So, I ask, can the government really suck and blow? I guess so because there are so many elements of this that both defy logic and are clearly unfair.
http://entwistlepower.com/2014/02/can-the-ontario-government-suck-and-blow.html
News and Views
Can the Ontario Government Suck AND Blow?
Proving an “economic loss” became a hot topic. Some insurers wanted to only pay the amount of the loss, and others would pay the amount of attendant care benefit (as calculated by the OT), as long as a loss existed. This issue was tried in court, and in Henry vs Gore (2013) the decision was that “the extent of the economic loss was irrelevant…as long as there was any economic loss during the period in question the person can qualify for the services they provided…”
Then, just last month this decision was overturned by the Ontario government, the SABS were amended, and now people providing care cannot receive more “than the extent of the economic loss sustained by the attendant…as a direct result of providing the care…”
Cheaper Car Insurance: Price is the least of the problems
The article “Cheaper Car Insurance: Ontario drivers will wait two more years” highlights many of the current problems in Ontario’s auto insurance industry. High premiums, fraud, problems with payouts for injuries, claim costs, resolution back-logs, and benefit cuts returning $2B back to insurers are all mentioned. As a rehabilitation provider working in the auto insurance industry, I can confirm that the current product is fraught with problems. However, from the health provider and claimant perspective, affordability is the least of the industry’s problems. Rather, there is growing concern regarding insurer practices that are unfair and deceptive, negligent, involve failed fiduciary duties, and seem to violate the Canadian Charter. Issues with professionals as assessors, and provider contracts are also rampant. This paper will review Ontario’s insurance industry, aiming to highlight the many legal problems surrounding a controversial product that impacts all drivers. Cheaper Car Insurance Price is the least of the problems by Julie Entwistle
One problem that requires fixing — the “Independent Medical Examination”
“There have been ongoing concerns regarding the quality and independence of medical examinations of injured claimants. So much so that the term “IME” no longer represents “Independent Medical Examination” but is now used to represent “Insurer Medical Examination”. The integrity of the system used to evaluate access to insurance benefits has lost the confidence of consumers.”….”The present Review of Ontario’s Dispute Resolution System is a consequence of this corrosion of confidence. It is important for the integrity of the IME system that a new method of evaluating claimants be considered.”
What is a Mild Traumatic Brain Injury?
What is a Mild Traumatic Brain Injury (mTBI)? [Video]
Brain injuries are classified mild, moderate, or severe. The leading causes are vehicle-related collisions, falls, sports injuries, and assaults. Of these brain injuries, 70-90% are considered “mild”. It is important to realize, however, that there is nothing “mild” about a traumatic brain i…
Frankly Scarlett, We Should Talk March 31 2014
Why the MIG Arbitration Should Concern Us
Alexander Voudouris and Eva Campbell will explain and discuss from their different perspectives, the decision on his appeal of Scarlett and Belair. Nadia Perruzza
will identify the pitfalls to avoid when documenting the needs of the seriously injured.
FAIR Submission to the 2014 Pre-Budget Consultations
We’d ask if democracy and debate were on holiday in December 2013 when these drastic changes were passed – changes that will limit access to care that affects those who are the most injured. There is, or should we say was, case law that defined incurred expenses that insurers did not agree with but is that a reason to circumvent thoughtful discussion and debate in order to bolster Ontario’s insurance industry profits?
FAIR submission to 2014 Pre-Budget Consultations Jan 23 2014
Toronto Sun – Letters to the Editor, Jan. 21
Coverage, not abuse
Re “Ensuring insurance is a fair deal” (Christina Blizzard, Jan. 15): It isn’t just about what we are paying for auto insurance, it’s what we get when we have to access benefits like treatment, rehab, income replacement, and attendant care if we need it. Why should consumers have to take an insurer to court to get what they need when they’ve paid for coverage? Along the way victims are subjected to invasive, sometimes useless medical examinations by their insurer. There is virtually no oversight of this process — the CPSO won’t tell the public any details about complaints regarding these assessors and yet the public is legislated to attend these examinations. Accident victims endure a lot more than a few “slings and arrows” — our legislators need to pay attention to this industry. Drivers pay for coverage, not abuse. Motor vehicle accident victims “feel something akin to understanding” alright — we feel ripped off and understand that our government is letting it happen.
Rhona DesRoches
FAIR Association of Victims for Accident Insurance Reform
(There are two kinds of fraud in the auto insurance industry — fraud by con artists who try to bilk the insurers and fraud by insurers who refuse to honour valid claims)
http://www.torontosun.com/2014/01/20/letters-to-the-editor-jan-21-2
Is There a Place for Collaboration in Times of Disharmony? Seminars 2014
Wednesday, January 29, 2014
Wednesday, February 12, 2014
Wednesday, February 19, 2014
Wednesday, February 26, 2014
The auto injury benefits environment in which claimants, insurers, service providers and
legal professionals must function is in an unprecedented state of flux. The potential
for misunderstanding and frustration has never been higher. When positions become
hardened, is there still a place for collaboration to fulfill the spirit of the SABS? The
prominent members of the insurance, legal and health communities who will be speaking
at this seminar believe that there is. Full details:
Is There a Place for Collaboration in Times of Disharmony Seminar
FAIR letter to the Dispute Resolution System Review, January 15, 2014
So when we talk about the cost of claims, we need to place some of the responsibility where it rightly belongs, with the most litigious of Ontario’s insurance companies whose cases form the better part of the volume at the Alternative Dispute Resolution Unit. Cases that are too often built on flawed medical opinion evidence provided by assessors who know they will not be held to task by their College oversight for their abuse of vulnerable accident victims
Who sets our rates and what the industry doesn’t want you to know
On January 16, 2104 the IBC placed advertising in many or Ontario’s major newspapers in respect to who sets the rates for Ontario’s drivers. In an ad entitled “Who is the Regulator and what has he done?” the Insurance Bureau of Canada asks and answers the question “Ever wondered who decides what you pay for auto insurance? Ontario’s government-appointed regulator sets those rates.” http://www.fairassociation.ca/?attachment_id=3005
Here’s what Ontario’s regulators say:
FSCO’s Rate Approval Process : “Insurers must submit proposed changes to their rates to FSCO for approval along with supporting actuarial data. FSCO and its actuaries review this data and insurers’ assumptions regarding claims costs, expenses and investment income to ensure that, as required by law, the proposed rates are: just and reasonable, not excessive, and not going to impair a company’s long-term financial solvency. As a result of FSCO’s review, an insurance company may be required to amend its proposed rates before the rates are approved.” https://www.fsco.gov.on.ca/en/auto/rates/Pages/q4-2013.aspx
So why are we being told two versions? Why shouldn’t Ontario’s insurers take responsibility for the abysmal coverage we now have and the highest premium rates in North America? Who is driving up the costs here with expensive advertising – costs which are reflected in our premiums – money that could pay for the treatment that is denied to more than half of Ontario’s accident victims every year.