Wednesday, March, 18, 2015 - 4:04:33 PM
Local voice against wrongful benefit denials not staying silent
Editor’s note: The following is the final installment of a three-part series about local insurance advocate Jokelee Vanderkop and her efforts to help legitimate claimants ensure they receive their rightful benefits.
PALMERSTON – Ontario’s Bill 15, the Fighting Fraud and Reducing Automobile Insurance Act, is being touted as a good thing but could prove to be anything but, says Palmerston resident and insurance advocate Jokelee Vanderkop.
“Many people sing its praises because they’ve been told it’s good – but don’t really understand why — other than it fights fraud and will save the insurance industry a lot of money,” Vanderkop said. “The true implication of this bill on accident victims is anything but good.”
After a life-altering motor vehicle collision and more than a decade of battling to receive the insurance benefits she paid for, Vanderkop said she refocused her anger into an energetic effort to expose “what goes on for the majority of motor vehicle accident claimants.”
Those efforts resulted in her book — So You Think You’re Covered! The Insurance Industry Rip-off. She said her book exposes the great lengths to which insurers will go to deny legitimate claimants. Now, speaking out on Bill 15 is one of Vanderkop’s endeavours in her efforts to raise awareness on what claimants may endure in the journey to receiving the benefits to which they’re entitled.
For instance, Bill 15, Vanderkop explains, has made the arbitration process worse for claimants by removing the right to take their insurer to court when they have been denied benefits.
“Insurers rarely pay benefits unless the claimant hires a lawyer,” she said in December 2014, shortly after the bill was passed. “The question I ask is why one even needs to hire a lawyer when you pay for insurance coverage for benefits you will need when seriously injured in a car accident?”
Pete Karageorgos, director for consumer and industry relations for the Insurance Bureau of Canada, explained that those involved in a collision have seven days to report the incident. A package of paperwork, including applications and forms for the individual involved or a physician, then goes out to be completed.
The forms are reviewed by an adjudicator, who will “work with you for that process, find out what sort of injuries you may have, answer any questions, and move forward,” he said in an interview with The Express.
Insurance companies are subjected to a health-care levy, to the tune of about $142 million annually, imposed by the provincial government to help cover health-care costs.
“As an industry, we pay into OHIP for those services provided in hospital,” he said.
Bill 15 is meant to help combat insurance fraud, which Karageorgos said is alive and well indeed.
Insurance fraud takes place when someone attempts to take advantage of an auto insurance claim, or a physical damage claim — anything from making a fraudulent claim for injuries that don’t exist or for enhanced abuse, which means exaggerating the situation. He cited an example of a police officer in the Peel region who was convicted of fraud for falsifying a claim, or people staging collisions to take advantage of benefits.
In the province of Ontario, the annual cost of estimated fraud in 2010 ranged from $768 million to $1.56 billion, said Karageorgos.
“When insurance fraud is committed, we all pay,” he said.
But for legitimate claimants?
“If someone has a legitimate claim, they’re not going to have a problem,” said Karageorgos.
But for Vanderkop and the many legitimate claimants like her, that is simply not the case.
“One woman . . . said the insurer’s lawyer told her that he was paid over $500,000 per year to deny [claims.] Most [insurance] fraud is perpetrated by organized crime groups,” she said. “There is no real way to quantify fraud. Meanwhile, claimants get lumped in too as fraudsters . . .with no consideration of insurers’ fraudulent behavior towards legitimate claimants.”
She said she doesn’t deny that fraud happens, but the other side of the story is how insurers fight to try and deny claimants who have legitimate, medically verifiable claims of their rightful medical, income and disability benefits.
“Inform yourself. This could be you,” she said. “These people are silenced because they are too injured to speak up. When they are at their weakest, they will have to fight their hardest.”
She said she hopes So You Think You’re Covered! The Insurance Industry Rip-off will help raise awareness and educate legitimate claimants on how to successfully navigate the process.
“People need to have their stories heard, and there are plenty of them,” she said. “Do you want to hear the inside story, read about what insurers don’t want you to know, and learn about their misguided process and how you can fight back?”
Vanderkop’s book is available online, at the Book Shelf in Guelph, and Words Worth Books in Waterloo. She is available for public speaking engagements, and more information on Vanderkop and her book is available at www.deniedbenefitclaims.com.
Source: http://www.southwesternontario.ca/news/local-voice-against-wrongful-benefit-denials-not-staying-silent-3/
No comments:
Post a Comment
Thank you for your comments.
Canadian Insurance News does not endorse any of the views posted. By submitting your comments, you acknowledge that we have the right to reproduce, broadcast and publicize those comments or any part thereof in any manner whatsoever.