Family wants insurance inquiry

Family wants insurance inquiry

A Lively family is calling for a public inquiry into the Ontario automobile insurance industry after uncovering what they believe are excessive payments to medical professionals treating accident victims, and how those payments are being declared by the industry.
"We don't have all the answers, but we have some of them," said Shawn Mason, son of Bill Mason, 62, who was seriously hurt in a motor vehicle accident on Municipal Road 55 in August. "Anyone who is a consumer of auto insurance should be aware of these things."
Shawn Mason made the charges while speaking to reporters during a press conference in the city on Monday.
Shawn was accompanied by father Bill, who did not speak, and Nickel Belt New Democrat MPP France Gelinas.
The Mason family has been locked in an ongoing battle with Bill's insurer -- the Dominion of Canada General Insurance Company -- over compensation for Bill's injuries. The family believes Bill fits into the category of "catastrophic care" or impairment, due to changes in his mental functioning and personality. The insurance company disagrees.

The self-employed owner-operator of an automobile supply business, Bill Mason can no longer look after his business. In fact, said Shawn, his father has spent $750,000 of his own money to help run the business in his absence.
The Mason family has also launched a civil suit arising from the accident. The suit will be going to court soon.
The Mason family also claims the Ontario automobile industry isn't following Insurance Bureau of Canada guidelines on how insurance premiums are spent. The bureau recommends 53.1 cents of every dollar paid in premiums go to policyholder claims, 10.5 cents for profit, 15.9 cents for taxes, and 20.5 for operating and regulatory costs

Using Freedom of Information requests for four different injured drivers, including Bill, the Mason family found similar instances of large payouts of up to $5,350 for insurer examinations, even though the designated limits ranged from $450 to $900.
The family suspects those payouts are coming not out of operating and regulatory costs, but out of the policyholders' claims portion of premiums paid by motorists.
"Four different incidents with four different drivers that show the same figures," said Shawn. "It led us to believe that everything is systemic. It's right on the books...
"We have discovered is the insurance company is dipping into other revenues to pay for something that should be coming out of their own pock-e ts. We even found that an insurance company dipped into the (claims) fund to pay for a private investigator. He is not a medical professional."
The Dominion of Canada General Insurance Company was one of the four companies examined. George Cooke, of the Dominion of Canada General Insurance Company, wouldn't talk about the case.
"Given the state of the file, the only thing I can do is decline to comment," he said Monday. "It would be wrong for us and it's (also) in litigation."
The Mason family says it got nowhere when dealing with the Financial Services Commission of Ontario -- the regulatory arm of the Ontario Ministry of Finance responsible for administering the Ontario Insurance Act.
The Mason family asked the commission to investigate the alleged misreporting and insurer examination payouts, but referred Bill Mason to the Ontario Provincial Police because it was "a criminal matter," says the family.

The OPP contacted the superintendent's office, said Shawn, and was told that Bill Mason was incorrect and confused.
Gelinas, who is helping the Mason family, wants a public inquiry.
Shawn Mason, who also wants a public inquiry, said Finance Minister Dwight Duncan refused to meet with the Mason family. The family then turned to Gelinas.
"I had it down (pat), so I could spill the story out in five minutes," Gelinas said of her meeting with Duncan. "He was rude. He didn't want anything to do with it."

At a subsequent meeting with Ontario's auditor general -- the independent person who keeps track of government spending, looks to find waste and propose changes -- Gelinas said she was told the auditor general doesn't take direction from MPPs.
Andrew Kovarcsik, an assistant to Duncan, said the provincially appointed Anti- Fraud Task Force is expected to come back with recommendations by the end of the year.
He acknowledged that Duncan and staff met with Gelinas.
"We responded to France," he said. "We were happy to meet with meet with her on the topic ... I can assure you it wasn't brushing off an MPP."
Kovarcsik said if someone believes they have found examples of fraud in the Ontario automobile insurance industry, they should report it to the Financial Services Commission of Ontario.
Kovarcsik, however, said, since the Mason family case is ongoing, he doubts the commission would comment on it.
Commission officials were unavailable for comment Monday.

hcarmichael@thesudburystar.com



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