Monday, 23 February 2015 08:00 | Written By Yamri Taddese
The Insurance Bureau of Canada says it would like to see regulatory
oversight of how personal injury lawyers structure their contingency
fees due to what it calls a major gap in transparency in the auto
insurance system.
“We need to at least review this issue. Why aren’t we talking
about this?” says Ralph Palumbo, Ontario vice president for the
Insurance Bureau of Canada.
All key players in the auto insurance
system, including insurance companies and rehabilitation providers,
must adhere to regulations around their fee structures, says Palumbo,
who notes additional players like tow-truck drivers are now subject to
regulation thanks to changes under Bill 15.
“It appears that the only major stakeholders in the system that really [aren’t] regulated are personal injury lawyers,” he says.
Palumbo
says trial lawyers should file their fee arrangements with the office
of the superintendent of insurance or another body that will review the
financial impact these fees may or may not have on insurance costs and
premiums.
“There is a sense that often providers, whether they’re
lawyers or rehab providers, push claims to a higher level so that the
awards are higher. That’s the sort of thing that we need to guard
against,” says Palumbo.
“No one is saying the claimant shouldn’t
get what is reasonable in the circumstances, but we want to make sure
there aren’t outside financial pressures that will drive up those
costs.”
Barbara Taylor, director of policy at Insurance Bureau of
Canada, says the change will protect consumers while allowing the
government to track the impact of lawyers’ fees on the auto insurance
system.
“First off, we’re asking for a consumer-friendly fee disclosure statement,” she says.
“So
that’s something where we want to make sure the consumer has clear
transparency on that arrangement that they have with the lawyer. Then
we’re asking that that information also be shared with someone like the
[Financial Services Commission of Ontario] superintendent, who can then
use that information to assess the impact on auto insurance as well as
perhaps issue an annual report.”
Ontario Trial Lawyers
Association president Steve Rastin says the Insurance Bureau of Canada
is suggesting lawyers work harder in order to maximize the value of the
case if they have a stake in it.
“You know what, that’s an insult to lawyers,” says Rastin.
“It
implies that I won’t do my utmost for my client unless I have a piece
in the action. You know what, I think lawyers everywhere should be
insulted by the allegation that we’ll work harder for our clients when
we have a stake in it.”
He adds: “I work to the best of my ability for every client whether I’m doing the file on a pro bono
basis or an hourly rate or contingency rate. To argue that I work
harder for somebody because I have a contingency fee, it would be a
fundamental violation of the professional code of conduct, our ethical
obligations, and I think there are right-thinking lawyers everywhere who
put their best effort in for the client no matter how they’re going to
be paid.”
Rastin also says there are already sufficient oversight
mechanisms in place to guard against improper conduct by lawyers. He
calls the Insurance Bureau of Canada’s call for more regulation “a
smokescreen” to mask the hefty profits earned by insurance companies.
“I can tell you that what I bill my clients is absolutely transparent,” says Rastin.
“My
client knows in the beginning what I’m going to bill them and at the
end. For people that are under disability, minors or people in
vulnerable situations, we have to get court approval for our accounts.
There is already an oversight body in place.
There are lawyers
[who] are disciplined for not billing according to proper practices. I
don’t want the insurance industry, which meddles in every private area
of our lives already, I don’t want them meddling in my personal
relationship with my clients.”
Contingency-fee arrangements
between lawyers and their clients aren’t to blame for insurance
companies’ costs, he adds, noting there are caps in place for the
damages plaintiffs can collect for several types of injuries.
Plaintiffs often opt to settle for fear of cost orders that would mean losing their life savings, Rastin adds.
To
Rastin, the noise around the issue is a distraction from what he calls
“way more serious” concerns with the auto insurance system. “For
instance, why are there government-mandated returns on capital for the
insurance industry that are something like 11 per cent?” he asks.
Palumbo, however, says it’s only “natural” that lawyers are resistant to regulatory oversight around their fees.
“It’s
pretty natural. They have a vested interest in making sure there is no
regulatory oversight on their pricing schemes,” he says.
“We don’t think that’s appropriate,” he adds.
Part
of the issue, he says, is transparency. “At the end of the day, if the
government decides not to impose a cap [on contingency fees], that’s
fair enough. But why is this a problem to talk about transparency? I
don’t quite understand that.”
The issue isn’t contingency fees
themselves, according to Palumbo, but whether those arrangements are
always appropriate. “We’re not suggesting for a moment that any of this
shouldn’t happen; we’re not against contingency fees. All we’re saying
is that the last piece of the [transparency] puzzle is personal injury
lawyers, really. No one is reviewing that aspect of the auto insurance
system.”
COMMENTS
Discuss IBC wants regulation for personal injury lawyers:
Moira Gracey says:
2015-02-23 07:15 PM
is the IBC suggesting that injured people who have been thrown out of work and are subsisting on the much-reduced accident benefits available be required to pay lawyers up front by the hour? How can the IBC suggest - or the Law Times uncritically report - that lawyers' contingency fees are not regulated? Does Ontario Regulation 195/04 (appropriately entitled "Contingency Fee Arrangements") not count as regulation? Until the insurance industry agrees to a specific tax to fund enough legal aid clinic with enough salaried lawyers to represent all the customers from whom the insurance companies are inappropriately denying benefits, there isn't much alternative to contingency fee arrangements that won't leave injured people high and dry - and insurers laughing all the way to the bank. Insurers should try spending less money fighting claims than they do paying them - that might be a more effective way to lower premiums!
Devils Trumpet says:
2015-02-23 06:30 PM
Sorry to get you excited,the comments were intended for another post that had nothing to do with regulation of lawyers or insurance.My post here was copy and paste,it included a line from a seperate post entirely. I have no knowledge of any insider information regarding Ontario auto insurance.If I did,I doubt very much that I would announce it in this forum. I apologize for my inadvertent mistake,I will double check before I post in the future.
Peter Cozzi says:
2015-02-23 06:05 PM
I have advocated at FSCO for a Consumer Bureau mirroring the Insurance Bureau of Canada to advance the interests of consumers to Government funded by a levy per insurance policy paid for by the same consumers who pay their insurance premiums to Insurance companies every day which in part are used by those insurance companies to fund the IBC. Such a consumer body, properly funded, like the IBC, will be able to inform Government concerning insurance issues from the consumers perspective and thereby provide Government with a balanced view when considering legislative and regulatory changes such as the IBC proposal concerning contingency fees and more.
Tim Boyle says:
2015-02-23 05:56 PM
That Mr. Francis is a shill for the insurance industry is obvious, the only thing unclear is how much he is being paid for being so.
Stew Daroux says:
2015-02-23 05:36 PM
It just amazes me that someone can hold such a lofty position in the insurance industry and really not have a clue regarding the degree to which lawyers are regulated and fee arrangements are scrutinized. In British Columbia there is legislating specifying the maximum percentage fee a lawyer can charge without prior court approval. In addition, clients are notified as part of any Contingency Fee Agreement that they have the right to have the fee ultimately charged reviewed by the Court. They also have recourse to the Law Society of any Province which overseas the practice of lawyers in that jurisdiction. Where is the lack of "regulation" that Mr. Palumbo refers to?
Curious Cat says:
2015-02-23 04:47 PM
What kinds of documents are you alluding to?
Devils a Trumpet says:
2015-02-23 04:10 PM
Another attempt to control every aspect of a claim,the insurance industry once again portrays everyone but themselves as theives while they defraud rate payers and the public.Of course lawyers rip off clients,just not as bad as the government sanctioned theft by the insurance companies. Not one participant other than the claimant has one scintilla of integrity,their just a bunch of criminals running the system. Wait till insurance insider documents begin to surface soon.
Brian Francis says:
2015-02-23 12:30 PM
RE: "Plaintiff lawyers are the only ones fighting for the clients' rights... Plaintiff lawyers (OTLA) advocate for their own interests - not the interests of injured claimants. They aren't always the same. If that weren't true OTLA would long ago have fought against the proliferation of rogue experts who inhabit the system - rather than happily profit from shoddy assessments and endless assessment battles. The only people buying OTLA's "fearless champions of the injured" rhetoric are the plaintiff lawyers.Maybe if OTLA revoked the membership of lawyers who over-bill so badly they are written up in even the mainstream press - and revoked the membership of lawyers who blame dead students for the firm's failings - these indignant protestations wouldn't ring so hollow.
Darryl Singer says:
2015-02-23 12:11 PM
The entire personal injury system is stacked against plaintiffs. The statutory threshold, $30,000 deductible, powerful insurers who sit on AB money for years before they pay it out for necessary treatment. Plaintiff lawyers are the only ones fighting for the clients' rights and attempting to level the playing field. Certainly the insurers do not care. And the provincial government has continually made changes that benefit only the insurers and make it more difficult for the victims to collect.
Darryl Singer says:
2015-02-23 12:06 PM
Lawyers are already regulated by the Law Society and in many cases the Superior Court. The insurance industry has no place in the lawyer-client relationship. If the insurers actually paid what they were supposed to pay to accident victims, when they were supposed to pay, then there would be no need for personal injury lawyers in the first place. Lawyer's fees have no bearing on insurance rates. And the marketplace dictates. If my fees are patently unfair then I will not have any clients.
Brian Francis says:
2015-02-23 10:10 AM
How ironic. This column (Court rejects attempt to blame articling student for delay) in today's Law Times offers even more reasons why Ontario personal injury plaintiff lawyers need oversight. OTLA talks about oversight as an "insult". It is insulting to consumers (injured auto accident victims) to hear plaintiff lawyers trying to download their failings on to students.
Brian Francis says:
2015-02-23 09:41 AM
Raston characterizes oversight of personal injury plaintiff OTLA lawyers as an "insult". What is an insult is systemic over-billing - staggering unreglated, self-awarded premiums - and unfair CFAs. A glance at the FAIR website offers ample illustration of endless plaintiff lawyer over- billing problems. Added to the over-billing problem is another "insult" to clients in the form of OTLA's stubborn, obstructionist stance toward cleaning up the IME/IE system (proliferated with rogue "experts") which is driving up Ontario's auto insurance litigation costs by causing endless assessment battles. But what,exactly, is wrong with a"a consumer-friend ly fee disclosure statement". How is that an "insult"? And what do accident victims think? Why not ask FAIR? Perhaps on this issue (if no other) the IBC and FAIR can find common ground?
Source: http://www.lawtimesnews.com/201502234500/headline-news/ibc-wants-regulation-for-personal-injury-lawyers
Monday, February 23, 2015
How to Measure a Medical Treatment’s Potential for Harm
By
Aaron E. Carroll and
Austin Frakt
As we wrote last week, many fewer people benefit from medical therapies than we tend to think. This fact is quantified in a therapy’s Number Needed to Treat,
or N.N.T., which tells you the number of people who would need to
receive a medical therapy in order for one person to benefit. N.N.T.s
well above 10 or even 100 are common. But knowing the potential for benefit is not enough. We must also consider potential harms.
Not
every person who takes a medication will suffer a side effect, just as
not every person will see a benefit. This fact can be expressed by
Number Needed to Harm (N.N.H.), which is the flip side of N.N.T.
For instance, the N.N.T. for aspirin to prevent one additional heart attack over two years is 2,000.
Even though this means that you have less than a 0.1 percent chance of
seeing a benefit, you might think it’s worth it. After all, it’s just an
aspirin. What harm could it do?
But
aspirin can cause a number of problems, including increasing the chance
of bleeding in the head or gastrointestinal tract. Not everyone who
takes aspirin will bleed. Moreover, some people will bleed whether or
not they take aspirin.
Aspirin’s
N.N.H. for such major bleeding events is 3,333. For every 3,333 people,
just over two on average will have a major bleeding event, whether they
take aspirin or not. About 3,330 will have no bleed regardless of what
they do. But for every 3,333 people who take aspirin for two years, one
additional person will have a major bleeding event. That’s an expression
of the risk of aspirin, complementing the fact that one out of 2,000
will avoid a heart attack.
When 2,000 People Take a Daily Aspirin for Two Years: Help and Harm Are the Outcome
People at risk for heart attacks are often recommended to
take aspirin daily — to prevent one, 2,000 such people must be treated.
But that aspirin will also cause major bleeding events in some people.
There is no way to know in advance who will be helped or harmed, but the
statistical effect of treatment looks like this:
Prevented by aspirin | Caused by aspirin | With or without aspirin | ||
---|---|---|---|---|
Bad outcome or side effect
|
No bad outcome or side effect
|
|||
Nonfatal heart attacks |
||||
Cardiovascular problems |
||||
Major bleeding events |
Source: The Lancet
Granted, one out of 3,333 is a pretty tiny risk. But remember that the chance of benefit is pretty small, too.
Sometimes,
though, the N.N.H. can be much lower, even lower than that of N.N.T.,
which suggests the chance of harm is greater than the potential benefit.
Consider screening mammograms, which are considered so essential that they are the only screening tests specifically mentioned in the Affordable Care Act, and coverage for them with no cost sharing is required by the law.
If you look at the data for all randomized controlled trials of breast cancer screening, the N.N.T. for recommending screening to prevent one death from breast cancer
after 13 years of follow-up is 1,477. But further analyses show that
the one woman would have probably died of other causes anyway. There may
be no benefit at all with respect to preventing death from all causes.
Screening with mammograms can cause harm, though. They lead to overdiagnosis, encouraging the provision of therapies that provide no benefits — but do carry risks, and therefore are considered harms.
When 1,477 Women Have a Screening Mammogram
Over 13 years, one death from breast cancer will be
prevented (although that woman might likely die of another cause). Many
more people will receive unpleasant, potentially dangerous treatments.
The statistical effect of treatment looks like this:
Prevented by screening mammogram | Caused by screening mammogram | With or without screening mammogram | ||
---|---|---|---|---|
Bad outcome or side effect
|
No bad outcome or side effect
|
|||
Death from breast cancer |
1 person
| |
1,471 | ||
Lumpectomy or mastectomy | 1,453 | |||
Radiotherapy treatment | 1,460 |
Source: The Cochrane Collaboration
If we look at those same studies, for every 333 women who are assigned to have a screening mammogram, one extra will undergo a lumpectomy or mastectomy
as a result. One in every 390 women assigned to have a screening
mammogram will undergo an extra course of radiation therapy as a result.
(In these randomized controlled trials, patients are either assigned to
get screening mammograms or they are not. The study then usually looks
at the outcome for all who were assigned to get the mammogram, whether
they actually did or not.)
In
other words, for about every 1,500 women assigned to get screening for
10 years, one might be spared a death from breast cancer (though she’d
most likely die of some other cause). But about five more women would
undergo surgery and about four more would undergo radiation, both of
which can have dangerous, even life-threatening, side effects.
Thus,
N.N.H., paired with N.N.T., can be very useful in discussing the
relative potential benefits and harms of treatments. As another example,
let’s consider antibiotics for ear infections
in children. There are many reasons that parents and pediatricians
might consider treatment. One commonly cited reason is that we want to
prevent serious complication from untreated infections.
Unfortunately, antibiotics
don’t do that, and the N.N.T. is effectively infinite. Antibiotics also
won’t reduce pain within 24 hours. Antibiotics have, however, been
shown to reduce pain within two to seven days. Not all children will see
that benefit, though. The N.N.T. is about 20 for that outcome.
Antibiotics can cause side effects, however, including vomiting, diarrhea or a bad rash. The N.N.H. for side effects in this population is 14.
This means that when a child is prescribed antibiotics for an ear infection,
it’s more likely that he will develop vomiting, diarrhea or a rash than
get a benefit. When patients are presented with treatment options in
this manner, they are sometimes more likely to agree to watchful waiting
to see if the ear infection resolves on its own. For most children with
ear infections, observation with close follow-up is recommended by the American Academy of Pediatrics.
When 20 Children Take Antibiotics for an Acute Ear Infection
Most children with an ear infection will improve without
antibiotics, but some will benefit. Some will also be harmed by
side-effects from the antibiotics. The statistical effect of treatment
looks like this:
Prevented by antibiotics | Caused by antibiotics | With or without antibiotics | ||
---|---|---|---|---|
Bad outcome or side effect
|
No bad outcome or side effect
|
|||
Pain persisting beyond 2-7 days |
||||
Ruptured eardrums | ||||
Diarrhea, vomiting and rash |
Source: The Cochrane Collaboration
A wealth of N.N.T. and N.N.H. data based on clinical trials is available on a website developed by David Newman,
a director of clinical research at Icahn School of Medicine at Mount
Sinai hospital, and Graham Walker, an assistant clinical professor at
the University of California, San Francisco. But it’s important to
understand that results from clinical trials do not always reflect what
happens in the real world. As criteria for treatment become more
permissive beyond those applied in trials, the N.N.T.s can go up.
But importantly, N.N.H.s often do not. Healthier people are less likely
to see a benefit from antibiotics or an aspirin. But they are not less
likely to have a side effect or complication.
This
is because the harms associated with treatment usually have nothing to
do with the underlying illness. They are caused by the therapy,
regardless of the reason for use. Children will develop diarrhea,
vomiting or rashes
from antibiotics in the same relative amounts no matter why we are
using them. Put another way, clinical trials are designed to target the
class of patients that most likely benefits from treatment, but they are
not targeted to those more or less likely to experience harm. When
treatments are applied in real-world clinical settings, we generally
don’t see changes in the proportion of patients harmed by them relative
to trials.
When
we stray from recommendations for therapies, and broaden the population
given studied treatments, the N.N.T.s often go up, but the N.N.H.s stay
the same. Things are often even worse than the data in studies make
them look. Fewer people benefit, but just as many are harmed.
We
hope that every therapy has a benefit. The N.N.T. shows us that
benefits are often much less likely than many might think. The N.N.H.
can show us how likely we are to have a harm compared with a benefit.
Considering both, especially in light of how practice often differs from
studies, can help us make better decisions about how to care for
ourselves and those we love.
Aaron E. Carroll is a
professor of pediatrics at Indiana University School of Medicine. He
blogs on health research and policy at The Incidental Economist, and you can follow him on Twitter at @aaronecarroll.
Austin Frakt is a health economist with several governmental and academic affiliations. He blogs at The Incidental Economist, and you can follow him on Twitter at @afrakt.
Austin Frakt is a health economist with several governmental and academic affiliations. He blogs at The Incidental Economist, and you can follow him on Twitter at @afrakt.
Source: http://www.nytimes.com/2015/02/03/upshot/how-to-measure-a-medical-treatments-potential-for-harm.html?_r=0
The Crash Tested Submission to Minister of Finance on Auto Insurance
C.Sousa,
Minister of Finance
Mr. Sousa,I am a motor vehicle accident survivor and a former small business owner however,I am not a low-information voter. I am perplexed,alarmed,dismayed and disgusted that your Ministry continues to acquiesce to each and every demand put forth by the Insurance Bureau of Canada (IBC). Ontario residents have seen benefits ravenously slashed to the bone or outright eliminated with no recourse.Meanwhile the insurance company plays games with rates and exponentially increases shareholder value on the backs of the injured,some catastrophically .Your government has forced legitimate accident claimants onto Social Services and require hospital care provided by the taxpayer while the insurer is allowed to avoid any responsibility and evade their contractual obligations.
Fraud has largely been perpetrated by organized crime and not the majority of the public yet you and your Ministry have fecklessly bought into the caustic propaganda the IBC has pervasively promoted.You've even outrageously come out as their boorish cheerleader touting what a wonderful thing these changes to auto insurance will do for Ontario drivers and those injured in a vehicle accident.You have never spoken specifically about Bill 15 but instead given the public your obtuse, irksome and mendacious platitudes and sound as if the new legislation is an accomplishment.
Your party claims to be the guardian of compassion but the punitive actions leveled against injured victims,including those who can no longer defend themselves,but you have chosen to accept personal cash benefits from an industry you and your Ministry are mandated to regulate.You are no longer serving the people,something you swore to do.
I will not get into issues such as contemptuously removing the Constitutional right to seek remedy in court.I will not waste my time pointing out the egregious and inherent problems with the removal of experienced arbitrators and scandalously replacing them with political appointees,that is absurd.There is little point in bring up the insurance industry's proclivity to use rouge doctors who produce bogus medical assessments.You are fully and completely aware of the widespread damage along with personal and financial grief caused by your horrible actions injured accident victims and their families will now face for a lifetime all for your exclusive purposes.You have abdicated your responsibility as Minister of Finance for personal gain while adamantly ignoring the issues that many,including myself,have tried unsuccessfully to convey to you and your Ministry regarding auto insurance.
I have no confidence you will listen to anyone but the IBC and this is largely a public relations exercise that will be neglected just as every single person,group and organization has been throughout the phony public consultations that your government held leading up to the passing of Bill 15.May I suggest that the pair of shoes you buy for budget day be a pair of sandals,they're full of holes,I have every confidence the symbolism will be forebodingly apt.
thecrashtested.com
Source: thecrashtested.com
Minister of Finance
Mr. Sousa,I am a motor vehicle accident survivor and a former small business owner however,I am not a low-information voter. I am perplexed,alarmed,dismayed and disgusted that your Ministry continues to acquiesce to each and every demand put forth by the Insurance Bureau of Canada (IBC). Ontario residents have seen benefits ravenously slashed to the bone or outright eliminated with no recourse.Meanwhile the insurance company plays games with rates and exponentially increases shareholder value on the backs of the injured,some catastrophically .Your government has forced legitimate accident claimants onto Social Services and require hospital care provided by the taxpayer while the insurer is allowed to avoid any responsibility and evade their contractual obligations.
Fraud has largely been perpetrated by organized crime and not the majority of the public yet you and your Ministry have fecklessly bought into the caustic propaganda the IBC has pervasively promoted.You've even outrageously come out as their boorish cheerleader touting what a wonderful thing these changes to auto insurance will do for Ontario drivers and those injured in a vehicle accident.You have never spoken specifically about Bill 15 but instead given the public your obtuse, irksome and mendacious platitudes and sound as if the new legislation is an accomplishment.
Your party claims to be the guardian of compassion but the punitive actions leveled against injured victims,including those who can no longer defend themselves,but you have chosen to accept personal cash benefits from an industry you and your Ministry are mandated to regulate.You are no longer serving the people,something you swore to do.
I will not get into issues such as contemptuously removing the Constitutional right to seek remedy in court.I will not waste my time pointing out the egregious and inherent problems with the removal of experienced arbitrators and scandalously replacing them with political appointees,that is absurd.There is little point in bring up the insurance industry's proclivity to use rouge doctors who produce bogus medical assessments.You are fully and completely aware of the widespread damage along with personal and financial grief caused by your horrible actions injured accident victims and their families will now face for a lifetime all for your exclusive purposes.You have abdicated your responsibility as Minister of Finance for personal gain while adamantly ignoring the issues that many,including myself,have tried unsuccessfully to convey to you and your Ministry regarding auto insurance.
I have no confidence you will listen to anyone but the IBC and this is largely a public relations exercise that will be neglected just as every single person,group and organization has been throughout the phony public consultations that your government held leading up to the passing of Bill 15.May I suggest that the pair of shoes you buy for budget day be a pair of sandals,they're full of holes,I have every confidence the symbolism will be forebodingly apt.
thecrashtested.com
Source: thecrashtested.com
Sunday, February 22, 2015
Dozens of gravely sick Canadians denied speedy social security hearings
Employment Minister Jason Kenney answers a question during Question Period in the House of Commons on Parliament Hill in Ottawa, Tuesday Nov. 26, 2014. Earlier this month, Kenney pledged to eliminate the backlog by the summer.(Adrian Wyld / THE CANADIAN PRESS)
Lee-Anne Goodman, The Canadian Press
Published Thursday, February 19, 2015 5:50AM EST
Last Updated Thursday, February 19, 2015 3:23PM EST
OTTAWA -- Dozens of gravely ill or financially strapped Canadians denied Canada Pension Plan disability benefits were refused accelerated appeals in 2014 by Ottawa's badly backlogged social security tribunal.
The backlog plaguing the tribunal has swelled dramatically since its launch almost two years ago, with thousands of injured or ailing Canadians now waiting as long as five years to have their appeals heard.
In 2014, 46 people asked for an expedited appeal due to financial hardship. Only seven were successful, the government reveals in responses to recent written questions from the NDP.
Eleven people sought expedited hearings in 2014 due to terminal illnesses. Four were turned down while seven were successful.
On Thursday, NDP Leader Tom Mulcair chastised the Conservatives during question period, accusing them of victimizing already vulnerable Canadians by refusing to grant accelerated hearings as wait times continue to worsen.
Pierre Poilievre, the new employment minister, responded by saying the government was on track to eliminate the backlog by this summer.
His predecessor, Jason Kenney, announced a plan earlier this month to wipe out the backlog within months.
"We agree that the backlog is unacceptable," Poilievre said.
"We are using experts within the department to review all of the cases that are under appeal to see if we can settle as many of them as humanly possible so that they don't even have to go before the tribunal at all."
Richard Beaulne, a spokesman for the tribunal, called it an "unfortunate reality" that most appellants experience financial hardship.
"But the tribunal would consider expediting such cases where the appellants are able to show exceptional financial hardship sufficient to justify assigning their case ahead of other appellants," he said in an email.
"The tribunal expedites the assignment of cases involving terminal illness only when requesters have provided the proper medical documentation to support their request."
The written responses also reveal that only three of the 63 people currently assigned to hear CPP disability cases are health-care professionals.
Under the old system, one person on each three-member panel had to be a health-care professional to ensure that appellants with disabilities received a fair hearing from someone who understood medical evidence.
Other responses show that the tribunal's backlog currently stands at 11,230 cases. That's a 24 per cent increase since February 2014.
The vast majority of those cases -- 90 per cent -- involve people seeking CPP disability benefits. Some of them have been waiting years for their appeals to be heard.
The tribunal, consisting of 74 full-time members and 22 part-timers, has been under a cloud of controversy since its inception in April 2013.
In addition to the ballooning backlog of cases, the government-in-council appointments to the tribunal have also been contentious. A third of them have ties to the Conservative party.
The government says the tribunal was established to streamline the appeals process and save Canadian taxpayers $25 million a year.
Source: http://www.ctvnews.ca/canada/dozens-of-gravely-sick-canadians-denied-speedy-social-security-hearings-1.2243123
Rick Mercer: Harper Government Makes Injured Veteran Prove His Legs Haven't Grown Back
The Huffington Post Canada | http://youtu.be/XQeRppIguas By Ryan Maloney
Posted: Updated:
The CBC host has addressed the topic many times in the past few years — from the cuts at Veterans Affairs to pension battles to the controversial lump-sum payments awarded to injured soldiers.
But his rant this week on the Rick Mercer Report, which focused on the class-action lawsuit veterans of the Afghan war have launched against the federal government, felt more personal than most.
Federal lawyers, however, have argued in court that Ottawa has no special obligation or "social contract" with vets, as was proclaimed during the First World War by Prime Minister Robert Borden. The lawyers also argue it is unfair to bind Prime Minister Stephen Harper's government to vows made nearly a century ago.
"They admit, yes, prior to the Battle of Vimy Ridge, Prime Minister Sir Robert Borden promised that Canada had a sacred obligation to veterans," Mercer said. "But our government is saying that's no longer true. No obligation at all."
But Mercer says that for anyone who knows a disabled veteran, this comes as no surprise. And it turns out he is one such person.
"My buddy Paul is a veteran," Mercer said. "He lost both his legs in Afghanistan. Every year they make him prove over and over again his legs are still gone."
Mercer said Paul has been told four times that he'd have to get a note from a doctor proving the extent of his injuries.
"Literally a note saying his legs have not grown back," he said. "You know, in case he's pulling a fast one."
Mercer ended his rant with a suggestion for Canadians, should they ever run into an MP boasting about how much is being done to care for veterans.
"Don't take them at their word," he said. "Tell them to prove it."
Retired Master Cpl. Paul Franklin, who was injured in a 2006 suicide bombing in Kandahar, has confirmed that he was was the subject of Mercer's rant.
In a Facebook post that has since been published on The Huffington Post Canada, Franklin said Veterans Affairs Minister Erin O'Toole requested a phone call with him shortly after Mercer's show aired.
In his written reply, Franklin told the rookie minister that he allowed Mercer to share his story "for all vets and their families that fight through this horror every day of their lives."
He also declined to speak with O'Toole by phone, saying the conversation may help him but not hundreds of thousands of other veterans.
"Until we are treated by all parties with the respect, dignity, honour and compassion we deserve, then I can't in good conscience take a phone call regarding my issues," he wrote.
Franklin, who lives in Edmonton, has become an advocate for amputees and serves on the board of directors of the Amputee Coalition of Canada.
He was also the subject of a 2006 documentary that appeared on CBC's "The National."
Source: http://www.huffingtonpost.ca/2015/02/05/rick-mercer-veterans-rant-_n_6622452.html?utm_hp_ref=tw
Spruce Grove man dying of cancer fighting for disability benefits
By Cailynn Klingbeil, Edmonton Journal February 8, 2015
EDMONTON
- A Spruce Grove man dying of cancer has spent one-and-a-half years
fighting to have his Canada Pension Plan retirement benefits switched to
disability benefits, but Service Canada has continually stated he does
not qualify because his condition is not severe and prolonged.
Peter McClure receives about $500 a month in retirement benefits, whereas disability benefits would be at least double that.
McClure, 62, went for a routine colonoscopy in the fall of 2012. Doctors found rectal cancer, and a followup test revealed tumours on his right lung, a second separate primary cancer. In early 2013, doctors told McClure he had six months to one year to live.
Worried about the loss of family income for his wife and himself, McClure applied for and started receiving retirement benefits from CPP in December 2012. Before applying, McClure said he called Service Canada and explained his circumstances: He could work at that time, but his condition might worsen.
“I was told if I applied for CPP I would have it right away. Disability would take three to four months to come,” McClure said. “No one told me the repercussions of doing that.”
But after McClure had to stop working and applied to switch his retirement benefits to disability benefits, he was denied. A reconsideration of that decision resulted in another denial, which McClure has appealed.
Michael Prince, the Lansdowne Professor of Social Policy at the University of Victoria, has extensively studied disability policy and said McClure’s case is not unusual.
About 47 per cent of CPP disability claimants are initially turned down, Prince said.
“This is a national issue, a quiet crisis,” Prince said. “Almost one out of every two Canadians discover this safety net isn’t there for them. It doesn’t give them the protection they had been advised would be there for them. It’s a shock on many levels.”
With so many people turned down, Prince points to a failure in communicating how to successfully apply for disability. “There needs to be an application process that is transparent and clear. Right now, the onus is on people to figure out this maze.”
“People who have played by the rules, who have paid into this, are suffering and struggling.”
After he was first diagnosed with cancer, McClure continued to work his job in sales. He used vacation days to attend medical appointments. After six weeks of treatment for rectal cancer, he began more aggressive treatments for stage IV lung cancer.
McClure, a former fitness and aquafit instructor and founder of the Edmonton Hikers Group, soon developed serious complications. The week after the first chemotherapy session, McClure was sent to the emergency room and doctors discovered a massive blood clot in his femoral artery, leading to a 10-day hospital stay.
McClure’s doctor told him he wouldn’t be able to return to work. He stopped working on April 23, 2013, and after relying on savings, he applied for disability benefits on Aug. 1, 2013. His application was denied the next day, in a form letter stating while he met the contribution requirements, he did not meet the CPP disability rule.
“You do not have a disability that is both severe and prolonged as defined under the CPP legislation,” the letter stated.
Peter McClure receives about $500 a month in retirement benefits, whereas disability benefits would be at least double that.
McClure, 62, went for a routine colonoscopy in the fall of 2012. Doctors found rectal cancer, and a followup test revealed tumours on his right lung, a second separate primary cancer. In early 2013, doctors told McClure he had six months to one year to live.
Worried about the loss of family income for his wife and himself, McClure applied for and started receiving retirement benefits from CPP in December 2012. Before applying, McClure said he called Service Canada and explained his circumstances: He could work at that time, but his condition might worsen.
“I was told if I applied for CPP I would have it right away. Disability would take three to four months to come,” McClure said. “No one told me the repercussions of doing that.”
But after McClure had to stop working and applied to switch his retirement benefits to disability benefits, he was denied. A reconsideration of that decision resulted in another denial, which McClure has appealed.
Michael Prince, the Lansdowne Professor of Social Policy at the University of Victoria, has extensively studied disability policy and said McClure’s case is not unusual.
About 47 per cent of CPP disability claimants are initially turned down, Prince said.
“This is a national issue, a quiet crisis,” Prince said. “Almost one out of every two Canadians discover this safety net isn’t there for them. It doesn’t give them the protection they had been advised would be there for them. It’s a shock on many levels.”
With so many people turned down, Prince points to a failure in communicating how to successfully apply for disability. “There needs to be an application process that is transparent and clear. Right now, the onus is on people to figure out this maze.”
“People who have played by the rules, who have paid into this, are suffering and struggling.”
After he was first diagnosed with cancer, McClure continued to work his job in sales. He used vacation days to attend medical appointments. After six weeks of treatment for rectal cancer, he began more aggressive treatments for stage IV lung cancer.
McClure, a former fitness and aquafit instructor and founder of the Edmonton Hikers Group, soon developed serious complications. The week after the first chemotherapy session, McClure was sent to the emergency room and doctors discovered a massive blood clot in his femoral artery, leading to a 10-day hospital stay.
McClure’s doctor told him he wouldn’t be able to return to work. He stopped working on April 23, 2013, and after relying on savings, he applied for disability benefits on Aug. 1, 2013. His application was denied the next day, in a form letter stating while he met the contribution requirements, he did not meet the CPP disability rule.
“You do not have a disability that is both severe and prolonged as defined under the CPP legislation,” the letter stated.
A
reconsideration of the decision — another denial — was given about a
month later. McClure appealed the reconsideration decision with the
Social Security Tribunal, which wrote to him to advise him of
“unavoidable delays” because of a significant volume of files.
The tribunal has a backlog of more than 11,000 appeals, mostly from people seeking disability benefits. Last November, more staff was added to deal with the backlog.
Service Canada’s media relations office said in an email that to switch from retirement benefits to disability benefits, the date of disability must be prior to the first monthly payment of the retirement pension.
McClure started receiving his retirement pension in December 2012, meaning he must be found to have been disabled prior to November 2012. His condition did not prevent him from working until April 2013.
But McClure said the rule was never made clear to him when he applied. Had he known, he would have waited until his condition changed in April — just five months after his initial pension application — and applied for disability then, avoiding the bureaucratic mess that ensued.
McClure wonders where in the system there is room to accommodate changes in medical conditions.
Frustrated by the delays, he questions if he’ll live to see the issue resolved. He currently receives palliative chemotherapy, intended to prolong his survival and ease his symptoms, but not cure the cancer.
“This whole process seems to be intended to be difficult,” McClure said, surrounded by a thick stack of papers, his correspondence with Service Canada since August 2013.
“I paid into CPP all my working life. Why is it not there when you need it? We should be doing a better job than this.”
cklingbeil@edmontonjournal.com
twitter.com/cailynnk
The tribunal has a backlog of more than 11,000 appeals, mostly from people seeking disability benefits. Last November, more staff was added to deal with the backlog.
Service Canada’s media relations office said in an email that to switch from retirement benefits to disability benefits, the date of disability must be prior to the first monthly payment of the retirement pension.
McClure started receiving his retirement pension in December 2012, meaning he must be found to have been disabled prior to November 2012. His condition did not prevent him from working until April 2013.
But McClure said the rule was never made clear to him when he applied. Had he known, he would have waited until his condition changed in April — just five months after his initial pension application — and applied for disability then, avoiding the bureaucratic mess that ensued.
McClure wonders where in the system there is room to accommodate changes in medical conditions.
Frustrated by the delays, he questions if he’ll live to see the issue resolved. He currently receives palliative chemotherapy, intended to prolong his survival and ease his symptoms, but not cure the cancer.
“This whole process seems to be intended to be difficult,” McClure said, surrounded by a thick stack of papers, his correspondence with Service Canada since August 2013.
“I paid into CPP all my working life. Why is it not there when you need it? We should be doing a better job than this.”
cklingbeil@edmontonjournal.com
twitter.com/cailynnk
© Copyright (c) Edmonton Journal
Source: http://www.edmontonjournal.com/touch/story.html?id=10797822
Patients can sue hospitals for invasion of privacy, appeal court rules
The ruling upheld an earlier decision that said the province’s health privacy laws do not bar patients from seeking legal action against hospitals if their privacy is breached.
In a potentially precedent-setting decision,
the Ontario Court of Appeal granted patients the right to sue hospitals
over privacy breaches Wednesday.
The unanimous ruling said provincial health
privacy laws are not a roadblock to patients who want to seek justice in
the courts when their medical records are snooped into by hospital
workers.
The decision comes on the heel of aStar investigation into health-related privacy violations and oversights in Ontario’s health privacy legislation.
“This case is a vindication for all of those
victims the Star has been writing about,” said Michael Crystal, lawyer
for the patients.
Wednesday’s ruling could have sweeping
implications for the province’s 155 hospitals as it has given the green
light to a multimillion-dollar privacy class action launched against
Peterborough Regional Health Centre.
Peterborough hospital would not answer
questions from the Star about whether it intends to appeal the ruling to
the Supreme Court of Canada, its last chance to get the case tossed
out.
A massive privacy breach at the hospital between 2011 and 2012 saw hundreds of patient medical records snooped into and seven staff members fired. The breach included a domestic violence victim who was in hiding and 414 abortion files that were inappropriately accessed by a high profile anti-abortion campaigner.
A group of affected patients launched a
$5.6-million privacy class action against the hospital, which in turn
fought to have the case thrown out in the Ontario Superior Court of
Justice, arguing the courts had no jurisdiction over health-related
privacy breaches.
The crux of the hospital’s argument was that
health privacy violations were the sole domain of the privacy
commissioner and that the Personal Health Information Protection Act
(PHIPA) ousts the jurisdiction of the courts.
The Superior Court ruled against the hospital
so it took the fight up to the Court of Appeal, which dismissed the case
Wednesday.
In its decision, the appeal court said health
privacy legislation does not exclude the jurisdiction of the courts.
Health privacy laws were tailored to handle “systemic issues rather than
individual complaints,” the court said.
Peterborough Regional Health Centre declined
to comment on the decision, saying “this matter remains in litigation
before the courts.”
In a written statement to the Star Wednesday, a
Peterborough hospital spokesperson said the center had a “zero
tolerance policy with respect to inappropriate access to medical
records.”
The hospital has 60 days to appeal the decision to the Supreme Court of Canada.
Acting Information and Privacy Commissioner Brian Beamish told the Star he was “very pleased” with the ruling.
All patients who are victims of privacy
violations should have the option of filing a complaint to the privacy
office or taking civil action, Beamish said.
Under PHIPA, the privacy commissioner’s office
acts as a watchdog over health institutions, ensuring they are
protecting patient information and abiding with privacy laws.
It is not up to the privacy commissioner,
however, to determine whether a patient should be awarded monetary
damages. The commissioner only has the power to recommend the Attorney
General launch a prosecution under PHIPA, which allows for fining
individuals up to $50,000 and institutions up to $250,000 if found
guilty.
Only one prosecution has been lodged so far under the act, which was introduced in 2004.
“This was a really important issue to get judicial guidance on,” Beamish said.
Ontario, once a leader in health-information
privacy laws, now seems to be lagging behind as other provinces tighten
up reporting. Earlier this year the Star found that eight other jurisdictions have passed laws to force hospitals to report breaches to the appropriate privacy body.
The heart of the Peterborough case is
“snooping” — where hospital staff willfully break the law by accessing
medical records when they have no authority to do so, such as in the
recent Rob Ford privacy violations, he said.
Health care workers can only access a
patient’s medical record if they are involved in their care and, Beamish
said, the Peterborough breach “highlights how seriously this issue of
snooping needs to be taken.”
The lead plaintiff of the Peterborough case is
Erkenraadje Wensvoort, who was in hiding when she had an operation at
the hospital. In the statement of claim, she alleges that she had left
an abusive relationship after 51 years of marriage.
Wensvoort says she was told a staff member had
opened her file without authorization and she feared her allegedly
abusive ex-husband had “paid someone to access her patient records in
order to find her,” the decision read.
There is no evidence linking Wesnvoort’s ex-husband to the inappropriate access of her record, according to Crystal, her lawyer.
The court awarded Wensvoort $24,000 for the legal fees associated with the appeal.
Crystal, who is the lawyer for all the Peterborough patients, said the court’s ruling grants patients “access to justice.”
“The highest court in Ontario has spoken and
said invasion of personal health information is not something that is
simply the domain of the privacy commissioner,” he said.
“Patients do not have to go through the administrative nooks and crannies of PHIPA legislation to achieve access to justice.”
If the latest decision is not appealed by the
hospital, Crystal said the next step would be setting dates for a motion
of certification for the Peterborough case.
Privacy commissioners from other parts of
Canada told the Star earlier this year that they have noted a rising
trend of health-care professionals snooping into private medical records with malicious intent.
Source: http://www.thestar.com/life/health_wellness/2015/02/18/patients-can-sue-hospitals-for-invasion-of-privacy-appeal-court-rules.html
Fair Association letter to the Minister of Finance
FAIR Association of Victims for Accident Insurance Reform
579A Lakeshore Rd. E
PO Box 39522
Mississauga, ON, L5G 4S6
February 13, 2015
Dear Minister Sousa
Thank
you for the opportunity to convey our concerns to the Minister of
Finance office in respect to the upcoming Ontario budget.
FAIR
is a not-for-profit organization whose concern is that Ontario’s
vulnerable auto accident victims are now a very disadvantaged group
within Ontario’s population. Big business concerns continue to eclipse
the fair treatment of injured and disabled citizens who are caught in
Ontario’s dysfunctional auto insurance scheme.
Without
proper consideration from your office and government legislators we see
innocent and often cognitively impaired MVA victims impoverished,
without adequate rehabilitation resources and punished by a system that
no longer functions. Present and past ‘fixes’ have only made the system
worse and the province has incrementally taken on more and more
financial responsibility for the 50-60,000 people injured on our roads
every year. The public unknowingly pays through our social nets when
Ontario’s wealthy insurers fail to live up to their contracts. Further,
these public systems are not designed for, and don’t have the resources
for the care of traumatically injured auto accident victims.
Ontario’s
auto insurers habitually evade their contractual obligations to
consumers and this is substantiated by the numbers when about half of all injury claims (pg 47) must use the courts to hold their insurer accountable.
Access
to benefits hinges on the (highly profitable) expert medical report;
the information and opinion that documents injuries and sets insurers on
a path to adjust claims and injured victims on the road to recovery.
Recovery simply isn’t happening because Ontario’s Third Party ‘expert’
medical examinations and reports are without any standards and virtually
no oversight from their regulatory colleges. Family physician and
treatment provider recommendations are conveniently trumped by highly
paid medical experts whose allegiance is to the business who pays them
and not the MVA victim. Failure to acknowledge and address this harm and
dishonesty is causing not only trauma to victims but also additional
costs to the publicly funded medical system where victims ultimately
must address their injuries. That cost would not be insignificant.
There are now hundreds of thousands of individuals collecting Ontario Disability Support
Program (ODSP) benefits and many of those people are unpaid MVA
victims. This isn’t just a few people who fell through the cracks; it is
a deluge of injured and disabled auto insurance claimants on our public
supports when poor quality medical reports were used to disqualify them
from accident benefits they paid for.
Recent
changes like Bill 15 and the LAT will do nothing to fix the problem
other than to shove MVA victims faster through the still dishonest
system. In fact the incentive of reduced interest payable by insurers on
overdue amounts owed to injured victims will only create more delays,
denials and court actions and the resulting reliance on our public
support systems such as welfare and ODSP. These are claimants whose
access to ‘justice’ is limited to ‘if’ they can afford the expensive
legal representation required to get through the process and so poverty
quickly becomes the barrier to justice and it becomes the bonus to
insurers.
Insurers talk about fraud and the high costs of claims but fail to address their own excessive legal costs and over spending (pgs
58, 59) by consistently spending more on assessments than treatment for
claimants. What about the industry practice of paying $1000
cancellation fees to their IME providers and what does that add to the
pockets of their medical opinion providers and ultimately take out of
the claims dollars?
The
auto insurance system is now so heavily skewed toward insurer interests
and profit that the public is well on the way to be the major payer to
auto accident victims – in other words, we pretty much have taxpayer
funded public insurance. Private companies and their well funded lobby
arm, the Insurance Bureau of Canada (IBC), have so successfully slanted
coverage in their favour that it no longer serves Ontarians in either
coverage or cost and has become a system so cumbersome and complex that
it causes harm to those who must use the product.
Insurers have abdicated their responsibility and it requires a twisted form of laws and incomprehensible regulations in
order to continue to fleece the taxpayers. Consumers are told they have
adequate coverage but the dishonest medical opinion evidence shows that
the system is without accountability and it has clogged up our courts
and requires that our lawmakers even remove Charter rights in order to accommodate big business.
We
are auto accident victims and their supporters and we are stuck in a
system where it appears that those who have the power to make this a
fair system now command a premium price for access
for a “better chance of really connecting” with Ministers. This isn’t
something that injured and disabled auto accident victims are prepared
or can afford to engage in. We ask that you act in the best interests of
the citizens of Ontario ALL of the time.
Respectfully,
we cannot have a system where consumers are forced to buy a product
that promises services that are delivered only half of the time and that
downloads indiscriminately to our public supports while causing chaos
in our court systems. All of these actions have a price to the taxpayer
and should be addressed. The answer isn’t calling injured MVA victims
fraudsters so as to justify slashing coverage. Or to prop up an industry
whose business practices include the use of dishonest bogus and/or
biased and indeed harmful medical reports in order to hike insurer
profits. Inaction on these issues ensures that costs of an MVA end up
being passed on to the public. This is something that the Minister of
Finance and the Minister of Health have the power to change through
regulation and enforcement. We hope that you will take steps to control
Ontario’s insurers who thus far are bleeding our medical and support
systems into dysfunction and deficit.
FAIR Association of Victims for Accident Insurance Reform
‘FAIR – supporting auto accident victims through advocacy and education’
How to clean up the inconvenient stench in Ontario politics: Cohn
Ontario is the Central Canadian province that remains the Wild West of political fundraising in this country.http://www.thestar. com/news/queenspark/2015/02/ 11/how-to-clean-up-the- inconvenient-stench-in- ontario-politics-cohn.html
Cruel cuts at WSIB; Platform for Change would refocus system
Thursday, February 19, 2015 - 08:00
in GUEST COLUMN
By Steve Mantis Thunder BayThe Ontario Workers’ Compensation System is 100 years old this year. It is the original public program in our social safety net.
While we celebrate that the system has provided income support to millions of disabled workers over many years, it is now showing signs of strain.
Like all the other industrialized nations, Canada has been subjected to the pressures of globalization. This has resulted in significant reductions in spending on programs supporting people with disabilities, regardless of how that disability happened.
Workers’ Compensation has turned into “Workplace Insurance” and adjudicators there are now instructed to “look to deny.”
Workers who receive this treatment are ending up discouraged, depressed and feeling helpless. Often they are also unemployed, struggling to makes ends meet and even ending up homeless.
The latest administration at the Ontario Workplace Safety and Insurance Board (WSIB) has targeted the people most in need of help — those with a permanent, life-long disability.
They have cut the system’s current annual costs by $700 million but the long-term cost savings to the WSIB are in the billions.
The Thunder Bay and District Injured Workers Support Group, begun in 1984, has been studying the workers’ compensation system and helping fellow injured and disabled workers.
Our members come from all sectors of society — workers, employers, owner/operators, union activists and civil servants.
The support group believes the system can be improved to the benefit of all our community.
We are releasing our Platform for Change for the Workers Compensation System on Feb. 19.
We believe that the WSIB may be balancing its books in the short term, but causing major hardships to many members in our community.
This short-term vision will leave us all with significant social deficits that lower our quality of life.
By refocusing the system to help workers who have become disabled in the course of their employment, we will see better employment outcomes and workers who have regained their capacity to re-engage in society.
Like the Scandinavian countries that have the best benefits for people with disabilities, they also have the highest levels of employment for disabled workers.
Injured workers need a rehabilitation system that recognizes the special difficulties they face as persons with disabilities in obtaining and maintaining employment.
In Ontario, this rehabilitation system will seek to assist injured workers with both social integration and the attaining of suitable employment.
It will be a system that fully compensates and supports those workers who have suffered a workplace injury or illness, assists such workers in returning to employment with dignity, and aids in protecting all workers from injury or illness at work.
To that end the Platform for Change outlines how this result can be achieved.
Now is the time the Ontario government needs to come to the table and have serious discussions with injured and disabled workers about improving our oldest social program with the intention of having a system that makes us all proud.
Steve Mantis co-founded the Thunder Bay and District Injured Workers Support Group, the Ontario Network of Injured Workers Groups and the Canadian Injured Workers Alliance.
Source: http://www.chroniclejournal.com/content/news/local/2015/02/19/cruel-cuts-wsib-platform-change-would-refocus-system
Peel Region cop convicted in car-insurance scam
Judge rules that 23-year veteran Const. Carlton Watson was paid to provide accident reports that passed off bogus car crashes to collect more than $1 million.
By:
Louie Rosella
Mississauga News,
Published on Fri Feb 13 2015
He won the lottery three years ago, but a Peel
Regional Police officer wasn't so lucky Friday when a Superior Court
judge found him guilty on more than 40 charges of fraud, breach of trust
and obstructing justice.
Const. Carlton Watson, 50, a 23-year veteran
of the force, was paid in cash by two men, including a tow truck driver
and manager, to provide accident reports that passed off staged or bogus
car crashes as legitimate ones, as part of a scam that bilked insurance
companies out of more than $1 million, Justice John Sproat said in his
ruling Friday morning in a Brampton court.
Watson was found guilty of multiple counts of
fraud, obstructing justice, uttering forged documents and breach of
trust, in connection with the nine insurance claims dating back to 2010.
“Const. Watson was a public officer. The fraud
was clearly in the course of his public duty, and he intended to commit
fraud in the course of his public duty,” Sproat said.
Watson and his lawyer, Susan Jane von Achten, had no comment when leaving the Brampton courthouse.
Watson, who lives in Mississauga, admitted in
testimony he prepared the accident reports without attending the scene
and, in most cases, didn't speak to any of the drivers or passengers
claiming to be involved in the crashes.
“The Crown alleges that Const. Watson was paid
cash, typically $6,000 per (accident report) and well understood the
(reports) were for fake accidents and to be used to defraud insurers,”
Sproat said in his ruling, later writing, “I am satisfied beyond a
reasonable doubt that Const. Watson was a knowing participant in the
insurance fraud, and was paid for providing the (accident reports).”
Watson has been suspended with pay since he
was arrested in the spring of 2011, following an investigation by the
force’s Internal Affairs Bureau. Peel police will be reviewing his
employment status following today's decision. Watson returns to court
May 29 for sentencing.
Watson claimed he was never paid for preparing
the reports and was doing it merely as a favour to friends, believing
the crashes to be real and the information accurate.
But the judge ruled that much of the officer's
testimony made no sense and that his police notes on the staged crashes
were “on their face clearly deceptive.”
“I can find no innocent explanation for making
deceptive police notes; recording a very short gap between accident
time and report time and failing to enter tickets into the court
system,” Sproat said. “They are, however, logically explained if Const.
Watson is party to the fraud.”
Most of the Crown's witnesses who were listed
as drivers and passengers in the collisions in question were “unsavoury
witnesses,” having agreed to participate in an insurance fraud, the
judge said.
Court heard that the Insurance Bureau of
Canada was also involved in the probe into the nine 2010 motor vehicle
collisions that were part of the case.
Insurers paid out more than $915,000 in claims
related to the fake car crashes and incurred a further $271,931 in
expenses for items such as independent medical exams, collision
reconstruction costs and legal expenses, the court was told.
Michael Lake, an investigator with the
Insurance Bureau whose focus is on “organized crime rings involved in
insurance fraud,” said several people claiming to be involved in each of
the crashes, many of which occurred in Brampton, pursued claims for
accident benefits, including property damage claims, vehicle loss,
physiotherapy and child-care claims.
The fraud involved staging of collisions,
followed by placing insurance claims for damaged vehicles and injuries
sustained during the impact.
Several insurance companies were defrauded, police said.
Crown prosecutor John Scott said the
fraudulent claims total just under $1 million. Watson provided “motor
vehicle accident reports” detailing information about the crashes, and
facilitated the reporting of the accidents as legitimate collisions.
Insurance claims were made for vehicle damage
and injuries to the drivers and passengers, court heard, with insurers
paying out settlements after the accidents.
One of the people involved in an accident back in February 2010 was Kevin Clarke.
The married Brampton father of two was alone
in his car when he skidded and broke the front axle on his 1999 Pontiac
Grand Am. But when the tow truck company he contacted showed up, the
driver told him that, for his insurance company to cover the crash
damage, he would have to lie and say three other people, including his
wife, were in the car at the time.
Though Clarke never called police, the tow
truck driver got him to sign a police-issued motor vehicle accident
report listing Watson as the investigating officer, showing that Clarke
had sustained serious injuries in the crash. The document also indicated
a different location for the accident, Clarke said.
While Clarke admitted during cross-examination
by von Achten that he realized he was lying and possibly participating
in something fraudulent, he said he simply wanted to get his car fixed.
Insurance covered the repair of the car, and Clarke's wife was given
$1,300 in accident benefits.
Also arrested in connection with the offences
is First Canadian Towing manager and tow truck driver Wayne Isaacs, 49,
of Brampton. He was charged with defrauding the public, and his case
remains before the courts.
Watson won $275,000 in the March 12, 2012, Daily Keno draw.
Source: http://www.thestar.com/news/crime/2015/02/13/peel-cop-convicted-in-insurance-scam.html
Source: http://www.thestar.com/news/crime/2015/02/13/peel-cop-convicted-in-insurance-scam.html
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