Canadian Insurance News

Showing posts with label ODSP. Show all posts

Wednesday, December 21, 2016

Bill to establish welfare rates based on cost of living introduced

“Over nine hundred thousand people in this province rely on Ontario Works or ODSP, but more than half of these families do not have enough to eat,” Miller said. “Children are going to school hungry. It has become impossible for the poorest people in this province to make ends meet.”

Sourc/more:

https://www.baytoday.ca/local-news/bill-to-establish-welfare-rates-based-on-cost-of-living-introduced-427193

Monday, December 12, 2016

The persistence of poverty in Ontario

Total benefit income for those who depend on Ontario Works (OW) and the Ontario Disability Support Program (ODSP) locks nearly 895,000 Ontarians into deep poverty, according to Ontario’s Social Assistance Poverty Gap (PDF), a May 2016 report authored by Kaylie Tiessen, an economist with the Canadian Centre for Policy Alternatives (CCPA).

Source/more:
https://nowtoronto.com/news/the-persistence-of-poverty-in-ontario/

Tuesday, December 22, 2015

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

Sunday, June 14, 2015

Simplify ODSP process

Re: Ontario rethinks complex disability reviews, May 17

Ontario rethinks complex disability reviews, May 17

In her interview with Laurie Monsebraaten, Mary Marrone of the Income Security Advocacy Centre gives us pause when she describes the process of Ontario Disability Support Program (ODSP) medical reviews as flawed, wasteful, and “careless with people’s lives.”

As a physician and a member of the Select Committee on Mental Health and Addictions, being careless with people’s lives is the last thing Helena Jaczek, the Minister of Community and Social Services, would want.

That’s why Ontario’s registered nurses, nurse practitioners, and nursing students urge her to simplify the ODSP application process. Right now, it is so complicated that more than half of community legal clinic cases involve ODSP appeals.

With more than half of these appeals being eventually approved by the Social Benefits Tribunal, this is not accountability but “denial by design.” We can and must be ever careful with the lives of every Ontarian, especially those most in danger due to health and disability challenges.

Doris Grinspun, CEO, Registered Nurses’ Association of Ontario, Toronto

Source: http://www.thestar.com/opinion/letters_to_the_editors/2015/05/29/simplify-odsp-process.html

Friday, May 29, 2015

Holding on to disability benefits an unfair struggle

They say the character of a society is judged by how we treat the most vulnerable amongst us. Those who live with a disability, whether physical or mental, that restricts their ability to work to support themselves and their families fall squarely into this group. The purpose of the Ontario Disability Support Program is to provide income to these individuals so they can survive. It's not a lot of money, and the benefits are notoriously difficult to obtain, but it serves as a crucial lifeline for many people in this province.

http://www.thestar.com/opinion/commentary/2015/05/28/holding-on-to-disability-benefits-an-unfair-struggle.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

Wednesday, May 27, 2015

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/

Thursday, May 14, 2015

Ontario may need to spend more to fix faulty social assistance program

TORONTO -- Ontario's minister of community and social services can't say whether the government will have to shell out more money to fix a support payment system that has already cost the province an additional $29 million.

http://www.ctvnews.ca/politics/ontario-may-need-to-spend-more-to-fix-faulty-social-assistance-program-1.2353911

Sunday, May 10, 2015

Liberal government ‘truly sorry’ for bungled welfare system rollout

Community and Social Services Minister Helena Jaczek has apologized and admitted that case workers weren’t properly trained on how to use the province’s new problem-riddled welfare caseload software.

http://www.thespec.com/news-story/5598726-liberal-government-truly-sorry-for-bungled-welfare-system-rollout/

People with disabilities deceived

The provincial system for disability assistance for those who require some assistance (either permanent or temporary) has many, many deceitful regulations.

In 2009, the Wesley Urban Ministry group produced a study called "No Community Stands Alone" and one sad reality from that study is adults end up on assistance for a variety of reasons, including a sudden illness, car accident or work injury for which there is no coverage.

http://www.thespec.com/opinion-story/5593153-people-with-disabilities-deceived/

Tuesday, May 5, 2015

Hard times on ODSP In Toronto

The Ontario Disability Support Program is designed to help those of us who are, for one reason or another, unable to earn a living. Last year there were 42,700 ODSP applications in Ontario.

More than half of these were denied.

On appeal — and it is a long, twisted, frustrating process — roughly a quarter of these initial denials end up being overturned.

I say roughly a quarter, but I am not taking into account all those people who, for one reason or another, simply give up in despair....

Source / more:

http://www.thestar.com/news/gta/2015/04/23/hard-times-on-odsp-in-toronto-fiorito.html

Tuesday, March 31, 2015

ACORN calls for a hike in disabled Ontarians' housing allowance

Members and volunteers of ACORN Ottawa gathered near the Human Rights Monument Wednesday to shine a light on problems with the Ontario Disability Support Program.

http://www.ottawasun.com/2015/03/18/acorn-calls-for-a-hike-in-disabled-ontarians-housing-allowance

Cost of Justice project

FAIR Association of Victims for Accident Insurance Reform

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

My name is Rhona DesRoches and I am the Board Chair of FAIR Association of Victims for Accident Insurance Reform - a not-for-profit that advocates for fair treatment of Ontario's accident victims.

I was just reading an article in Legal Feeds by Yamri Taddese regarding your study of the ill effects of the lack of access to justice on Canadian's health. I've taken a look at your website and from what I understand the study surveyed 3000 individuals across Canada.

I'm wondering if your ongoing study will include car accident cases in the civil courts? According to recently released statistics from StatsCan there are currently 61,063 auto insurance related cases that are in Ontario's civil courts. According to the latest data there are an additional 34,075 mediation or arbitration cases pending at the Financial Services Commission of Ontario Dispute Resolution System (DRS) unit. That's a total of 95,138 unresolved MVA claims that are in Ontario's courts alone and these are all people with physical injuries, often cognitively impaired and facing serious challenges in overcoming traumatic injury. An indication of the dysfunctional legal climate in Ontario is that the volume of auto insurance cases before the civil courts in Ontario is up 42% since 2009/2010 according to the StatsCan website, an increase in cases that is far greater than the other provinces who were part of the survey.

Victims must deal with their insurance company and comply with Ontario's legislation that requires attendance at third party for-hire medical expert assessments arranged by their insurer where a victim's injuries are more than likely minimized or deflated in order to control insurer pay-outs. This leads victims back to their own treating physicians who continue to try and help their patients - just because your insurer's bought and paid for opinion vendors say there is nothing wrong or have minimized an injury doesn't mean you are magically made better. In fact, the opposite is more likely to be true. Hobbling treating practitioners and favoring insurer driven medical opinions in our courts works against the health of MVA victims and significantly impacts health care costs through repeat doctor visits along the way to undoing the damage done by insurer medical 'experts'.

According to the Ontario auditor General's report in 2011, about half of all auto accident claims in Ontario are turned down by Ontario's insurers. On average that would be around 30,000 injured people each year who are injured and whose health is made worse by the lack of timely access to treatment and by the often vindictive treatment at the hands of their insurer. So victims, without basic funding (income replacement) often face bankruptcy and often have no access to needed rehabilitation. They are unable to reach their maximum recovery and they know it; they know it while its happening to them, and that they are losing the window of opportunity so they are definitely at a higher risk of developing psychological issues. Many victims suffer from PTSD and it isn't always from the accident trauma itself but is caused by the protracted claims experience while they wait for justice in our courts.

Ontario's insurance companies have a delay and deny business model that causes serious harm to those who find they must use the insurance product. I have yet, in my capacity of assisting these individuals, to meet a MVA victim, including myself, that wasn't harmed psychologically at the hands of the insurer that denied their legitimate claim.

Your study is based on the economic costs of one extra visit per year to deal with stresses related to having a court case. From my experience in dealing with MVA victims I can tell you that there would be multiple of visits per year to treating physicians while going through Ontario's No-Fault Auto Insurance system. Victims are required by law to attend at insurer medical examinations (IME) many times during a claim and there is a proliferation of biased medical experts in the system whose partisan reports have been prepared for use in our courts. An accident victim will often wait 5 to 8 years to finally get to a hearing and the longer it takes to get there the more money is made by those who serve them, Ontario's insurers, defense and plaintiff lawyers, and medical assessors. Some victims are sent to up to 47 IMEs during the course of a denied and delayed claim and there would be an equal or greater number of medical visits through our public systems. OHIP, welfare and Ontario Disability Support Program (ODSP), all pick up the tab when insurers fail to pay.

The dysfunctional auto insurance scheme in Ontario is based on, and indeed dependent on, these bogus and substandard medical opinions to delay and deny claims and the subsequent backlog of cases in our courts is the result. Ontario's third party medical assessors oversight consists of self-regulatory colleges who protect their member interests over the public's interest and so that secrecy and protection is a fundamental problem. The lack of fiduciary duty to MVA claimants, who are considered clients and not patients, and to whom the physician owes no duty of care further marginalizes the accident victim. The lack of transparency and regulatory oversight from Ontario's colleges is at the core of the court dysfunction (and that is a necessity to Ontario's insurers) has contributed to the lack of public trust in this abysmal and virtually non-existent oversight is chronicled in CPSO's ongoing consultation on transparency.

So when looking to examine the user-centered perspective to understand the connections between the law and legal problems there would likely not be a better sample to look at than Ontario's auto accident claimants who are stuck in a system that criminalizes and punishes them at every turn while denying timely access to justice. All while Ontario's elite and privately paid physician assessors put up obstacles in the way of their achieving wellness and whose boldly biased and often unqualified opinions are given a free pass by their colleges which allows them to continue to sabotage both victims and our courts with impunity in a system that causes medical harm.

Ontario's answer to the court backlog is to pass Bill 15 and a Licensed Appeal Tribunal (LAT) system of hearings without correcting the underlying dishonesty in the system. The future looks bleak for victims who will be simply shoved through the dishonest system faster.

I look forward to further updates on your study and hope that you will include MVA victim circumstances and outcomes in your upcoming material. If I can be of assistance in respect to your study, please let me know. I've included links below that substantiate the facts and figures of what I've said above and much of the information can also be accessed on the FAIR website at http://www.fairassociation.ca/ I've also included the link to Ontario's Insurance Act, a document that virtually guarantees that one must hire legal representation to get through the system.

Best regards

Rhona DesRoches

FAIR, Board Chair

579A Lakeshore Rd. E

PO Box 39522

Mississauga, ON, L5G 4S6

http://www.fairassociation.ca/

2014 - 61,063 active court cases/Ontario/auto accident http://www5.statcan.gc.ca/cansim/a47

2013 - DRS Interim Report 23,323/mediation and 10,752/arbitration

http://www.fin.gov.on.ca/en/consultations/auto/request-for-submission-interim-report.html#_Toc371082800

Ontario Auditor General 2011 report on Auto Insurance http://www.auditor.on.ca/en/reports_en/en11/301en11.pdf

Current College of Physicians and Surgeons of Ontario CPSO consultations in respect to transparency at: http://policyconsult.cpso.on.ca/?page_id=5062 http://www.cpso.on.ca/Policies-and-Publications/Consultations and http://policyconsult.cpso.on.ca/?page_id=4981

HCDB 2014 Report with stats on MVA victims http://www.fairassociation.ca/wp-content/uploads/2015/02/HCDB-standard-report-2014h1-final.pdf

Resolving auto insurance benefit disputes stacked against public http://www.torontosun.com/2015/01/24/resolving-auto-insurance-benefit-disputes-stacked-against-public

http://www.fairassociation.ca/wp-content/uploads/2014/11/Before-you-pass-Bill-15.pdf

http://www.fairassociation.ca/the-independent-medical-examination-imeie/

http://www.fairassociation.ca/wp-content/uploads/2014/12/more....pdf

http://www.fairassociation.ca/choosing-a-lawyer/

http://www.fairassociation.ca/wp-content/uploads/2015/02/Whats-in-YOUR-legal-bill2.pdf

Insurance Act ONTARIO REGULATION 34/10 STATUTORY ACCIDENT BENEFITS SCHEDULE — EFFECTIVE SEPTEMBER 1, 2010 Consolidation Period: From January 1, 2015 to the e-Laws currency date. O. Reg. 236/14. http://www.e-laws.gov.on.ca/html/regs/english/elaws_regs_100034_e.htm#BK61

Legal pains: The cost of justice includes physical health http://www.canadianlawyermag.com/legalfeeds/

Sunday, February 22, 2015

Fair Association letter to the Minister of Finance

FAIR Association of Victims for Accident Insurance Reform

579A Lakeshore Rd. E

PO Box 39522

Mississauga, ON, L5G 4S6

mailto:fairautoinsurance@gmail.com

http://www.fairassociation.ca/

February 13, 2015

Dear Minister Sousa

Thank you for the opportunity to convey our concerns to the Minister of Finance office in respect to the upcoming Ontario budget.

FAIR is a not-for-profit organization whose concern is that Ontario’s vulnerable auto accident victims are now a very disadvantaged group within Ontario’s population. Big business concerns continue to eclipse the fair treatment of injured and disabled citizens who are caught in Ontario’s dysfunctional auto insurance scheme.

Without proper consideration from your office and government legislators we see innocent and often cognitively impaired MVA victims impoverished, without adequate rehabilitation resources and punished by a system that no longer functions. Present and past ‘fixes’ have only made the system worse and the province has incrementally taken on more and more financial responsibility for the 50-60,000 people injured on our roads every year. The public unknowingly pays through our social nets when Ontario’s wealthy insurers fail to live up to their contracts. Further, these public systems are not designed for, and don’t have the resources for the care of traumatically injured auto accident victims.

Ontario’s auto insurers habitually evade their contractual obligations to consumers and this is substantiated by the numbers when about half of all injury claims (pg 47) must use the courts to hold their insurer accountable.

Access to benefits hinges on the (highly profitable) expert medical report; the information and opinion that documents injuries and sets insurers on a path to adjust claims and injured victims on the road to recovery. Recovery simply isn’t happening because Ontario’s Third Party ‘expert’ medical examinations and reports are without any standards and virtually no oversight from their regulatory colleges. Family physician and treatment provider recommendations are conveniently trumped by highly paid medical experts whose allegiance is to the business who pays them and not the MVA victim. Failure to acknowledge and address this harm and dishonesty is causing not only trauma to victims but also additional costs to the publicly funded medical system where victims ultimately must address their injuries. That cost would not be insignificant.

There are now hundreds of thousands of individuals collecting Ontario Disability Support Program (ODSP) benefits and many of those people are unpaid MVA victims. This isn’t just a few people who fell through the cracks; it is a deluge of injured and disabled auto insurance claimants on our public supports when poor quality medical reports were used to disqualify them from accident benefits they paid for.

Recent changes like Bill 15 and the LAT will do nothing to fix the problem other than to shove MVA victims faster through the still dishonest system. In fact the incentive of reduced interest payable by insurers on overdue amounts owed to injured victims will only create more delays, denials and court actions and the resulting reliance on our public support systems such as welfare and ODSP. These are claimants whose access to ‘justice’ is limited to ‘if’ they can afford the expensive legal representation required to get through the process and so poverty quickly becomes the barrier to justice and it becomes the bonus to insurers.

Insurers talk about fraud and the high costs of claims but fail to address their own excessive legal costs and over spending (pgs 58, 59) by consistently spending more on assessments than treatment for claimants. What about the industry practice of paying $1000 cancellation fees to their IME providers and what does that add to the pockets of their medical opinion providers and ultimately take out of the claims dollars?

The auto insurance system is now so heavily skewed toward insurer interests and profit that the public is well on the way to be the major payer to auto accident victims – in other words, we pretty much have taxpayer funded public insurance. Private companies and their well funded lobby arm, the Insurance Bureau of Canada (IBC), have so successfully slanted coverage in their favour that it no longer serves Ontarians in either coverage or cost and has become a system so cumbersome and complex that it causes harm to those who must use the product.

Insurers have abdicated their responsibility and it requires a twisted form of laws and incomprehensible regulations in order to continue to fleece the taxpayers. Consumers are told they have adequate coverage but the dishonest medical opinion evidence shows that the system is without accountability and it has clogged up our courts and requires that our lawmakers even remove Charter rights in order to accommodate big business.

We are auto accident victims and their supporters and we are stuck in a system where it appears that those who have the power to make this a fair system now command a premium price for access for a “better chance of really connecting” with Ministers. This isn’t something that injured and disabled auto accident victims are prepared or can afford to engage in. We ask that you act in the best interests of the citizens of Ontario ALL of the time.

Respectfully, we cannot have a system where consumers are forced to buy a product that promises services that are delivered only half of the time and that downloads indiscriminately to our public supports while causing chaos in our court systems. All of these actions have a price to the taxpayer and should be addressed. The answer isn’t calling injured MVA victims fraudsters so as to justify slashing coverage. Or to prop up an industry whose business practices include the use of dishonest bogus and/or biased and indeed harmful medical reports in order to hike insurer profits. Inaction on these issues ensures that costs of an MVA end up being passed on to the public. This is something that the Minister of Finance and the Minister of Health have the power to change through regulation and enforcement. We hope that you will take steps to control Ontario’s insurers who thus far are bleeding our medical and support systems into dysfunction and deficit.

FAIR Association of Victims for Accident Insurance Reform

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

How to clean up the inconvenient stench in Ontario politics: Cohn

Ontario is the Central Canadian province that remains the Wild West of political fundraising in this country.http://www.thestar.com/news/queenspark/2015/02/11/how-to-clean-up-the-inconvenient-stench-in-ontario-politics-cohn.html

Source: http://www.fairassociation.ca/

Hundreds of ODSP workers rally across Ontario to protest SAMS breakdown

TORONTO, Feb.12, 2015 /CNW/ -

Hundreds of frontline workers with the Ontario Disability Support Program (ODSP) rallied in towns and cities across the province today in a show of solidarity with recipients of the program whose social assistance payments have been compromised by a deeply flawed computer system.

"It's painfully obvious: SAMS has introduced chaos into Ontario's social assistance system placing an incredible amount of pressure on frontline staff and depriving social assistance recipients of essential income, employment and medical supports," Ontario Public Service Employees Union President Warren (Smokey) Thomas told a crowd of ODSP workers and supporters in downtown Toronto today. OPSEU represents more than 2,000 ODSP caseworkers and support staff in 30 communities across the province.

"For months prior to the launch of SAMS, OPSEU members were incredibly vocal about the shortcomings and deficiencies of the flawed software. You warned the government multiple times that SAMS was incapable of administering critical program functions and that the software was not ready to be implemented," said Thomas. "Unfortunately, those warnings were ignored."
The OPSEU president repeated his call that Ontario Premier Kathleen Wynne should fire Helena Jaczek, minister of community and social services, for her failure to heed the warnings of ministry staff that launching SAMS last autumn was premature and that the system contained flaws that required correcting.
The rallies coincided with the union's application today to seek a Court order to suspend the SAMS program from use until it can provide reliable, timely and accurate benefits to those in need. OPSEU was joined in its application by community groups and affected recipients.

Thomas said OPSEU has no intention of letting up pressure on the government to thoroughly examine the troubled computer system and what steps must be taken to fix the problems.

And he paid tribute to the tireless work of those OPSEU members who ensure that ODSP and Ontario Work recipients are treated with the dignity to which they are entitled.

"You carry the weight of your client's hardships," he said. "You put in the time and energy to try and resolve problems created by SAMS. You work to ensure vulnerable people are not forced to go without."

SOURCE Ontario Public Service Employees Union (OPSEU)
For further information: Warren (Smokey) Thomas, 613-329-1931

Source: http://www.newswire.ca/en/story/1486465/hundreds-of-odsp-workers-rally-across-ontario-to-protest-sams-breakdown

Friday, February 20, 2015

Why not tell the Minister of Finance what you think about downloading the costs of accident victims to the public systems where the taxpayer is picking up the tab. Or how the the bogus and biased medical reports commissioned by Ontario's insurers to deny claims is affecting victim's health and how that increases the use of our publicly funded OHIP system and social supports. Or the ODSP or even CPP disability. Or ask why our courts are clogged down with unpaid auto insurance claimants trying to hold their insurer accountable and who is paying for that? Or why MVA victims are often forced to rely on foodbanks?

Consider ccing your MPP or indeed all of the MPPs who are the ones that keep passing the legislation that is harming vulnerable MVA victims. You can find a list of MPP emails at: http://www.ontla.on.ca/web/members/member_addresses.do?locale=en or see complete list below.

WHAT MATTERS TO YOU?

The Budget affects all Ontarians – that’s why we’re looking for your input and ideas for the 2015 Ontario Budget.

Email:submissions@ontario.ca

http://www.fin.gov.on.ca/en/consultations/prebud/