Auto insurance changes

Auto insurance changes with @IBAOntario and Jokelee Vanderkop http://www.zoomerradio.ca/show/fight-back-on-zoomer-radio/michael-brattman-jokelee-vandekop-june-1/ …

Accident victims victimized with Ontario 2015 budget

  Ontario's "Building Ontario Up" 2015 budget which was released yesterday (April 23, 2015) has some very negative news for motor vehicle accident victims. Worse, some media think the changes regarding auto insurance represents a loss for insurance companies. Canadian Press, in their "Commuters and students win, while insurers lose"  April 24, 2015  article in  the Waterloo Record is completely off the mark. The writer says, under the heading “Losers” in the Ontario budget, that insurance companies lose because they will be required to give drivers a discount for using winter tires and will lose some interest money in lowering the maximum interest charged on monthly auto insurance premium payments. This budget is a home run for insurers with the aforementioned loss a pittance to the gains insurers will make. http://deniedbenefitclaims.com/blog.html


 ...This government has also approved, with IBC lobbying, a redefinition of catastrophic injuries. Catastrophic injuries now imply a paraplegic, quadraplegic, someone blinded in a car accident, or someone who has lost a limb or has serious brain injuries. Insurers point to total  claim costs and how they are rising, therefore requiring higher premiums, but they don’t mention that the increase is not because of what they pay out to claimants but what they pay their third-party-for hire medical ‘experts’ to assess and counter what a claimant’s own treating doctor (or doctors) has determined and this in order to be able to deny benefits. Their medical vendors are paid much more than in private practice making it worthwhile to keep the job and write whenever possible in the insurers favour. Meanwhile, claimants are sent to multiple and repeated insurance examinations in order for these ‘insurance vendors’ to find a way to deny benefits.

Source/more:
 http://deniedbenefitclaims.com/blog.html

Letter: Lawyers not to blame for auto insurance costs

Monday, 23 March 2015 08:00 | Written By Bert Raphael 

 

It is not enough that the Insurance Bureau of Canada and its insurance clients have control of every aspect of the lives of innocent accident victims, but they now want to monitor how personal injury lawyers structure their fees.

Barbara Taylor, director of policy at the insurance bureau, suggests that the tracking of lawyer fees will protect consumers while allowing the government to note the impact of lawyer fees on the auto insurance system (see “IBC wants regulation for personal injury lawyers,” Feb. 23). If the insurance industry really wants to control costs, I suggest that they take a hard look at what is expected of accident victims when they announce their intention to advance a claim. Immediately, there is a list of dozens of demands including an employment file, income tax returns, clinical notes and records of doctors, hospital records, drug store records, Facebook records, information on previous accidents, names and addresses of witnesses, identity of insurer, a statutory declaration as to how the accident occurred, and on and on.

This is even before there is a determination on whether the case will cross the verbal threshold. While the insurer gratuitously offers to pay reasonable costs, that does not include the time of the lawyer to pursue the various requested items. Has the insurance bureau ever costed the expense to the insurance company and therefore the system of reviewing the various productions when perhaps no claim has ever been advanced?

If litigation is instituted and the matter proceeds to examinations for discovery, again under direction from the insurance company, the defence lawyer will demand further productions and often these items generate some 30 or 40 letters that have to be prepared by the plaintiff’s lawyer. Assuming all these items are produced, has the insurance bureau computed the costs of first the defence lawyer collecting these items and the adjuster reviewing the same? By this time, the plaintiff’s lawyer will have incurred the cost of medical reports and the defence lawyer will make it clear that while they have to be produced, the insurer will not pay for them. Again, the plaintiff’s lawyer has to lay out that money and, of course, spend the time writing for and receiving medical reports.

If the lawyer for the defence wants a medical report, he will usually choose someone who is totally sympathetic to the defence position and, of course, that is an expense to the insurance company that often runs into the thousands of dollars. Then, based on that report, there is a denial arguing that the case does not meet either the threshold or the $30,000 deductible. At this point, having invested time and money, a plaintiff’s lawyer must decide whether to proceed to trial or throw in the towel.

In reality, if a settlement is achieved, it is usually based on analysis of two or three medical reports amounting to a compromise between the plaintiff’s medical information and the defence doctor’s report. In the end, the piles of paper generated by productions throughout the course of the claim are redundant; however, they have justified the salary of adjusters and defence lawyers, all of which costs the system and affects increases to automobile insurance premiums.

My point is that even if this paper chase is eliminated, the insurance bureau and insurance carriers will still find another way to shortchange proper compensation for innocent accident victims.

Bert Raphael,
Raphael Barristers,
Thornhill, Ont.

Comments   

brian francis 2015-03-23 10:45

Mr. Raphael is “on the money” in his description of how the auto insurers’ standard claims handling practices give rise to costs the IBC then lament (and blame others for). As Mr. Raphael points out; a key element in the way auto insurers do this is by shopping at their preferred (insurer-friend ly) medico-legal assessment mills for accusations of fraudulent malingering. The question this article begs – is this: when will the plaintiff lawyers lobby government to clean up the abusive and costly auto insurance IME/IE system that is hurting their clients so badly (an issue repeatedly raised in the mainstream press and even in a couple of previous Law Times social justice columns)? Their perpetual failure to do so makes the lawyers (on both sides) responsible for the endless bogus, wrongful accusations of malingering driving up the cost of litigation - and by extension - responsible for the high cost of insurance.

 

Devils Trumpet 2015-03-23 16:02

The statements by Barbara Taylor is another dog and pony show meant to change the discussion away from the real problem of bogus medical assessments from insurance industry-owned assessment mills,altered reports presented as evidence in court and unqualified doctors that personal injury lawyers do little about.Rarely much is mentioned about the high costs by those who work within the system.

That being said,the insurance industry is looking for new opportunities to squeeze more money into their pockets with the lawyers being their next target to lobby(pay)the government for legislation that sets financial limits on what personal injury lawyers can earn from representing a client.
Nothing will change until changes occur at Queen's Park first.

 

brian francis 2015-03-23 18:19

Do you really believe OTLA's 1,300 members need you to protect them from the IBC's attempt to make them its "next victims". What with all the lawyerly indignation - you seem to have overlooked the IBC's recommendation that injured auto accident victims be provided an easily understandable (consumer friendly) fee-structure outline. I'm no fan of the IBC but what the Hell is wrong with that idea? Of course the IBC is looking to target plaintiff lawyers and to blame them for the costs of Ontario auto insurance. They are insurer lobbyists for God's sake. That is the sort of stuff the IBC spokespersons are paid to do - and say they do on their website (ie. frame issues to the advantage of IBC's auto insurer members). But does that mean you intend to ignore the IBC when it calls for a clear fee structure statement - disclosing self-awarded premiums? It is rare for any of the long time stakeholders to lobby for anything but their own financial interests. So isn't it silly to ignore this one?

 

Rhona D 2015-03-24 00:21

Claimants don’t understand why the legal profession doesn't agree to a fee schedule. Not because the IBC is demanding it but because all of the ways insurers run up plaintiff legal costs would be revealed. If the IBC and plaintiff lawyers truly want to control costs then both sides need to get to work to clean up the mess. Start with the IMEs where delays and denial begins. Get a roster of qualified examiners and get rid of the bad apples whose shoddy medical opinions have created a civil court backlog of over 61,000 cases. Why isn't either side doing something about this problem that is harming victims, driving costs, and blocking access to timely justice? Lawyers need to listen to what MVA victims expect of them. High on that list of priorities would be to take action when dishonest medical opinions end up in a file – not dealing with this as it happens isn't acceptable and is adding legal costs to claims. Better yet, fix the system that allows the deception.

 

Tammy Kirkwood 2015-03-24 14:43

Survivors have been made to pay for a MVA that took away their well being pre accident. We have consistently had our recovery tools decreased or taken away. 1. Qualified, Treating doctors have their reports ignored or altered. 2. Taxi's service to get to and from appointments has been taken away. 3. Access to rehab personnel has been decreased due to the travel to the survivor has been eliminated. The list goes on.The insurers will spend thousands of dollars to traumatize victims again and again through their abusive IME system.
This dysfunctional system helps all the hands in the victims pockets grease their own palms.

"IBC's recommendation that injured auto accident victims be provided an easily understandable (consumer friendly) fee-structure outline" Sounds good, but is it more bullshit?

"Nothing will change until changes occur at Queen's Park first." Indeed! Look at the cuts to benefits the gov't as been making to social services themselves.

 

 Jokelee Vanderkop 2015-03-24 16:56

The whole system would be better if the legitimate claimant of a mva was put first. Insurers focus on how they can avoid paying benefits and make use of too many for-hire experts in their IMEs who are so well paid that they'll write in favour of the insurer to keep their income levels up, then too many personal injury lawyers put their firm's financial interests first, with too many providing ill-advise, late on deadlines, overbilling, and when you do find a good one, you risk losing a great part of your settlement to a "premium success fee". I thought a client hired them to win so why the bonus. The legislators acquiesce to the IBC and we end up with an ill-conceived Bill 15, and the IBC points fingers at everyone "in the accident business" forgetting that they are in that business too and more than willing to turn a blind eye to how their industry treats claimants.

 

 FAIR Association 2015-03-25 19:57

A consumer friendly fee structure would expose the cost of the extraordinary demands imposed by the insurers and their counsel during the course of a claim. We do not agree that lawyers should be able to award themselves ‘premiums’ or bonuses for a job well done and for which they’ve already been well paid. Nor should an hourly wage increase happen without consultation with a client. There is ample evidence that many legal professionals are not keeping proper dockets which translates into billing that equates to a guesstimate of services. The legal profession has failed to self regulate and in the bargain failed victims. 78% of Ontario’s legal bills are reduced at an assessment hearing and 61.063 mva case languishing in Ontario civil court tells us its costing victims too much. If the IBC proposal is offensive then come up with some regulations so that once a victim has been put the ringer by their insurer they don’t end up fleeced by yet another person they paid to help them.

Source: http://www.lawtimesnews.com/201503234553/letters-to-the-editor/lawyers-not-to-blame-for-auto-insurance-costs

Local voice against wrongful benefit denials not staying silent

Wednesday, March, 18, 2015 - 4:04:33 PM

 

Local voice against wrongful benefit denials not staying silent

 

BY SHANNON DUFF EXPRESS MANAGING EDITOR

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/

Local voice against wrongful benefit denials still speaking out

March, 12, 2015 - 11:11:26 AM

Local voice against wrongful benefit denials still speaking out

BY SHANNON DUFF EXPRESS MANAGING EDITOR

Editor’s note: The following is the second installment of a story featuring local insurance advocate Jokelee Vanderkop and her efforts to help legitimate claimants ensure they receive their rightful benefits.

Palmerston – After a life-altering motor vehicle collision and more than a decade of battling to receive the insurance benefits she paid for, Palmerston resident Jokelee 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 not only her book — So You Think You’re Covered! The Insurance Industry Rip-off — but also the opportunity to speak on CBC’s Ontario Today radio show in January.

“The host said she had never seen the [call-in] board light up so completely before a show had even started,” Vanderkop said. “The accident victims who spoke of their negative experiences with their insurers were very moving. One woman said she had spent six months in intensive care after an accident and was denied benefits. Another said the insurer’s lawyer told her that he was paid over $500,000 per year to deny her.”

Ten days after the show, Vanderkop received an explanation of benefits from her insurer, stating that since she now had earnings, the company could not consider further payments until it received copies of her earning statements.
Vanderkop said the letter left her shaking her head.

“What earnings?” she asked. “No mention was made of how [I] was supposedly making these earnings.”

In a February interview with finance and consumer journalist Ellen Roseman, Vanderkop stated the insurance company does have a right to request information, but “normally they tell you it’s required in order to continue benefits. In my case, they cut me off first.”

Joe Daly of Desjardins General Insurance Co. said the situation was a misunderstanding and indicated questions arose once the company learned of Vanderkop’s book.

“When we learned that Ms. Vanderkop published and is promoting a book, we sent her a standard form asking for copies of her tax returns,” he explained to Roseman. “Under the legislation, a portion of any income she earns from the book, or any other source, could be deducted from the weekly income replacement benefits we send her. We naturally assume she wrote the book to earn income.”

“If her tax returns indicate she has little or no income from the book or other sources, then her weekly entitlement payments will not be affected.”
Daly continued, “In retrospect, the claims advisor who decided to send the form obviously didn’t understand the realities of publishing in Canada. It’s tough to make any money writing a book.”

Indeed, the book has been more of an expense than anything, said Vanderkop.
Rhona DesRoches, chairperson of FAIR Association of Victims for Accident Insurance Reform [FAIRAssociation.ca], a not-for-profit advocacy group for motor-vehicle accident victims and insurance reform, also appeared on the CBC radio show with Vanderkop.

Vanderkop’s and others’ experiences, said DesRoches, indicates that benefits aren’t a sure thing.

“I think it is outrageous that a person’s benefits are always at risk,” she said in an interview with Roseman. “Settling a case with an insurer is no guarantee that the negative experience of making a claim with auto insurance benefits is really over.”

Vanderkop and DesRoches have since kept in contact, joined in their efforts to help legitimate claimants receive their benefits.

FAIR treatment

FAIR is predominately made up of accident victims, their family members and supporters, DesRoches explained.

“We’re a voice for those victims who really can’t speak out for themselves. Accident victims tend not to speak very loudly,” DesRoches said in an interview with The Minto  Express.

“Jokelee is an unusual person in that she speaks up and speaks out. Predominately accident victims are very quiet about what’s happened to them,” she said.

FAIR members advocate for change and education. “We find a lot of accident victims don’t know what they’re entitled to or why this is happening to them. People are very isolated, and they’re not sure why,” said DesRoches.

The association was founded in 2011, and DesRoches, a member since 2012, said motor accident victims finally have a voice at the table.

“Prior to FAIR, there was always complications,” she said. “But, there really wasn’t anyone at the table to give the accident victims’ perspective on how difficult the system is, and why it isn’t working.”

“Auto insurance isn’t just unaffordable, it’s also problematic in the quality of service it delivers,” DesRoches continued. “We’ve made ourselves a voice. A lot of what we do is directed towards our legislators and various other stakeholders in the auto insurance field. We do consult and submit on various issues that come up.”

Vanderkop, whose book is available at www.deniedbenefitclaims.com and who is available for speaking engagements, says she is now concerned about the recent passing of Bill 15. The Fighting Fraud and Reducing Automobile Insurance Rates Act is being touted as a good thing, she said, but could only make things more difficult for accident victims making claims.

Editor’s note: Please see next week’s Minto Express for the next installment of this story.

Source: http://www.southwesternontario.ca/news/local-voice-against-wrongful-benefit-denials-still-speaking-out/

Local voice against wrongful benefit denials not staying silent

Thursday, March, 05, 2015 - 1:01:20 PM

Local voice against wrongful benefit denials not staying silent

BY SHANNON DUFF EXPRESS MANAGING EDITOR

PALMERSTON – Even a rural, small-town voice can make a difference.
That voice belongs to Palmerston resident and insurance activist Jokelee Vanderkop, who even after self-publishing her own book and speaking out on national radio, still hasn’t given up her quest to help legitimate claimants receive the insurance benefits to which they’re entitled.

After fighting for her own claim, a battle that would last 12 years, Vanderkop finished So You Think You’re Covered! The Insurance Industry Rip-Off, which she began penning in 2003. The Minto Express first reported in August 2013 on the book launch and Vanderkop’s experience. Since then, she has only delved deeper into the issue, and “unless I carried on, one book wasn’t enough,” she said in a recent interview.

Vanderkop was involved in a head-on collision in February 1997. The crash cost her career as a secondary school teacher and resulted in multiple health conditions including chronic pain and brain impairment.

At her expense, the automobile insurance provider and employer’s extended health provider battled over providing long-term disability. She explained the process saw her stripped of all her benefits other than a conciliatory stipend by the health carrier while both insurers “duked it out.” She said she learned later that the car insurer had already determined to cut off her benefits regardless of what transpired during mediation — even though she qualified for those benefits.
Vanderkop was without income from 2003 to 2009 and lived on her credit line, existing on $30 per week for groceries.

Now revised, updated and expanded, So You Think You’re Covered! is a tool Vanderkop she says will inform readers on how insurance providers can attempt to deny claims, and what claimants can do to help ensure they receive the benefits for which they’ve been paying.

The process can be long, and not at all simple. Vanderkop’s fundamental warning?

“Having a legitimate claim, medically backed by one’s doctors, is no guarantee that an insurer will pay the benefits for which an individual has paid,” she said.
This is frequently met with denial and even disbelief. More frequently, it’s met with understanding from someone who has been there.

The insurers’ for-hire, legal-medical experts are well versed in how to counter these diagnoses and deny benefits, Vanderkop explained. She said she has spoken to many rehabilitation specialists who work with motor vehicle accident victims and who say some insurers are practiced at denying benefits.

In a 2011 report, the auditor-general stated about half of all injured claimants ended up in mediation.

“Are we to believe that almost one out of every two claimants is scamming and is refused benefits on that basis?” Vanderkop asked.

She has since learned that even the provincial auditor-general in a 2011 report stated that “half of all injured claimants ended up in mediation”. That means that almost 50 per cent of all claimants are denied.

Vanderkop said she refocused her anger into an energetic effort to expose “what goes on for the majority of motor vehicle accident claimants.

Source: http://www.southwesternontario.ca/news/local-voice-against-wrongful-benefit-denials-not-staying-silent/

Writing a book can lead to repercussions: Roseman

Jokelee Vanderkop fought two insurance companies to get benefits after a car accident. Now she’s fighting to keep her benefits after writing a book.

By: Ellen Roseman On Your Side, Published on Tue Feb 10 2015

 

Jokelee Vanderkop wrote a book about how to fight your insurance company to get benefits. Now she’s preparing for another fight about her benefits.

In 2008, she won a lawsuit against the Personal Insurance Co. after a car accident left her unable to continue working as a high school teacher. When the company appealed in 2009, she won again.

She was 44 when injured in 1997. Now 62, she lives on income replacement benefits paid by her insurer. 

Hoping to share her experiences of a court battle that lasted more than a decade, she put out a self-published book, So You Think You’re Covered? The Insurance Industry Ripoff, in 2013.

Most of the 200 copies were given away to friends or dumped, she says. When told the writing was weak, she published a revised edition last fall and sold 84 copies (at $25 apiece).

As part of her publicity campaign, she was a guest on an hour-long CBC radio phone-in program on Jan. 21, Ontario Today. It didn’t take long for her insurance company to follow up.

“I received a letter, dated Jan. 31, saying I now had earnings that could be deducted from my benefits entitlement,” she says. “They said they could not consider any further payments until I submitted my earnings statements and my tax returns for the last five years.

“The insurance company has a right to request information, but normally they tell you it’s required in order to continue benefits. In my case, they cut me off first. This is pure intimidation.”

Desjardins General Insurance Co., which owns The Personal, said there was a misunderstanding about her benefits being cut off.

“When we learned that Ms. Vanderkop published and is promoting a book, we sent her a standard form asking for copies of her tax returns,” explained spokesperson Joe Daly.

“Under the legislation, a portion of any income she earns from the book, or any other source, could be deducted from the weekly income replacement benefits we send her. We naturally assume that she wrote the book to earn income.

“Please note that we have not cut off her benefits and have no intention of doing so. If her tax returns indicate that she has little or no income from the book or other sources, then her weekly entitlement payments will not be affected.

“We didn’t send the note to intimidate Ms. Vanderkop. We were just curious if she was now working as a writer, which is a difficult and demanding job, and earning income.

“In retrospect, the claims adviser who decided to send the form obviously didn’t understand the realities of publishing in Canada. It’s tough to make any money writing a book.”

Rhona Desroches is chair of a non-profit advocacy group called FAIR, the Association of Victims for Accident Insurance Reform. She was a guest on the CBC radio show with Vanderkop.

“We heard from six to eight callers, who all had benefit claims that were about seven years old,” she says. “The people were injured and not in the best shape. I found it very moving.”

Desroches has heard from many frustrated insurance customers. She finds Vanderkop’s story a bit more complicated than most because there were two insurers battling it out at her expense.

She was insured by Personal under a motor vehicle policy and by Manulife under her employer’s group policy. When Manulife denied her application for long-term disability benefits in 1997, she ended up settling for a $57,500 lump sum during a private mediation in 2002.

After the mediation, Personal refused to pay income replacement benefits to Vanderkop, even though she met the test for entitlement, because of the settlement she made with Manulife. Personal argued that it could deduct any long-term disability benefits that might have been payable had Vanderkop been successful in her litigation. 

The Ontario Court of Appeal said income replacement benefits could be reduced by long-term disability benefits resulting from an accident. But Personal could not set off hypothetical benefits applied for, but refused. 

The long legal fight has led to other health problems for Vanderkop. But she’s keen to give tips to accident victims, such as not keeping a journal during a hearing (since it may be confiscated and used as evidence).

Desroches draws a lesson from the author’s tussle with her insurer about potential book earnings.

“I think it is outrageous that a person’s benefits are always at risk,” she says. “Settling a case with an insurer is no guarantee that the negative experience of making a claim with auto insurance benefits is really over.”

Ellen Roseman writes about personal finance and consumer issues. You can reach her at eroseman@thestar.ca or www.ellenroseman.com 

Source: http://www.thestar.com/business/personal_finance/2015/02/10/writing-a-book-can-lead-to-repercussions-roseman.html

Writing a book can lead to repercussions: Roseman

Jokelee Vanderkop fought two insurance companies to get benefits after a car accident. Now she’s fighting to keep her benefits after writing a book.

By: Ellen Roseman On Your Side, Published on Tue Feb 10 2015

 

Jokelee Vanderkop wrote a book about how to fight your insurance company to get benefits. Now she’s preparing for another fight about her benefits.

In 2008, she won a lawsuit against the Personal Insurance Co. after a car accident left her unable to continue working as a high school teacher. When the company appealed in 2009, she won again.

She was 44 when injured in 1997. Now 62, she lives on income replacement benefits paid by her insurer. 

Hoping to share her experiences of a court battle that lasted more than a decade, she put out a self-published book, So You Think You’re Covered? The Insurance Industry Ripoff, in 2013.

Most of the 200 copies were given away to friends or dumped, she says. When told the writing was weak, she published a revised edition last fall and sold 84 copies (at $25 apiece).

As part of her publicity campaign, she was a guest on an hour-long CBC radio phone-in program on Jan. 21, Ontario Today. It didn’t take long for her insurance company to follow up.

“I received a letter, dated Jan. 31, saying I now had earnings that could be deducted from my benefits entitlement,” she says. “They said they could not consider any further payments until I submitted my earnings statements and my tax returns for the last five years.

“The insurance company has a right to request information, but normally they tell you it’s required in order to continue benefits. In my case, they cut me off first. This is pure intimidation.”

Desjardins General Insurance Co., which owns The Personal, said there was a misunderstanding about her benefits being cut off.

“When we learned that Ms. Vanderkop published and is promoting a book, we sent her a standard form asking for copies of her tax returns,” explained spokesperson Joe Daly.

“Under the legislation, a portion of any income she earns from the book, or any other source, could be deducted from the weekly income replacement benefits we send her. We naturally assume that she wrote the book to earn income.

“Please note that we have not cut off her benefits and have no intention of doing so. If her tax returns indicate that she has little or no income from the book or other sources, then her weekly entitlement payments will not be affected.

“We didn’t send the note to intimidate Ms. Vanderkop. We were just curious if she was now working as a writer, which is a difficult and demanding job, and earning income.

“In retrospect, the claims adviser who decided to send the form obviously didn’t understand the realities of publishing in Canada. It’s tough to make any money writing a book.”

Rhona Desroches is chair of a non-profit advocacy group called FAIR, the Association of Victims for Accident Insurance Reform. She was a guest on the CBC radio show with Vanderkop.

“We heard from six to eight callers, who all had benefit claims that were about seven years old,” she says. “The people were injured and not in the best shape. I found it very moving.”

Desroches has heard from many frustrated insurance customers. She finds Vanderkop’s story a bit more complicated than most because there were two insurers battling it out at her expense.

She was insured by Personal under a motor vehicle policy and by Manulife under her employer’s group policy. When Manulife denied her application for long-term disability benefits in 1997, she ended up settling for a $57,500 lump sum during a private mediation in 2002.

After the mediation, Personal refused to pay income replacement benefits to Vanderkop, even though she met the test for entitlement, because of the settlement she made with Manulife. Personal argued that it could deduct any long-term disability benefits that might have been payable had Vanderkop been successful in her litigation. 

The Ontario Court of Appeal said income replacement benefits could be reduced by long-term disability benefits resulting from an accident. But Personal could not set off hypothetical benefits applied for, but refused. 

The long legal fight has led to other health problems for Vanderkop. But she’s keen to give tips to accident victims, such as not keeping a journal during a hearing (since it may be confiscated and used as evidence).

Desroches draws a lesson from the author’s tussle with her insurer about potential book earnings.

“I think it is outrageous that a person’s benefits are always at risk,” she says. “Settling a case with an insurer is no guarantee that the negative experience of making a claim with auto insurance benefits is really over.”

Ellen Roseman writes about personal finance and consumer issues. You can reach her at eroseman@thestar.ca or www.ellenroseman.com

 

 

Source :http://www.thestar.com/business/personal_finance/2015/02/10/writing-a-book-can-lead-to-repercussions-roseman.html

 

After my presence on CBC radio show, insurer cuts my benefits

January 8, 2015

Since I was on CBC's Ontario Today show on January 21st - 'So You Think You're Covered! (can listen to podcast by going to previous episodes), the car insurer paying my income replacement benefits has cut them without warning, Ten days after the show they prepared an Explanation of Benefits form and wrote: "Since you now have earnings which we can deduct from your weekly benefit entitlement, we cannot consider any further payments until we receive copies of earnings statements. You must submit a copy of each earning statement. Please note that we require documentation of any/all post accident income you have received. Please provide copies of your tax returns for the last 5 years."

You would think that they might first ask for these documents and then cut you off if you refuse, don't send them within a certain time period or have made a lot of money which you've been hiding. But I am found guilty from the get-go and lose my benefits immediately. I am cut off while getting to them what they request and are happy with the response. Going on public radio has displeased them tremendously so they are punishing me financially. For those of you who think people with serious injuries are scamming their insurers, think again. Winning my court case and the appeal doesn't mean they will ever leave me alone. People have no idea what they will have to face when they require their insurer to honour their policy for accident or disability benefits.

 

I have no idea what earnings they surmise me to have other than they think I am making money on the book, which was showcased on Ontario Today. It is interesting that they don't say what they think those earnings are based on, only that I have them. However, I am well in debt writing this book as I've been giving out copies all over the place to make people aware of what insurers do to legitimate claimants. The few book sales after the show are a pittance in relation to my disbursements.  I'm the first one to speak up by writing a book and they want to shut me up right quickly. And people think they're the good guys and claimants are the fraudsters. I won't be shut up. I am presently working (have been for weeks) on a major research piece backed by strong references (court cases, govt. docs, College of Physician and Surgeons and much more) which will show how shoddy these guys really are. This piece lays it on the line and exposes the industry with proof of altered assessment reports from catastrophic to non catastrophic, and much more. I can back up everything I say.

 

Insurers have the right to request your tax returns and send you to more medical evaluations even after you have won your case. But cutting off my benefits without warning, based on their notion that I now have earnings is incredible and is, as a matter of fact, intimidation and harassment. And this after an IBC rep (Insurance Bureau of Canada which is the industry umbrella for insurance companies) is on the show and probably ticked off to no end that someone had the audacity to write a book about what insurers do to claimants to deny their benefits as well as show readers how to fight back and get through the process successfully. A  good friend of mine who was in a serious car accident in May was sent  for an insurance assessment this past Jan. 7th. The assessor denied her claim verbally (didn't even have to wait for the forthcoming written report to get the news) saying, "It doesn't matter what I write on the assessment, the insurance company will deny it. If you appeal, they will send you to someone else and then deny that, because that is what insurance companies do."

Source: http://deniedbenefitclaims.com/blog.html

Ontario Today Show - Did you have to fight to get your insurance benefit?

@ noon:Did you have to fight to get your insurance benefit? w/ @InsuranceBureau @FAIRAssociation @DeniedBenefits #cbcott 1-888-817-8995
— Ontario Today (@CBCOntarioToday) January 21, 2015

Download the Podcast:
http://podcast.cbc.ca/mp3/podcasts/ontariotoday_20150121_55195.mp3

FAIR will be on the CBC Ontario Today show

FAIR will be on the CBC Ontario Today show Wednesday, January 21 at 12 pm. 

 

 At issue is what car insurers and extended health insurers put legitimate claimants through in order to deny their benefits. Jokelee Vanderkop, author of  ’So You Think You’re Covered! The Insurance Industry Rip-Off’, an all-too-real story about her 12 year long battle for benefits and her odyssey through Ontario’s dysfunctional auto insurance system, discusses her experiences. Rhona DesRoches, Chair of FAIR will be on an open talk line to answer questions about the thousands of seriously injured people with medically valid claims who are denied access to benefits.

 

You can find the Ontario Today show at 99.1 or 100.9 or 93.5 (check online for your area) or you can listen online. The call-in number is 1-888 817 8995. Online http://www.cbc.ca/player/Radio/

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