For immediate release
News Release
Auto Accident Victims at Risk
When Attending Clinics and Assessments
FAIR Calls for Better Oversight of Ontario’s For-hire Physicians and Medical Assessors
FAIR Calls for Better Oversight of Ontario’s For-hire Physicians and Medical Assessors
TORONTO – September 25, 2014 – FAIR, the Association of Victims For Accident Insurance Reform, urges the
Ontario government to fix the province’s broken auto insurance system and
provide better oversight to protect vulnerable auto accident victims.
FAIR Association of Victims for Accident
Insurance Reform is a grassroots not-for-profit organization of MVA (Motor
Vehicle Accident) victims who have been injured in motor vehicle collisions and
who have struggled with the current auto insurance system in Ontario.
FAIR is concerned that the victims and survivors of car accidents are
exposed to significant risk when attending medical assessments and treatment
clinics when regulatory oversight and enforcement is virtually non-existent.
According to the Health
Claims for Auto Insurance Processing report released last month Ontario’s
auto insurers spent over $242 million dollars for 89,826 visits by MVA victims
at private clinics, assessment facilities and medical offices for medical
opinions or treatment in 2013.
Theresa
Boyle’s Toronto Star story this past weekend exposed the dangers facing
Ontarians who are treated in a for-hire medical system. The risks exist because
of the lack of transparency at the College of Physicians and Surgeons in
respect to the oversight of these privately run facilities. The disregard for
the health and safety of Ontarians was highlighted again on Tuesday when
another Toronto
Star article exposed another College
failure to advise other patients or even those whom they knew had been harmed.
It is a major concern for vulnerable and injured accident victims who
are legislated to attend assessments at private facilities. Court documents
reveal that accident victims as well as WSIB
claimants have been treated at Rothbart Pain Clinic in the past and
possibly even during this crisis at the clinic where there were infection
control deficiencies.
It is worth noting that only after the Star coverage that highlighted
the lack of regulatory oversight and transparency that a Notice
of Hearing appeared on the College’s website.
The Insurance
Bureau of Canada acknowledges that IMEs are used “to control overall costs for the millions of
consumers who buy auto insurance in Ontario. Everyone knows there is a fraud
problem. Insurance companies use IMEs to combat fraud.”
It is one thing to suffer harm in the course of an auto accident and
another to suffer harm at the hands of those who are supposed to be
assisting you as a tactic to fight ‘fraud’. Many of our members have made complaints
to the CPSO about their experiences at medical assessments with the intent
of protecting others from abuses. The reality is that CPSO has consistently
relied on remedial cautions that are private and confidential in order to hide
the past history of physician complaints. In protecting their members, whose
flawed medical reports and testimony are routinely used to disqualify
legitimate claimants, the CPSO has abdicated their responsibility to the
public.
While
considering changes
to auto insurance with the intent to fine claimants $500 for failing to
appear at insurer ordered assessments, our legislators ought to consider just what
the risks are. Current fraud "fixes" favor protecting the financial health of
Ontario's private auto insurers and their medical assessors at
the expense of the physical health of injured claimants.
FAIR Association of Victims for Accident Insurance Reform has contacted
the CPSO on many occasions in regards to the lack of transparency but our repeated
requests for greater transparency to protect the public’s interests and
safety have fallen on deaf ears.
Ontario’s Ministry of Health, through the Health Professions Appeal and
Review Board (HPARB), is compounding that failure to inform the public by
providing only
the initials of the physicians whose cases come before them by way of the
HPARB appeal process.
FAIR wants MPPs
from all political parties to look more closely at auto insurance in
Ontario when Bill 15 is considered.
Bill 15 includes the recommendation from the
final Anti-Fraud
Task Force Report that FSCO continue to rely on the CPSO and Ontario’s
regulatory colleges to oversee Ontario’s third-party for-hire medical opinion
providers. These practitioners provide the medical opinions on which claimants
and insurers rely on to decide access to benefits. The entire system, from the
claims process to court hearings, is dependent on these medical reports and
opinions to be fair, objective and non-partisan to function.
The Anti-Fraud
Task Force acknowledged that “Health regulatory colleges should work
together to develop professional standards, guidelines and best practices to
improve the quality of independent medical assessments of auto insurance claimants
conducted by their members”. FAIR has not yet seen any action on protecting
accident victims since this recommendation in 2012.
FAIR believes that the poor quality of the
medical opinions in the system and poor performance of adjusters is one of the
root causes of our present court backlog. Justice Cunningham in the Dispute
Resolution DRS Final Report recognized the problem with the quality of IMEs
as “obvious” and acknowledged that “IE assessors working in the auto insurance
system have no standard assessment protocols, report formats or timelines, and
I imagine it must be a challenge to insulate themselves from outside influence”
The problem exists because we continue to rely on
the CPSO and other regulatory colleges whose lack of transparency and regulation
enforcement has allowed the
‘independent’ for-hire assessors to ignore the College regulations while pursuing
profits from insurers.
The wrongful denial of
policy benefits to injured claimants based on shoddy insurer assessments has overloaded
our public support systems such as ODSP and CPP Disability. These
questionable ‘independent’ opinions often deny or delay victims getting the
help they need and drive
up costs to both the injured victim and the taxpayer who must shoulder the
financial burden when insurers fail to do so.
We hope that our
government and legislators will put public health and safety first and
foremost, demand transparency and accountability, and take action to ensure
that we have adequate oversight and regulations that protect the public.
FAIR Association of
Victims for Accident Insurance Reform
‘FAIR – supporting auto
accident victims through advocacy and education’
For more information, contact:
Rhona DesRoches
Email: fairautoinsurance@
Website: www.fairassociation.
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