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Ontario’s Shame and Scandal – how the injured and disabled are punished by government policy

Victim’s group calls for the Auditor General and the Ontario Ombudsman to investigate what is happening to Ontario’s injured and disabled citizens

TORONTO, November 17, 2015 PRESS RELEASE - Ontario auto insurers are poised to make higher profits on the backs of Ontario’s disabled and injured MVA victims in 2016 while continuing to build up the provincial deficit by downloading the expense of victims to the taxpayers. Recently passed legislation means that coverage for the most injured MVA victims will be cut in half.

In October Ontario’s over 9 million drivers learned through the Lazar Prisman Report that they had been overcharged for auto insurance and likely overpaid by $1.5 billion in the last two years alone.

In recent weeks we learned just how challenging recovery is and how poorly the WSIB injured workers are treated in the Prescription Over-Ruled: Report on How Ontario’s Workplace Safety and Insurance Board Systematically Ignores the Advice of Medical Professionals.

How are these two stories related? Both systems are focused on their bottom line profits and their investments and not on recovery or the best interests of their clients. Both systems are based on medical evidence to support or deny claims; access to treatments and benefits relies on it. So what happens if those medical examinations aren’t reliable?

Ontario’s auto insurance companies have been delaying and denying their customer’s claims by way of poor quality or biased medical opinion reports in much the same way as is happening at the WSIB. Many of the same experts are employed under the two systems and those assessors who are auto insurers’ “preferred vendors” of these “independent” assessments are often beholden to the company that pays them. Similar to the WSIB assessment model where expectations are to be met or there are consequences.

Providing auto insurers’ with “favourable” medico-legal opinions by minimizing/trivializing legitimate injuries is unethical and it should be treated as a form of fraud. It is after all the mirror image of the type of fraud the FSCO, the Insurance Bureau of Canada and the WSIB say they won’t tolerate.

The insurers’ assessment is the only component of our broken Ontario auto insurance regime that has escaped regulatory scrutiny. It is the corrupted insurer medico-legal (IME/IE) assessment system that stands between injured claimants and their access to the Statutory Accident Benefits (SABs).

The current legislation allows auto insurers to deny policy benefits (including treatment, income replacement, attendant care, etc.) to seriously injured auto victims solely on the basis of the opinions of these second opinion insurer assessments commissioned to question the validity of the diagnosis and prognosis of attending physicians and treatment providers.

No matter how many attending physicians attest to the legitimacy of an injury ultimately the insurer assessor’s opinion (even if unqualified or biased) trumps those of the attending physicians’ in terms of the injured claimant’s eligibility for treatment and benefits.

The legislative changes and cuts to coverage will find many untreated and injured MVA victims dumped onto our OHIP and public supports systems. Insurers have been taking advantage of the taxpayer who ends up paying the costs of car crash survivors through Ontario Works (OW) and Ontario Disability Support Program (ODSP). Insurers’ profits and WSIB books get balanced while victims end up impoverished and at the food bank.

Ontario’s injured and disabled individuals deserve better treatment at the hands of our government be they car crash survivors or WSIB claimants. They have the right to expect to have their medical conditions addressed through the recommendations of their treating physicians and providers who shouldn’t be second-guessed by “hired gun” insurer ‘experts’.

We ask that the Ontario Ombudsman look into the systemic abuse of Ontario’s victims and why the Financial Services Commission of Ontario and the Minister of Finance have failed to protect the interests and well-being of injured Ontarians with meaningful regulation and enforcement.

We ask the Auditor General to look into the reasons why the Minister of Finance (MOF) has not taken action on the Auditor General’s 2011 report recommendation that an update on the assessment of health system costs be done. These are the costs to the taxpayer through our medical systems that should be paid by Ontario’s insurers through a transfer of funds. Health care costs and the volume of MVA victims dependent on our social supports have increased substantially since the inception of No-Fault insurance. Yet the transfer of funds from Ontario's insurers to the province has not increased since 2006 before the majority of MVA victims have had their med/rehab claims capped at $3500.00 in 2010, down from $100,000.00 in previous years.

We would ask the Auditor General to go further and assess the cost of the public supports to unpaid MVA victims and WSIB claimants when they are downloaded to OW, ODSP and ultimately CPP Disability. Ontario’s insurers will slash benefits in half to $1 million for med/rehab/attendant care for the most catastrophically injured MVA victims in June of 2016. This will have far reaching costs to taxpayers who not only pay the highest auto insurance premiums in Canada but who are also going to have to pick up the majority of the costs of seriously injured MVA victims and provide additional services through OHIP.

Our auto insurance system is surely broken when insurers are so routinely using our courts as a tool to deny claims. According to StatCan there are over 61,000 auto insurance related cases waiting for hearings in Ontario civil court and over 19,000 more MVA victims at the Financial Services waiting for hearings. All of these delays and denials have a cost and insurers don’t seem to be the ones paying for it.

SOURCE FAIR Association of Victims for Accident Insurance Reform is a not-for-profit organization of MVA victims and their supporters. http://www.fairassociation.ca/

For further information: Media Contact: Rhona DesRoches, 705 543-0574, fairautoinsurance@gmail.com

Social Security Tribunal OUT OF SERVICE Backlog

The rush to relieve the backlog of thousands is on at the Social Security Tribunal of Canada.

Minister Jason Kenny said the backlog of thousands would be gone by this summer.

The New Minister Pierre Poilievre Responsible for taking care of the backlog (that this blogger has contacted, but had no response from) has not gotten rid of the backlog of Appeals.

Someone called. We could not make it out. Someone called again, it was the Social Security Tribunal of Canada, her message said “if your matter has already been completed then you can disregard this call” “otherwise you can call us” and left an OUT OF SERVICE NUMBER 1-877-277-8577.

I emailed the Social Security Tribunal and was informed that I had been given the wrong number by them and it should have been 1-877-227-8577.

To make matters worse the email he replied back to me with quoted someone else s case number! Not mine!

Am I in the twilight zone?

I was a MVA victim in 2007 after a fatal 3 car crash. My application for CPP Disability Benefits was launched in 2008. I still have not received a complete copy of my file, and a lot of what they have sent me so far, is unreadable to any human. At least they didn't leave my medical-legal file on a bench in front of our house unattended this time.

The latest opinion from xxxx the Medical Adjudicator at Service Canada in August was that I have not established a Disability that is “Severe and Prolonged”.The (hired gun) Adjudicator out of the Chatham office goes on to say that I did not provide any medical documentation to support my Disability. 

They have however acknowledged receipt of my 105 page fax to them with the case file number GD37-1. The fax included the Ontario Superior Court of Justice Mediation Brief that included medical documentation to support a finding of a “severe disability”. 

My submitted Doctors findings should not be taken lightly as they come from respectable sources. 

One submission in the Brief is from a Doctor with a 25 year career in the hospital sector focusing on neurological disorders, schizophrenia, and pediatric brain injury and pediatric oncology including consultation to the hospital MS Clinic an acute psychotic disorders clinic. He has a long career in psychological research and scientific publication and presentation. He has published in the areas of chronic insomnia, neurohorrnoes in schizuphrenia, metabolic brain imaging in schizophrenia (positron emission tomography), and neuropsychology of schizophrenia. He carries out psychological asssessment and treatment, supervises clinicians, and carries out psycho legal and multidisiplinary-legal assessments and testifies at Arbitrations and Court. He was the Director of the Hamilton Medical-Legal Society and past President. He has been co-chairman of the Ontario Psychological Association Task Force on Auto Insurance. He was appointed by the Minister of Finance to the Accident Benefits Advisory Committee for Bill 164. He was appointed by the Minister of Finance to be a member of the Ministers Committee on the Designated Assessment Center System for Bill 59 and held the position for a year. He was appointed to the Expert Panel reviewing the Catastrophic Impairment SABS. He was a founding member of the Canadian Academy of Psychologists in Disability Assessment (CAPDA). He received the Karl Heiser Presidential Award from the American Psychological Association and the Ontario Psychological Association Award for his advocacy efforts on behalf of professional psychology. He received the OPA Lifetime Achievment Award. 

Other medical-legal documentation provided to the Social Security Tribunal was from a doctor whos is a registered psychologist with areas of competence in rehabilitation and clinical psychology. He is a partner at a psychology clinic and assessment centre. His doctoral degree is in Clinical Psychology, with a minor in Health Psychology. He has a post graduate diploma program (DESS) through the University of Montreal Faculty of Medicine in Insurance Medicine and Medicolegal Expertise. He has a Master of Science in Community Counselling with specialized training in vocational assessment and counselling. His doctoral training included assessment, diagnosis and treatment of severe mental and behaviour disorders in private and public psychiatric inpatient hospital settings, as well as sheltered workshops. He has also performed disability assessments for patients with severe mental disorders applying for Social Security Disability. As a clinical psychologist, he worked in several chronic care facilities, assessing, diagnosing and treating patients with severe psychological disorders, including psychotic and severe mood disorders. Upon immigrating to Canada he has re specialized in rehabilitation psychology. He since has performed hundreds of psychological disability assessments in relation to M.V.A, WSIB, and other personal injury contexts. He was on the FSCO roster for Post 104 and Catastrophic disability assessors, and has performed hundreds of Catastrophic, Post-I 04 disability and psycho-vocational assessments. He has published scholarly works with respect to catastrophic impairment, and created educational modules addressing catastrophic impairment evaluation for psychological disability assessors. disability and psycho-vocational assessments. He delivered the 2010 Keynote Address to the British Psychological Societys Division of Counselling Psychology on the intersection of psychological assessment and the law. He has also edited two books on the application of humanistic theory to psychological treatment and has also published book chapters and articles in this area. He was the President of the Canadian Academy of Psychologists in Disability Assessment (CAPDA). He has been accepted as an expert witness in Ontario courts. GD37-52

Their medical documentation in the Brief supports a finding of a “chronic pain” , “severe disability” , “severe depression” , “PTSD” , “suffers permanent and serious impairment” , I am “neither exaggerating nor feigning” , “tends to minimize his complaints” , “suffers a complete inability to engage in any employment for which he is reasonably suited by education, training or experience”, “is at a competitive disadvantage in the workforce”. GD37-33 / GD37-34 / GD37-35 / GD37-37 /GD37-38

Also included was a Chronic Pain Assessment from yet another doctor that states: “his neck disability” , “suffered a significant functional, financial and emotional loss” , “suffers from Degenerative Disc Disease in his Cervical Spine, as well as debilitating Myofascial pain syndromes in his cervical spine.” , “severe disability”, and “complete disability” , “WADS III of the neck”. GD37 – 105 / GD37-23 / GD37-25 / GD37-105.

Also included in the Brief was yet another doctor report that states: “completely disabled from any occupation to which he is suited by way of his education, training or experience.” GD37-43

Another Doctors report included in the Brief states: Overall, I am “not employable”. GD37-32.

Rather that go long winded in this post I submit that I have provided enough medical documentation to establish my disability just from the above doctors. You have the other reports and blog postings I will not duplicate them here.

Today I finally received a date for my Appeal Hearing. The date on the notice was 39 days ago. The notice says that my hearing is not going to be until 2016, next year!

In this effort to get rid of the backlog of thousands how many are getting run over. What happened to the pledge to wipe out the backlog by this past summer? How many Appellants are still backlogged at the Social Security Tribunal of Canada?

If my Medical-legal experts are good enough for the Ontario Superior Court, a mediator, numerous doctors and lawyers, and 4 insurance companies they should be good enough for Service Canada and the Social Security Tribunal. I hope that the Tribunal Member that decides my appeal takes into account my medical-legal evidence submitted here in from real Medical experts, that write the rules, and not Service Canada employees with an agenda.

Sincerely,

name removed

CPP Disability Applicant since 2008,

MVA-Insurance-Victim since 2007.

Thank you to all those who help me with my writing and blogging and to those who follow my blog. Unfortunately I have been diagnosed with astigmatism and cataracts in my eyes recently. Advocating for MVA victims will have to be less frequent. Seeing (reading and writing) has now been added to my list of Medical problems.

NO NAMES ARE POSTED ON THIS PAGE AT THIS TIME

THIS POSTING WAS SENT TO THE SOCIAL SECURITY TRIBUNAL OF CANADA NAME INCLUDED 

Cc: undisclosed

Social Security Tribunal appeal stacked against claimant

Monday, July 27, 2015
Social Security Tribunal appeal stacked against claimant


Via Facsimile 1-855-814-4117 Social Security Tribunal of Canada
RE: IN THE MATTER OF APPEAL GP-xx-xxx

Dear Social Security Tribunal:

I acknowledge receipt of a letter by xxx -IS Operations Manager, General Division Dated July 16, 2015 informing me that your are now “ready to proceed” with my Appeal.

I do not understand how you can be ready to proceed without fulfilling your obligation to provide me a copy of my previously requested file.

Until I am able to receive a complete copy of my file I am unable to proceed in defending myself and presenting the facts.

As you know my file represents the how, when, and why I have an appeal with you, and is the record of events for any future actions against the Social Security Tribunal in the event of the continuation of these unjust denials. Its all relevant. I wish to discuss with the Member assigned my file all relevant information regarding my file and my Appeal. So again, I kindly ask for an updated copy of my file.

Even if I am unsuccessful in my Appeal I still require everything that I sent to the Tribunal to be part of the record as it confirms and demonstrates the facts of my long journey through this preconceived nightmare designed to deny, humiliate and thoroughly frustrate legitimate victims that have already been threw enough interrogations from their insurance companies hired guns and wordhirelings. All orchestrated by the IBC and bad politicians that pray on the week, sick, and injured, for profit.

Doctors that don't stand up for legitimately injured patients are most to blame in this charade of politics and money makers. My 7 year Appeal process is just another example of an upside down world where the money doesn’t go to where its suppose to. Bad Doctors that don't properly investigate are at the core of the backlog problems at F.S.C.O, our courts, and the Social Security Tribunal of Canada.

As Service Canada has used my blogging (about them) as an excuse not to pay my disability benefits attached you will find my latest blog entry advocating for the thousands of people waiting at your Tribunal because of bad decisions by disgraceful, dishonourable and unprofessional Service Canada employees.



As you know my faxes to you and my blog still asks for the Chairperson of the Social Security Tribunal xxx to answers numerous, unanswered, questions.
I have no acknowledgement that the Chair is getting my correspondences. Is she receiving anything? Should I resend?

Also, will I be permitted to audio/video record my appeal hearing?

Finally, attached you will find my completed “Hearing Information Form”. You will notice that I have not answered the witness question at this time. What are the rules for witnesses?
I submit that anyone that has correspondences, investigations, or relevant knowledge of this appeal makes them a witness to this Appeal. Furthermore, is there a limit to the number of witnesses?

With my injuries, no consumer protection, no consultation or mind reading skills I continue to have difficult understanding why this process is designed so difficult for a legitimately injured person. You should all be ashamed.

Looking forward to hearing from you as soon as possible in this regard.



Thanks to all those who help me write my letters and blog postings since 2007.


Cc: undisclosed

Source: http://survivingacollision.blogspot.ca/2015/07/social-security-tribunal-appeal-stacked.html

CPP Disability take a number now serving appeal 200,000

What are the number of appeals backlogged at the Social Security Tribunal?

The following comment was made by Fair Association of Victims for Accident Insurance Reform on the Toronto Sun site back in November of last year.

In February of this year Minister Jason Kenney pledged to wipe out the Social Security Tribunal backlog of 11,000 by this summer.


The backlog was also discussed later in the house by Mr. Robert Aubin (NDP).
He said: "Mr. Speaker, on Tuesday the chair of the Social Security Tribunal confirmed that there are significant delays in the processing of cases: 14,677 cases are languishing on her desk."


So what are the numbers now?


More importantly, how would you get rid of such a backlog of appeals...fairly?


The Tribunal Chair refuses to acknowledge or respond to my letters as an appeal applicant, or as an advocate for these disabled Canadians that have been waiting for years at the tribunal backlog.


Knowing that these disabled Canadians can't respond our government has reaped the $$$ in withholding these benefits. Appeals in the take-a-number-lineup because of bad decisions by Service Canada and their policy of delay, deny, wait for them to die.

In my case these benefits that my employers and I have paid into mandatorily since 1979.

http://survivingacollision.blogspot.ca/2015/01/delay-deny-wait-for-them-to-die-at-sst.html

http://survivingacollision.blogspot.ca/2015/05/where-do-victims-go-when-insurers-dont.html

And what of my appeal that was launched back in 2008?

Will it be fairly heard after my blogging about the Social Security Tribunal and advocating for the unknown thousands of Appellants?

What do I have to do to be heard and what will It take to at least acknowledge my correspondences by the Social Security Chair Ms. Brazeau.

Sincerely,
Mr. xxxx xxx
Surviving a Collision:   http://survivingacollision.blogspot.ca/
Crash Survivor 2007.



Social Security Tribunal says more than 14,600 Canadians are now waiting for a hearing:
http://survivingacollision.blogspot.ca/2014/11/social-security-tribunal-says-more-than.html

Ontario Government Abandons Auto Accident Victims

TORONTO, May 28, 2015 /CNW/ - Last week the Standing Committee on Finance and Economic Affairs met with the public and industry stakeholders to consult on Bill 91, Building Ontario Up Act.

Our legislators chose not to invite auto accident victims to the consultation process and instead opted to look at empty chairs rather than look auto accident victims in the eye and listen to their concerns.

Ontario already has the highest premiums in Canada and the lowest coverage with 80% of claims capped at $3500 for med/rehab. As pointed out by the Ontario Auditor General in 2011, about half of all claims are turned down by insurers and this means that our benefits are also too difficult to access.

Our government is proposing to cut $1 million dollars in coverage from catastrophically injured auto accident victims who currently have $2 million in coverage. Seriously injured victims will see their coverage drop from $86,000 to $65,000.

It appears that our government hasn't considered the recent study that revealed that Ontario drivers were overcharged by their insurance companies by $840 million in 2013 and that we have overpaid insurers by $3-4 billion dollars since 2001.

It is unacceptable to be giving away money to wealthy insurance companies who are already using some very shady business practices to deny a record number of claims.

Victims are downloaded to OHIP, Ontario Works (OW), Ontario Disability Support Program (ODSP) and CPP disability. These programs are already overburdened and don't offer the specialized treatments that many victims require so they will simply be left to fend for themselves.

Our government is giving insurers a financial gift by allowing insurers to pay injured victims less and simultaneously download the cost of victims to the unsuspecting taxpayers who are also the same drivers looking for a break on insurance premiums.

So what are we going to do about it?

We invite the public and Ontario's auto accident victims to join FAIR and the Accident Benefit Coalition on Wednesday June 3rd, 2015 from 12 pm- 1:30 pm at Queen's Park at the #Rally4AccidentVictims.

We hope you will sign the petition asking the Government to Stop Reducing Accident Benefits.

FAIR Association of Victims for Accident Insurance Reform is a not-for-profit organization of MVA victims and their supporters. http://www.fairassociation.ca/

SOURCE FAIR Association of Victims for Accident Insurance Reform

For further information:

Media Contact: Rhona DesRoches, 705 543-0574, fairautoinsurance@gmail.com

Ontario auto insurance - what are we buying into? FAIR submission

Hello



FAIR was not chosen, nor were any of our members who also applied for an appearance, to speak to auto accident victim issues and the deep cuts to coverage at the Standing Committee on General Government in respect to Bill 91.



Below and attached is our submission to the Standing Committee fyi. As consumers who forced to buy a product that does more harm than good for half of Ontario's MVA victims already and whose coverage is about to be slashed in half, there ought to be a public outcry. So if you paid your premium last week, by the time Bill 91 passes, you will have $1 million less coverage if you are catastrophically injured. No rebate, no notice in the mail, it's just done. You'll find out when you get in an auto accident or on your next premium renewal in the small print. It doesn't just affect you, it affects that person you might accidentally hit with your car, and now that person will also have only $1 million for med/rehab and only 5 years to collect it (as opposed to $2 million and 10 yrs right now). As if people who are so traumatically injured, perhaps in a wheelchair, or seriously brain injured are magically better in just 60 months. It takes longer than that for many victims to just get to court to even hold their insurer accountable. 



We pay insurance in that off-chance that we get in an accident so we, and those we injure, have coverage and so we won't be dependent on our families and loved ones or a burden on society. But the reality is that over the past 25 years our coverage is now only a fraction of what it was when Ontario entered into the No-Fault insurance system in 1990. We have no meaningful way to hold this industry accountable except in individual circumstances and at great personal expense. It's an industry that now poses a direct threat to our economy when it is the taxpayer who is paying a premium for benefits that are increasingly difficult to get when you need them and when you factor in the download to the tax payer through the use of our public systems.



Something that seems to get lost in all of the rhetoric and in the complexity of the Insurance Act with all of the changes and stripping of benefits is this: there isn't much difference between the person that is 52% whole body impairment (serious injury) or the person who is 55% or catastrophically injured. But there's a big difference in the amount of coverage available. A $935,000.00 difference. Certainly an amount insurers will fight hard to hold onto. It is these thresholds like the MIG cap at $3500 (80% of claims) vs serious injury vs catastrophic injury categories that is feeding the adversarial system and leaving victims high and dry.



These specialized treatments that we talk about, and the timing that is so very important to recovery, aren't available in our public systems and are outside our public coverage with OHIP. Only a few will be able to afford what is necessary for a best recovery scenario. The rest will pay out of pocket if they can. Most will go without. Many will not recover without assistance. Will it be you? Will it be you that will end up on welfare or ODSP or CPP Disability? Or the people you accidentally injured? How would it feel to know the treatment to make you better is there but you can't afford it? This is already happening to half of all auto accident victims.



"We take you now to a dark land where fraud is rife, corruption abounds and the government seems powerless. No, not some calcified dictatorship in Africa or South America. This is Ontario, home to Canada’s worst auto insurance system, a vast subculture of lawyers, health-care operators, inept regulators and gaming politicians who cannot or will not come to grips with a regulatory failure that costs motorists billions." Terence Corcoran http://business.
When we talk about fraud (a great distraction away from the poor coverage and access) we need to talk about the fact that Ontario's insurers are selling us a product that only works for half of those who pay and we need to look at the fraud in the system that allows that to happen. http://www.



Sent to our MPPS and  media.



Rhona DesRoches
FAIR, Board Chair



Tammy Kirkwood
FAIR, Vice Chair
www.fairassociation.ca 



                                                                               
 May 25, 2015



Why is our Government allowing Ontario’s wealthy insurers to slash benefits to the most injured of auto accident victims?



The 2015 budget is an absolute windfall for Ontario’s insurers who are the beneficiaries of Building Ontario Up by building up their already substantial profits on the backs of Ontario’s seriously injured auto accident victims.



 Consumers and accident victims alike are already being short-changed when the coverage they purchased isn’t there when they need it. According to the Auditor General’s 2011 report on auto insurance about half of all claims end up in court trying to get what they paid for and that isn’t any more acceptable than purchasing a car and finding out that the brakes only work half the time. 



Ontario’s wealthy insurance companies have had an "easy ride for over 20 years" according to the recent Schulich School of Business report on Ontario’s insurance industry.  Insurers have overcharged Ontario drivers by billions and are making 17% on their investments while claimants, who have paid in good faith, are left hanging out to dry at a time when they need assistance.



How can it be that our government, under the guise of protecting victims, is proposing to cut over a $1 million dollars in coverage for the most seriously injured among us? How is that fiscally responsible?
Victims don’t just disappear when insurers fail to live up to the promise of coverage; they just end up on our public support systems at the tax-payers’ expense.



The Budget does nothing to ensure that insurer claims management practices are fair and there has been no action on FAIR’s concerns about the biased and corrupt insurer medical examination (IME) reports that are disqualifying innocent and legitimate accident victims every day. The auto insurance landscape should be cleaned up but instead we see Ontario’s auto insurers being rewarded handsomely for disqualifying as many claims as they manage to handle through the biased medical opinions that have poisoned our insurance system, our courts, and are causing such hardship for legitimate claimants.



We can only speculate why our government is under such significant pressure to support the abuses and dysfunction in our insurance system. The new LAT system and increasing the $30,000 deductible requires that our MPPs ignore the Charter rights of all accident victims to access to our courts. We would like to know why our elected officials are willing to create a third class citizen by making our courts unaffordable and inaccessible. It is no small thing to denigrate the most vulnerable members of our society so an elite industry can profit.



We have no doubt that the new Tribunal hearings system will benefit Ontario’s insurers who are still doing nothing about their excessive claims turn down rate because our Government isn’t even asking that the insurers be accountable for their shoddy claims handling practices. This inaction on the insurance file has led to the unprecedented volume of cases in our civil court system. The new LAT system will be faster but it will still punish victims and be based on Ontario’s insurers’ dependence on their deceptive and dishonest medical reports.



Ontario insurance is an adversarial delay and deny business model and profits depend on the turn down of claims. But who is paying for that?  Well, first the victims who endure the endless bogus medical examinations required by our insurers in order for them to deny to access benefits. There are now so many thresholds and quantifiers of injury because insurers and the IBC work very hard to keep injured Ontarians at the lowest level of coverage. It’s a simple plan because the more levels of coverage there are; the more opportunity there is for an insurer to deny the claim.



According to HCAI data insurers have consistently spent more on medical assessments than they do on treatment. There’s a reason for this and it has nothing to do with returning their customers to wellness; it has to do with ‘shopping’ for medical opinions until the insurer gets what they want, an excuse to turn down the claim. All of these coverage issues are ultimately worked out in our courts at a cost to the taxpayer. This costs Ontario’s insurers nothing and the biggest price is paid by the victims who are more likely than not going to have to pay for their own recovery while caught in the system. This isn’t coverage; it’s a false impression of comfort that just isn’t there. It’s now a fantasy of coverage our government is forcing us to buy.



Even small changes such as the “require goods and services not explicitly listed in the Statutory Accident Benefits Schedule (SABS) to be “essential” and agreed on by the insurer” will become a point of contention and lead to even more cases in our courts if these changes pass into law.



Many of our members are already on public supports.  There were over 42,000 Ontario Disability Support Program (ODSP) applications last year and too many of them are auto accident claimants who are forced to wait many years for their benefits and who are already going without the treatment they need for recovery.



There are 61,063 auto insurance cases on the docket in Ontario courts, there are over 25,000 claims at the Financial Services Commission DRS unit, and many of our members are already on ODSP and CPP disability so Ontario’s insurers are well on the road to paying less than their fair share of MVA expenses and we already have a distorted form of public auto insurance.



Why is the Ontario government willing to allow insurers to shave more than a million dollars of coverage from our policies and willing to punish victims in a way we haven’t seen before?  There are about 600 or so catastrophically injured MVA victims every year and so this will be an immediate saving of $600 million in just the first year alone. Victims will be downloaded to the public systems that are not set up to service their disabilities and unlike the fantasy world of protecting claimants in Building Ontario Up, victims will be sacrificed to build up insurer profits.  These seriously injured individuals will face a lifetime of increased physical, emotional and financial challenges if Bill 91 is passed as is.



We are very concerned about the changes to the Catastrophic Impairment designation. The direction and the insurer presence on the CAT Panel haven’t inspired confidence that the industry will do the right thing here. At one point only 75% of that Panel agreed that paraplegia or quadriplegia was a catastrophic injury. Now the potential that the industry will separate mental and physical injuries as if they were unrelated is another danger for injured victims and this too will lead to increased court challenges.



Why is our government indexing the court deductible of $30,000 for tort claims but not considering indexing the inadequate $400/wk income replacement for victims that has also stayed the same for well over a decade now? Here is a clear demonstration of the imbalance in how our government views auto insurance when the insurer’s income from the deductible (and it is the insurer who gets to hang on to that $30,000) is indexed to inflation and yet MVA victims are expected to survive on an amount that is lower than our minimum wage and far below the poverty line.



It is an illusion to say that we are ensuring affordable insurance by allowing insurers to pay injured victims less and simultaneously be downloading the cost of victims to the taxpayers who are also the same drivers looking for a break on insurance premiums.



The system is broken and no matter how much our government is willing to give to insurers and take away from the injured, it will still be broken and dysfunctional. We are asking you to put a moratorium on these changes until further review can be done to ensure that Ontario’s auto insurance is providing the coverage we need. We need to look at changing the system, making it more reliable for victims and easier to navigate. These are procedural changes that insurers must make and it is up to government to ensure that they do so.



Thank you for the opportunity to present our point of view. We think it is important that you hear from victims and hope that next time the Standing Committee will invite actual victims to these hearings on issues that affect them rather than just listening to Ontario’s insurers.



FAIR Association of Victims for Accident Insurance Reform is a grass roots not-for-profit that advocates for Ontario’s auto accident victims.



‘FAIR – supporting auto accident victims through advocacy and education’

FAIR Association of Victims for Accident Insurance Reform
579A Lakeshore Rd. E., PO Box 39522, Mississauga, ON, L5G 4S6 mailto:fairautoinsurance@
http://www.fairassociation.ca/

WHERE DO VICTIMS GO WHEN INSURERS DONT PAY?

Letter to Social Security Tribunal of Canada

 

Dear Ms. /Mrs. Brazeau:

Please acknowledge receipt of my Facsimile Submission to you on January 22, 2015 included herein and also online at: http://survivingacollision.blogspot.ca/2015/01/delay-deny-wait-for-them-to-die-at-sst.html

Your lack of response only serves to substantiate my previous claims about how my claim for CPP Disability Benefits has been handled to date.

See: http://survivingacollision.blogspot.ca

As an appeal applicant I require you to answer my enquires involving my Canadian Pension Plan Disability Application.

As you know I have gone public about Service Canada, the Social Security Tribunal, and the Insurance industry puppets that prey on legitimate accident victims. The information I have compiled during my problematic 7 year battle to receive Canadian Pension Plan Disability Benefits shows how much of a dysfunctional product it is.

As a member of Fair Association of Victims for Accident Insurance Reform

http://www.fairassociation.ca/ I also require an answer to my questions as an advocate for the 15,000 people that are waiting at your Social Security Tribunal backlog.

These same people discarded by their auto insurance companies. These same people with legitimate injuries that were already backlogged At FSCO because of our justice system has run amok.

Then these same people were denied by Service Canada ending up at your door backlogged once again as part of a delay, deny, wait for them to die tactic directed at injured victims already victimized by Motor Vehicle crashes.

These backlogged consumers that were mandated to purchase security and piece of mind from Ontario's insurers through government legislation.

The same people who already have a severely diminished quality of life. They are injured, broke, medicated, terminally ill, often organ transplant recipients, they are stressed out, dying and suicidal.

See:

-SOCIAL SECURITY TRIBUNAL – BROKEN:

http://administrativejusticereform.ca/social-security-tribunal-broken/
http://www.parl.gc.ca/HousePublications/Publication.aspx?Language=E&Mode=1&Parl=41&Ses=2&DocId=6781650#Int-8510994
http://survivingacollision.blogspot.ca/2014/11/social-security-tribunal-says-more-than.html
- 14,500 Canadians waiting at Broken Social Security Tribunal: https://youtu.be/9WTzdq7E2K0
-SOCIAL SECURITY TRIBUNAL – More
http://administrativejusticereform.ca/social-security-tribunal/
-Fair Association of Victims for Accident Insurance Reform http://fairassociation.ca
-So You Think You're Covered! The Insurance Industry Rip-Off: http://deniedbenefitclaims.ca/
-Government on hot seat about dying Alberta man denied CPP disability benefits: http://www.winnipegfreepress.com/arts-and-life/life/health/government-on-hot-seat-about-dying-alberta-man-denied-cpp-disability-benefits-294252741.html

-Administrative Justice and DISABILITY Claims – NOT A PRETTY PICTURE

http://administrativejusticereform.ca/administrative-justice-disability-claims-not-a-pretty-picture/
-‘Amputate your leg’ Insurer’s expert recommendation to accident victim
http://cinsurancenews.blogspot.ca/2014/03/amputate-your-leg-insurers-expert.html
-Social security tribunal backlog includes terminally ill, others deep in debt
http://www.theglobeandmail.com/news/politics/social-security-tribunal-backlog-includes-terminally-ill-others-deep-in-debt/article21864630/
-In the House of Commons on April 27th, 2015. Mr. Speaker, we are talking about people who are desperate. They have serious health issues; some of them are depressed and suicidal.
https://openparliament.ca/debates/2015/4/27/jinny-sims-5/only/


Service Canada mentions my blogs in their submission to the Social Security Tribunal, and uses my blogs as an excuse not to pay Canadian Pension Plan Disability Benefits.
See GD-12-10.
You can't have it both ways Ms Brazeau. Service Canada can't use my blog as an excuse not to pay CPP Disability Benefits and at the same time choose not to include my email appeal submissions regarding my blog? Clearly my blog has become relevant and should be included in the conversation and made part of the record.
Herein are examples of some relevant information :
-Social security officials idle in tribunal's early months as backlog grew
http://cinsurancenews.blogspot.ca/2015/01/social-security-officials-idle-in.html

-Was government really blindsided by disability benefits backlog? http://cinsurancenews.blogspot.ca/2015/01/was-government-really-blindsided-by.html

-Kenney: Social security backlog ‘unacceptable’
http://cinsurancenews.blogspot.ca/2015/01/kenneysocial-security-backlog.html
-Fraud against insurance claimants - business-as-usual
http://cinsurancenews.blogspot.ca/2015/01/fraud-against-insurance-claimants.html

-Baloney Meter: social security tribunal

http://cinsurancenews.blogspot.ca/2015/01/baloney-meter-social-security-tribunal.html
-Wait Stretches years due to tribunal backlog
http://globalnews.ca/news/1703378/disability-benefits-wait-stretches-years-due-to-tribunal-backlog/
-Question Period: Shameful Social Security Tribunal Backlog: https://youtu.be/E9uUP294qaA
-Question Period: Social Security Tribunal:
https://youtu.be/61KIM-q5-pc
-Question Period: Social Security Tribunal:
https://youtu.be/c0FjdxdHYcY
-Social Security Tribunal members earned $100 000 a year to sit https://youtu.be/uznIpeWQXSs

Please address the following CPP Disability Appeal

issues that remain outstanding

1-Ontario will introduce legislation to tackle privacy violations of health records http://www.thestar.com/news/queenspark/2015/03/30/ontario-will-introduce-legislation-to-tackle-privacy-violations-of-health-records.html my issues regarding health records are the following:

(a)-My Medical file that was left on a bench in front of our house on December 3, 2014. http://t.co/lEyFQ9zJyr .

(b)- Anonymous access to my medical records have been downloaded
HCAI Security Breach:
http://survivingacollision.blogspot.ca/2013/12/hcai-security-breach.html and transferred to unsecured mail servers.

Phillis Brodie RN Service Canada said she would decide where she was going to get medical information from and let me know by letter. She never did. She wrote down my lawyers name, address, fax number, phone number, so she could.
Where did Phillis Brodie of Service Canada get my medical records from?
See: audio recordings Phillis Brodie RN Service Canada
2- Please respond to the Social Security Tribunal Unreasonable Conduct described in my fax submission to you on January 22, 2015 and Service Canada Intent to Deceive, Bad Faith Administering my Claim, and Service Canada being Caught in Lie.
See attached: January 22, 2015 Fax Submission to Ms Brazeau -Social Security Tribunal Chairperson.
3- Social security officials idle in the tribunal's early months as backlog grew
http://cinsurancenews.blogspot.ca/2015/01/social-security-officials-idle-in.html
4- Again, please acknowledgement that I did not write the posting: Ottawa’s unjust approach to disability insurance by Jackie Esmonde , Marie Chen published September 12, 2014. GD15-3
5-Please acknowledge I do not “make software” or “build computers” as Service Canada has said in there submission to the Social Security Tribunal.
GD-12-10
6-Please fix the error in my file that I administrate the Fair Association site at http://www.fairassociation.ca/ GD5-3
7-Because the Social Security Tribunal Backlog has stretched on for years and Service Canada s routine denials of benefits it is reasonable that there will be an earning freeze on my claim. I also request an adjustment to my starting date to my first application for Disability benefits in 2008 -when I first applied one year after I was disabled by a fatal automobile crash.
I submit that Service Canada never did a full investigation with my 1st application.

SOCIAL SECURITY TRIBUNAL – PROFITING FROM PROCESSING DELAYS

http://administrativejusticereform.ca/social-security-tribunal-cpp-profits-from-delays/
7-Again, I kindly request a pre hearing.
8-And yet again, I still would like an answer to my question of how Service Canada can write “we know you cant work” and still continue to deny me access to Disability benefits?











9- I AM USING THE SAME EMAIL. WE HAVE NOT MOVED. PLEASE DO NOT SAY THAT WE HAVE. If we do I will of course notify you. Is this how you will get rid of the 15,000 appeals by “proceeding in your absence” decisions?
See email Jonathan Lylyk- Case Management Officer Social Security Tribunal.


Again, I kindly request that you include ALL my submissions for my appeal. Since you have decided not to allow my email submissions I will begin sending them by fax when I am able. That will include all the years of contents from my blogs.

Because you may not respond again I will be sending this to all the Members of the Social Security Tribunal, that have not quit, in hopes that someone with intelligence will respond.

See: http://metronews.ca/news/canada/1172725/benefits-arbitrators-dont-get-benefits/
Chelsea Murielle Brazeau I remind you that my employers and I have paid into the Canadian Pension Plan since 1979. That's how you get a $233,900 salary. I deserve better than to be treated unfairly, delayed, denied, and lied to. We had enough of that behaviour from Service Canada, the Insurance companies, and our backlogged justice system for the rich.
See: http://www.appointments-nominations.gc.ca/prsnt.asp?menu=1&page=renum&lang=eng
This is abuse-of-process. I paid many years into our society for the privilege of not being ignored. Please give my claim the attention it deserves. It is reasonable that I request full and fair disclosure of my relevant documents by the Social Security Tribunal of Canada. It is clear that there is an ongoing duty and obligation to adjust my file. I also recommend that you ameliorate this situation for those of us that are most vulnerable and at risk in our society.
For almost 8 years this is all that I do, I am consumed by this one sided process.
Someone should do the right thing and fix this mess.
Looking forward to hearing from you, and everyone that gets a copy of this correspondence in this regard. My application for CPP Disability was first submitted in 2008. I told you the longer this takes the louder I will be.


Cc: undisclosed at this time



Please note:
This letter has taken a long time for me to write given my headaches and mixing up letters of the alphabet. I want to say thank you to all the people that help me edit my letters and blog postings. Thank you. If it were not for you, my letters would not be so coherent and family friendly.

The attachment:

DELAY DENY wait for them to DIE at the SST