Ontario’s Independent Medical Examinations - Open Letter

Reducing Fraud with Transparency in Ontario’s Independent Medical Examinations - Open Letter

FAIR Association of Victims for Auto Insurance Reform
579A Lakeshore Rd. E. P.O. Box 39522
Mississauga, ON L5G 4S6
http://www.fairassociation.ca/

September 16, 2013

Reducing Fraud with Transparency in Ontario’s Independent Medical Examinations - Open Letter

Hi

Several months ago FAIR Association of Victims for Accident Insurance reform wrote to you in respect to the inadequate oversight of Ontario’s ‘independent’ medical assessors.

Several letters were sent out that proposed what we feel might be viable solutions to the problem of patient safety and the integrity of the professions when it comes to the Independent Medical Examinations (IME) performed by Ontario’s medical professionals.

The credibility of the auto insurers’ preferred  IME/IE vendors, whose assessments are often used to deny and delay seriously injured claimants’ access to policy benefits is not only affecting access to treatment, it is affecting our justice system.

Accident victims are lined up by the thousands at the Financial Services Commission of Ontario looking for hearings to access the treatment they were promised and then denied on the basis of an often flawed or unqualified ‘expert’ medical opinion.  Innocent legitimate accident victims, some cognitively impaired, are treated like criminals, often threatened and intimidated during an IME and the reports that are generated often of poor quality and of little use except to disqualify that patient for treatment recommended by other health professionals.

Those in Ontario’s auto insurance industry have made comments that cry out for better regulatory oversight and governance and that too is being ignored.

The President of the Canadian Society of Medical Evaluators (CSME) recently wrote that Ontario’s auto insurance IME domain is at risk of “public scandal” due to the inferior quality of “amateurish, biased and fraudulent” medico-legal assessments.

The President of the Association of Independent Assessment Centres (AIAC) said “The value of these independent assessments is directly proportionate to the independence and quality that courts and arbitrators attach to them.”

Ontario’s Arbitrators, who must decide whether or not an injured driver is deserving of treatment or benefits have called some of these medical reports on which they must rely “‘inaccurate, failed, misleading, defective, incomplete, deficient, not correct and flawed”.

A discussion at a FSCO Dispute Resolution Services Counsel meeting included the comment “100% of ALL assessments are “doctored” – in that the actual doctors and assessors are not able to do MOST of the report...” adding a suggestion that “FSCO needs to look at this in a more systemic way”.

We’ve put some suggestions out there to various governing bodies and have not received an answer to a question of public safety. We’ve proposed several possible solutions to those whose duty it is to protect the interests and safety of Ontarians.

FAIR would ask that you consider and respond to our suggestions that the annual public disclosure of fees paid by auto insurers to their medico-legal assessors (as is done in British Columbia) would improve transparency and accountability. FAIR would like to see an end to regulators’ ‘secret cautions’ that keep vulnerable accident victims in the dark about their medical examiners. More importantly, we feel assessors with prior adverse comments by judges and arbitrators regarding a poor quality IME should be subject to a ‘three strikes rule’ that would purge those who repeatedly abuse accident victims from plying their trade in our court systems.

Public safety should not be sacrificed so that a few rogue assessors can get rich by harming innocent auto accident victims. Surely the most vulnerable citizens who find themselves injured on our roadways deserve better treatment and more respect than that.

We look forward to hearing back from you on the issue of transparency, adverse comments and decisions, and on the ways that might be of use to clean up what has become a harmful medical system for Ontario’s accident victims.

Sincerely,

Rhona DesRoches

Board Chair, FAIR Association of Victims for Accident Insurance Reform email: fairautoinsurance@gmail.com

http://www.fairassociation.ca/wp-content/uploads/2013/03/An-Open-Letter-to-Ontarios-Auto-Insurance-Stakeholders-March-4-2013.pdf

http://www.fairassociation.ca/wp-content/uploads/2013/03/Open-Letter-to-additional-Stakeholders-March-11-2013.pdf

http://www.fairassociation.ca/wp-content/uploads/2013/03/Open-letter-to-Stakeholders-March-19-2013.pdf