Author Archives: Admin2

2013 Annual Report of the Office of the Auditor General of Ontario – Auto

Auto Insurance, Regulatory Oversight – Follow-up to VFM Section 3.01, 2011 Annual Report.  
 

It’s time our publicly funded health care system takes a good look at what all these poor quality IMEs are costing the system when insurers turn away their own customers for medically required treatments.

Increased volume of claims turned down led to increased mediation and the hiring of outside mediators – that cost the taxpayer another $38.2 million over 3 years. Time to look at the causes of these costs – insurer claims handling practices – and not lay it at the feet of the innocent accident victims.  http://www.auditor.on.ca/en/reports_en/en13/401en13.pdf

THE NOT-SO-INDEPENDENT MEDICAL EXAMINATION

These examinations are commonly referred to as an independent medical examinations, or IMEs. Unfortunately, the more accurate definition for IME is insurermedical examination. Too often doctors and medical professionals performing these examinations are skewed and even biased against the injured victim in favour of the defendant and/or insurance company. The result is that an already vulnerable person is victimized again in her pursuit of justice. http://otlablog.com/the-not-so-independent-medical-examination/

Strategizing costs

The legal costs of a personal injury trial can often exceed the damages awarded by judgment. In motor vehicle accident cases, it is common for insurers to raise the “threat of costs” to deter victims from pursuing litigation in cases where the statutory threshold of “permanent and serious,” and the deductible on general damage awards, are in play.

http://www.lawyersweekly.ca/index.php?section=article&articleid=2042

Lawyers Return Fire at IBC

The Ontario Trial Lawyers Association isn’t buying the Insurance Bureau of Canada’s claim to be “the real consumer advocate.” … In a post on the association’s website OTLA’s John Karapita called that an “amazing and audacious” claim.

Lawyers Return Fire at IBC – Thompson’s World Insurance News Dec 6 2013

WILL THE REAL CONSUMER ADVOCATES PLEASE STAND UP?

Let’s be clear: the Insurance Bureau of Canada represents insurers and their shareholders. Those interests lie in maximizing the return on equity. Most reasonable people might conclude that the core mandate of the insurance industry is not just incompatible with the consumer interest but diametrically opposed to the interests of consumers. Real consumer advocates, like the people at FAIR, are those who have been through the system and have some valuable advice and lessons for others who at this point do not even know that they will be in an accident one day. They are the ones who have nothing to gain at this point and even shoulder some risk in speaking up to a powerful industry lobby. That’s the definition of a real consumer advocate.

http://otlablog.com/?p=230

MADD Canada criticizes Ontario auto insurance law on 15% rate reduction

The Progressive Conservatives have said that if their party is elected to power it would adopt a “file and use” system that would eliminate government reviews of rates and would require auto insurer CEOs to personally sign off on any rate filing or discount offering. The PCs also say they would, if elected, establish a special unit in the Crown Attorney’s office to investigate auto insurance fraud.

http://www.canadianunderwriter.ca/news/madd-canada-criticizes-ontario-auto-insurance-law-on-15-rate-reduction/1002774862/

FAIR submission to the Ontario Dispute Resolution System Interim Report

We see two very fundamental problems that are affecting the volume of cases denied. One is the actions of individual adjusters and the lack of training and inconsistencies in claims handling practices that exists in that part of the industry. The second is the quality of the IMEs and the lack of independence and integrity or quality in these reports that are used to deny claims and delay treatment.

FAIR response to the Ontario Dispute Resolution System Review Interim Report December 2 2013

Other Stakeholder submissions:

Response to the Interim Report on DR System Review – Ontario Rehab Alliance (2)

OTLA’s Submission on The Interim Report of the DRS Review December 2 (3)

Ontario Psychological Association of Ontario Submission to the DRS Interim Report http://opajoomla.knowledge4you.ca/images/Response%20to%20Interim%20Report.pdf

READ the DRS Interim Report:  http://www.fin.gov.on.ca/en/consultations/auto/documents/Ontario%20Automobile%20Insurance%20Dispute%20Resolution%20System%20Review_Interim%20Report.pdf

ALL Stakeholder submissions:  http://www.fin.gov.on.ca/en/consultations/auto/odrsrs.html

New arbitration hearing ordered in Ontario minor injury guideline dispute

Scarlett v. Belair Insurance Company – A delegate in the Office of the Director of Arbitrations with Ontario’s auto insurance regulator has rescinded a decision made earlier this year related to the minor injury guideline in the accident benefits legislation, also ordering a new arbitration hearing. http://www.canadianunderwriter.ca/news/new-arbitration-hearing-ordered-in-ontario-minor-injury-guideline-dispute/1002764034/508s0pqv8wrps0w24W6x08yM2vx/?ref=enews_CU&utm_source=CU&utm_medium=email&utm_campaign=CU-EN12032013

Canadian insurance regulators launch new database of disciplinary actions

A new database will allow the public and insurance industry participants to access the names of people and firms disciplined by the various regulators in Canada.

http://www.canadianunderwriter.ca/news/canadian-insurance-regulators-launch-new-database-of-disciplinary-actions/1002763660/508s0pqv8wrps0w24W6x08yM2vx/?ref=enews_CU&utm_source=CU&utm_medium=email&utm_campaign=CU-EN12032013

Docs dispute transparency

Insurer argues that only ‘proven and credible findings’ relevant to ‘patient safety’ be disclosed – 

That, as the Ontario Trial Lawyers Association has stated, is a distortion of the principles upon which physicians have been given the power of self-regulation. Concerns for the protection of privacy of physicians in this context are misguided and conflict with the mandate of acting “first and foremost in the interest of the public.”

http://www.torontosun.com/2013/11/29/docs-dispute-transparency