complying with or has contravened or failed to comply with any of the following, the Chief Executive Officer may, by order, impose an administrative penalty on the person in accordance with this section and the regulations:

1. A provision of this Act, the regulations or the Authority rules as may be prescribed.

2. A condition, requirement or obligation described in clause (b), (c) or (d) of the definition of “requirement established under this Act” in section 441.1. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 22; 2021, c. 8, Sched. 5, s. 7.

Proposal to impose a penalty

(2) If the Chief Executive Officer proposes to impose an administrative penalty under this section, the Chief Executive Officer shall give written notice of the proposal to the person, including the details of the contravention or failure to comply, the amount of the penalty and the payment requirements; the Chief Executive Officer shall also inform the person that he, she or it may request a hearing by the Tribunal about the proposal and shall advise the person about the process for requesting a hearing. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 22.

Notice of combined proposals

(3) A notice of proposal to impose an administrative penalty under this section may be combined with a notice of proposal authorized by any other section. 2012, c. 8, Sched. 23, s. 75.

Limitation

(4) The Chief Executive Officer shall not give notice of a proposal more than two years after the day the Chief Executive Officer became aware of the contravention or failure to comply. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 22.

Hearing requested

(5) If the person requests a hearing in writing within 15 days after the notice under subsection (2) is given, the Tribunal shall hold a hearing. 2012, c. 8, Sched. 23, s. 75.

Order

(6) Subject to the regulations, the Tribunal may, by order, direct the Chief Executive Officer to carry out the proposal, with or without changes, or substitute its opinion for that of the Chief Executive Officer. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 22.

Hearing not requested

(7) If the person does not request a hearing or does not make the request in accordance with subsection (5), the Chief Executive Officer may carry out the proposal. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 22.

Effect of paying penalty

(8) If the person pays the administrative penalty in accordance with the terms of the order or, if the order is varied, in accordance with the terms of the varied order, he, she or it cannot be charged with an offence under this Act in respect of the same contravention or failure to comply. 2012, c. 8, Sched. 23, s. 75.

Section 441.4§Sections Summary administrative penalties

(1) If the Chief Executive Officer is satisfied that a person is contravening or not complying with or has contravened or failed to comply with a provision of this Act, the regulations or the Authority rules as may be prescribed, the Chief Executive Officer may, by order, impose an administrative penalty on the person in accordance with this section and the regulations. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 22; 2021, c. 8, Sched. 5, s. 8.

Same

(2) Before imposing a penalty, the Chief Executive Officer shall give the person a reasonable opportunity to make written submissions. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 22.

Limitation

(3) The Chief Executive Officer shall not make an order under this section more than two years after the day the Chief Executive Officer became aware of the contravention or failure to comply. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 22.

Appeal

(4) The person may appeal the Chief Executive Officer’s order to the Tribunal in writing within 15 days after the order in subsection (1) is given to the person. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 23.

Same

(5) An appeal commenced in accordance with subsection (4) operates as a stay of the order until the matter is finally disposed of. 2012, c. 8, Sched. 23, s. 75.

Same

(6) The Tribunal may confirm, revoke or vary the order within the limits, if any, established by the regulations. 2012, c. 8, Sched. 23, s. 75.

Effect of paying penalty

(7) If the person pays the administrative penalty in accordance with the terms of the order or, if the order is varied, in accordance with the terms of the varied order, he, she or it cannot be charged with an offence under this Act in respect of the same contravention or failure to comply. 2012, c. 8, Sched. 23, s. 75.

Section 441.5§Sections Maximum administrative penalties

(1) An administrative penalty imposed under section 441.3 shall not exceed the following amounts:

1. For a contravention or failure to comply by a person, other than an individual, $200,000 or such lesser amount as may be prescribed for a prescribed requirement established under this Act.

2. For a contravention or failure to comply by an individual, $100,000 or such lesser amount as may be prescribed for a prescribed requirement established under this Act. 2012, c. 8, Sched. 23, s. 75.

Same

(2) An administrative penalty imposed under section 441.4 shall not exceed $25,000 or such lesser amount as may be prescribed for a prescribed requirement established under this Act. 2012, c. 8, Sched. 23, s. 75.

Section 441.6§Sections Enforcement of administrative penalties

(1) If a person fails to pay an administrative penalty imposed under section 441.3 or 441.4 in accordance with the terms of the order imposing the penalty, the Chief Executive Officer may file the order with the Superior Court of Justice and the order may be enforced as if it were an order of the court. 2012, c. 8, Sched. 23, s. 75; 2018, c. 8, Sched. 13, s. 22.

Same

(2) For the purposes of section 129 of the Courts of Justice Act, the date on which the order is filed with the court is deemed to be the date of the order. 2012, c. 8, Sched. 23, s. 75.

Same

(3) An administrative penalty that is not paid in accordance with the terms of the order imposing the penalty is a debt due to the Crown and is also enforceable as such. 2012, c. 8, Sched. 23, s. 75.