Cost of Justice project

FAIR Association of Victims for Accident Insurance Reform

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

Hi

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/

 

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/

IBC wants regulation for personal injury lawyers

Monday, 23 February 2015 08:00 | Written By Yamri Taddese

The Insurance Bureau of Canada says it would like to see regulatory oversight of how personal injury lawyers structure their contingency fees due to what it calls a major gap in transparency in the auto insurance system.

“We need to at least review this issue. Why aren’t we talking about this?” says Ralph Palumbo, Ontario vice president for the Insurance Bureau of Canada.

All key players in the auto insurance system, including insurance companies and rehabilitation providers, must adhere to regulations around their fee structures, says Palumbo, who notes additional players like tow-truck drivers are now subject to regulation thanks to changes under Bill 15.

“It appears that the only major stakeholders in the system that really [aren’t] regulated are personal injury lawyers,” he says.

Palumbo says trial lawyers should file their fee arrangements with the office of the superintendent of insurance or another body that will review the financial impact these fees may or may not have on insurance costs and premiums.

“There is a sense that often providers, whether they’re lawyers or rehab providers, push claims to a higher level so that the awards are higher. That’s the sort of thing that we need to guard against,” says Palumbo.

“No one is saying the claimant shouldn’t get what is reasonable in the circumstances, but we want to make sure there aren’t outside financial pressures that will drive up those costs.”

Barbara Taylor, director of policy at Insurance Bureau of Canada, says the change will protect consumers while allowing the government to track the impact of lawyers’ fees on the auto insurance system.

“First off, we’re asking for a consumer-friendly fee disclosure statement,” she says.

“So that’s something where we want to make sure the consumer has clear transparency on that arrangement that they have with the lawyer. Then we’re asking that that information also be shared with someone like the [Financial Services Commission of Ontario] superintendent, who can then use that information to assess the impact on auto insurance as well as perhaps issue an annual report.”

Ontario Trial Lawyers Association president Steve Rastin says the Insurance Bureau of Canada is suggesting lawyers work harder in order to maximize the value of the case if they have a stake in it.

“You know what, that’s an insult to lawyers,” says Rastin.

“It implies that I won’t do my utmost for my client unless I have a piece in the action. You know what, I think lawyers everywhere should be insulted by the allegation that we’ll work harder for our clients when we have a stake in it.”

He adds: “I work to the best of my ability for every client whether I’m doing the file on a pro bono basis or an hourly rate or contingency rate. To argue that I work harder for somebody because I have a contingency fee, it would be a fundamental violation of the professional code of conduct, our ethical obligations, and I think there are right-thinking lawyers everywhere who put their best effort in for the client no matter how they’re going to be paid.”

Rastin also says there are already sufficient oversight mechanisms in place to guard against improper conduct by lawyers. He calls the Insurance Bureau of Canada’s call for more regulation “a smokescreen” to mask the hefty profits earned by insurance companies.

“I can tell you that what I bill my clients is absolutely transparent,” says Rastin.

“My client knows in the beginning what I’m going to bill them and at the end. For people that are under disability, minors or people in vulnerable situations, we have to get court approval for our accounts. There is already an oversight body in place.

There are lawyers [who] are disciplined for not billing according to proper practices. I don’t want the insurance industry, which meddles in every private area of our lives already, I don’t want them meddling in my personal relationship with my clients.”

Contingency-fee arrangements between lawyers and their clients aren’t to blame for insurance companies’ costs, he adds, noting there are caps in place for the damages plaintiffs can collect for several types of injuries.

Plaintiffs often opt to settle for fear of cost orders that would mean losing their life savings, Rastin adds.

To Rastin, the noise around the issue is a distraction from what he calls “way more serious” concerns with the auto insurance system. “For instance, why are there government-mandated returns on capital for the insurance industry that are something like 11 per cent?” he asks.

Palumbo, however, says it’s only “natural” that lawyers are resistant to regulatory oversight around their fees.
“It’s pretty natural. They have a vested interest in making sure there is no regulatory oversight on their pricing schemes,” he says.

“We don’t think that’s appropriate,” he adds.

Part of the issue, he says, is transparency. “At the end of the day, if the government decides not to impose a cap [on contingency fees], that’s fair enough. But why is this a problem to talk about transparency? I don’t quite understand that.”

The issue isn’t contingency fees themselves, according to Palumbo, but whether those arrangements are always appropriate. “We’re not suggesting for a moment that any of this shouldn’t happen; we’re not against contingency fees. All we’re saying is that the last piece of the [transparency] puzzle is personal injury lawyers, really. No one is reviewing that aspect of the auto insurance system.”

COMMENTS

Discuss IBC wants regulation for personal injury lawyers:

Moira Gracey says:
2015-02-23 07:15 PM
is the IBC suggesting that injured people who have been thrown out of work and are subsisting on the much-reduced accident benefits available be required to pay lawyers up front by the hour? How can the IBC suggest - or the Law Times uncritically report - that lawyers' contingency fees are not regulated? Does Ontario Regulation 195/04 (appropriately entitled "Contingency Fee Arrangements") not count as regulation? Until the insurance industry agrees to a specific tax to fund enough legal aid clinic with enough salaried lawyers to represent all the customers from whom the insurance companies are inappropriately denying benefits, there isn't much alternative to contingency fee arrangements that won't leave injured people high and dry - and insurers laughing all the way to the bank. Insurers should try spending less money fighting claims than they do paying them - that might be a more effective way to lower premiums!

Devils Trumpet says:
2015-02-23 06:30 PM
Sorry to get you excited,the comments were intended for another post that had nothing to do with regulation of lawyers or insurance.My post here was copy and paste,it included a line from a seperate post entirely. I have no knowledge of any insider information regarding Ontario auto insurance.If I did,I doubt very much that I would announce it in this forum. I apologize for my inadvertent mistake,I will double check before I post in the future.

Peter Cozzi says:
2015-02-23 06:05 PM
I have advocated at FSCO for a Consumer Bureau mirroring the Insurance Bureau of Canada to advance the interests of consumers to Government funded by a levy per insurance policy paid for by the same consumers who pay their insurance premiums to Insurance companies every day which in part are used by those insurance companies to fund the IBC. Such a consumer body, properly funded, like the IBC, will be able to inform Government concerning insurance issues from the consumers perspective and thereby provide Government with a balanced view when considering legislative and regulatory changes such as the IBC proposal concerning contingency fees and more.

Tim Boyle says:
2015-02-23 05:56 PM
That Mr. Francis is a shill for the insurance industry is obvious, the only thing unclear is how much he is being paid for being so.

Stew Daroux says:
2015-02-23 05:36 PM
It just amazes me that someone can hold such a lofty position in the insurance industry and really not have a clue regarding the degree to which lawyers are regulated and fee arrangements are scrutinized. In British Columbia there is legislating specifying the maximum percentage fee a lawyer can charge without prior court approval. In addition, clients are notified as part of any Contingency Fee Agreement that they have the right to have the fee ultimately charged reviewed by the Court. They also have recourse to the Law Society of any Province which overseas the practice of lawyers in that jurisdiction. Where is the lack of "regulation" that Mr. Palumbo refers to?

Curious Cat says:
2015-02-23 04:47 PM
What kinds of documents are you alluding to?

Devils a Trumpet says:
2015-02-23 04:10 PM
Another attempt to control every aspect of a claim,the insurance industry once again portrays everyone but themselves as theives while they defraud rate payers and the public.Of course lawyers rip off clients,just not as bad as the government sanctioned theft by the insurance companies. Not one participant other than the claimant has one scintilla of integrity,their just a bunch of criminals running the system. Wait till insurance insider documents begin to surface soon.

Brian Francis says:
2015-02-23 12:30 PM
RE: "Plaintiff lawyers are the only ones fighting for the clients' rights... Plaintiff lawyers (OTLA) advocate for their own interests - not the interests of injured claimants. They aren't always the same. If that weren't true OTLA would long ago have fought against the proliferation of rogue experts who inhabit the system - rather than happily profit from shoddy assessments and endless assessment battles. The only people buying OTLA's "fearless champions of the injured" rhetoric are the plaintiff lawyers.Maybe if OTLA revoked the membership of lawyers who over-bill so badly they are written up in even the mainstream press - and revoked the membership of lawyers who blame dead students for the firm's failings - these indignant protestations wouldn't ring so hollow.

Darryl Singer says:
2015-02-23 12:11 PM
The entire personal injury system is stacked against plaintiffs. The statutory threshold, $30,000 deductible, powerful insurers who sit on AB money for years before they pay it out for necessary treatment. Plaintiff lawyers are the only ones fighting for the clients' rights and attempting to level the playing field. Certainly the insurers do not care. And the provincial government has continually made changes that benefit only the insurers and make it more difficult for the victims to collect.

Darryl Singer says:
2015-02-23 12:06 PM
Lawyers are already regulated by the Law Society and in many cases the Superior Court. The insurance industry has no place in the lawyer-client relationship. If the insurers actually paid what they were supposed to pay to accident victims, when they were supposed to pay, then there would be no need for personal injury lawyers in the first place. Lawyer's fees have no bearing on insurance rates. And the marketplace dictates. If my fees are patently unfair then I will not have any clients.

Brian Francis says:
2015-02-23 10:10 AM
How ironic. This column (Court rejects attempt to blame articling student for delay) in today's Law Times offers even more reasons why Ontario personal injury plaintiff lawyers need oversight. OTLA talks about oversight as an "insult". It is insulting to consumers (injured auto accident victims) to hear plaintiff lawyers trying to download their failings on to students.

Brian Francis says:
2015-02-23 09:41 AM
Raston characterizes oversight of personal injury plaintiff OTLA lawyers as an "insult". What is an insult is systemic over-billing - staggering unreglated, self-awarded premiums - and unfair CFAs. A glance at the FAIR website offers ample illustration of endless plaintiff lawyer over- billing problems. Added to the over-billing problem is another "insult" to clients in the form of OTLA's stubborn, obstructionist stance toward cleaning up the IME/IE system (proliferated with rogue "experts") which is driving up Ontario's auto insurance litigation costs by causing endless assessment battles. But what,exactly, is wrong with a"a consumer-friend ly fee disclosure statement". How is that an "insult"? And what do accident victims think? Why not ask FAIR? Perhaps on this issue (if no other) the IBC and FAIR can find common ground?



Source: http://www.lawtimesnews.com/201502234500/headline-news/ibc-wants-regulation-for-personal-injury-lawyers

Accident Benefits: Auto Collision Victims Shafted

Posted on  February 4, 2015

In late 2014, the Liberal Ontario government passed Bill 15, the “Fighting Fraud and Reducing Automobile Insurance Rates Act, 2014”. The new law only benefits multi-billion dollar insurance companies while giving auto collision victims in Ontario the shaft when in need of accident benefits. Here are some of the new lows coming from the Bill:

• all accident benefits disputes in Ontario will be heard by the Licence Appeal Tribunal (LAT)
• the right to go to court for accident benefits disputes has been taken away from auto accident victims
• interest payable by an insurance company on benefits that should have been paid only starts when the injured victim files for mediation and not from when the insurer unfairly denied paying the benefits
• the interest rate payable on damages for injuries to a person innocently injured has been reduced from 5 percent, which is the standard for all personal injury damages owing in all cases in Ontario to 1.2 percent for motor vehicle cases

The most egregious change is the removal of the right for auto accident victims to access the civil courts if an insurance company refuses to pay auto accident benefits. The right to access our courts to settle disputes is a fundamental right for all Canadians. The deck has been stacked against auto accident victims for years and this is another Ace for the insurers.

Why are Ontarians being denied the right to have disputes over accident benefits heard by an impartial and independent decision maker? The reason is simple, insurance companies who give lots of money to the Ontario Liberal government wanted to take away the right to ensure that they don’t have to pay as much for claims.

Alan Shanoff recently wrote a column in the Toronto Sun exposing the danger to all auto accident victims from having their disputes with their insurers now being heard by the LAT. From what he says in his column we can expect the following.

• more delays in getting disputes heard
• disputes heard by individuals without experience or training in the complex auto accident benefits regime
• majority of claims being denied

Currently, the LAT hears disputes for liquor licence appeals, reviews of medical suspensions of drivers’ licences, motor vehicle impoundments and claims under the Ontario New Home Warranties Plan. Mr. Shanoff refers to a study that was conducted by the Canadians for Properly Built Homes (CFPH), a national, non-profit consumer protection organization that analyzed the 2006-2013 LAT decisions pertaining to homeowner appeals of Tarion decisions concerning new home warranties. During the eight-year period of the study, LAT (the tribunal that will be hearing auto accident disputes) refused 96 percent of homeowners’ claims. That is an outstanding failure rate. I can understand why the automobile insurers wanted to have the LAT decide auto accident benefits disputes. You can read Mr. Shanoff’s column by clicking here.

Since September 2010, auto accident benefits have continued to be reduced. These are accident benefits that every person in Ontario contracts for with a private auto insurance company to pay in the event that the person is injured in a motor vehicle collision. These are not “free” benefits or granted by the goodwill of the automobile insurance companies — these are benefits paid for with our premium dollars.

In response to the argument that the accident benefits paid need to be slashed because of fraud, I say show me the proof. The insurance companies have never been able to produce any solid evidence that there is any substantial fraud in auto insurance. What have we received in return for our auto insurance benefits being slashed? A mere 6.1 percent reduction in average auto insurance rates since August 2013. Hardly worth the cost of what we have lost.

Kristian Bonn, Personal Injury Lawyer
Bonn Law Office, Trenton/Belleville, Ontario

Source: http://bonnlaw.ca/2015/02/04/accident-benefits-car-crash/

No Appeal to Courts?

Letters to the Editor, Feb. 1, 2015 

 http://www.torontosun.com/2015/01/31/letters-to-the-editor-feb-1-2015

NO APPEAL TO COURTS?

Re “Car crash victims in for a rough ride” (Alan Shanoff, Jan. 25): I was rather disturbed to read about the changes in resolving auto insurance benefit disputes as described in Alan Shanoff’s column. Perhaps there may be reasons for the changes but I have never been convinced that the province of Ontario leadership really know what they are doing. However, what is really appalling is the reference, “Bill 15 removes the option of pursuing remedies through the courts and forces all accident benefit claims to be resolved without recourse to courts.” Since when does the provincial government have the authority to decide what should and can be decided in a court of law? This is a basic freedom in Canada and I don’t believe any province can override that freedom to have disputes settled by a judge in a formal court hearing. I sincerely hope that our elected representatives will have the courage to speak up and remove this section of Bill 15 as it is detrimental to all citizens of Ontario.

David C. Conway

Oshawa

Source: http://www.torontosun.com/2015/01/31/letters-to-the-editor-feb-1-2015

 

Personal injury lawyer launches challenge against Bill 15

by Donald Horne | 26 Jan 2015

 A lawyer has launched a constitutional challenge on behalf of automobile accident victims aimed directly at Bill 15.

Lawyer and advocate Joseph Campisi is launching a constitutional challenge in the Ontario Superior Courts, seeking a declaration that parts of the legislation that were recently passed by the Liberal Government are discriminatory and unconstitutional and should be inoperative.

“The right to access the Superior Courts is a fundamental right for Canadians.  I am concerned that the recent proclaimed legislation will deny this right to individuals who have been severely disabled,” said personal injury lawyer Joseph Campisi.  “Historically, the deck has been stacked against automobile victims. The recent amendments to the legislation have turned a bad situation into a worse one for these vulnerable individuals.”

In the fall, of 2014, the Ontario passed Bill 15, which took aim at fraud in the insurance industry with the aim of reducing insurance rates.

One of the legislative amendments changes how disputes between insurers and insured are settled, which has raised the ire of groups like FAIR and those in the health care industry, like the Ontario Rehab Alliance.

Historically, disputes could be brought before the Superior Courts or before arbitrators with expertise in interpreting insurance law.  Bill 15 has changed how disputes are resolved by giving the sole adjudicative power to individuals who will be appointed “at the whim of the Liberal Government,” said Campisi.

“No longer will these individuals be allowed to have the assurance of impartiality and independence that is a cornerstone of our justice system when litigating a claim against their own insurance company,” said Campisi. “I could not stand idly by and let this happen.”

These are the same decision makers who jurisdiction on matters ranging from film classification to upholstered and stuffed articles, Campisi went on to say, adding that unlike historical appointments individuals without any specialization or guaranteed independence or impartiality will be ruling on disputes that can run into the millions of dollars and will determine the quality of life that an automobile victim will face going forward.

“This application will challenge Bill 15 on the basis that it violates disabled person’s Charter s.15 (1) right to be free from discrimination,” he said. “Bill 15 is also being challenged based on s.96 of the Constitution which relates to the public’s right to have access to the courts.  The way in which Bill 15 is drafted opens the door to political interference.  The government of the day can choose who will hear any dispute and if the government does not agree with the arbitrator’s decisions, the government can get rid of the adjudicator the next day.  When it comes to lobbying the government there is little doubt as to who has the deeper pockets; automobile insurers or accident victims.  Introducing such laws is undemocratic and detracts from the rule of law.  This legal challenge will fight for disabled individuals’ right to fair treatment and the public’s right to access the impartial court system.”

Barb Taylor, the director of policy at the Insurance Bureau of Canada, had spoken out last Thursday on what she saw as “strong opponents” of those fighting for change in the insurance industry. Click here for the article, 15 per cent target for Ontario auto 'does not compute'

“We have strong opponents. These groups also have the ear of government and will seek media attention. Specifically, I am talking about trial lawyers, medical rehab providers and the NDP,” Taylor told those gathered for the 2015 Crystal Ball conference. “We are asking the (Ontario) government to require personal injury lawyers and paralegals who represent auto insurance claimants to submit to the Superintendent all information about their fees – including contingency fee arrangements, disbursements, court awarded and settled costs, and referral arrangements."

Source: http://www.insurancebusiness.ca/news/personal-injury-lawyer-launches-challenge-against-bill-15-187471.aspx?p=2

Personal injury lawyer launches challenge against Bill 15

A lawyer has launched a constitutional challenge on behalf of automobile accident victims aimed directly at Bill 15.

Lawyer and advocate Joseph Campisi is launching a constitutional challenge in the Ontario Superior Courts, seeking a declaration that parts of the legislation that were recently passed by the Liberal Government are discriminatory and unconstitutional and should be inoperative.

“The right to access the Superior Courts is a fundamental right for Canadians.  I am concerned that the recent proclaimed legislation will deny this right to individuals who have been severely disabled,” said personal injury lawyer Joseph Campisi.  “Historically, the deck has been stacked against automobile victims. The recent amendments to the legislation have turned a bad situation into a worse one for these vulnerable individuals.”

In the fall, of 2014, the Ontario passed Bill 15, which took aim at fraud in the insurance industry with the aim of reducing insurance rates.

One of the legislative amendments changes how disputes between insurers and insured are settled, which has raised the ire of groups like FAIR and those in the health care industry, like the Ontario Rehab Alliance.

Historically, disputes could be brought before the Superior Courts or before arbitrators with expertise in interpreting insurance law.  Bill 15 has changed how disputes are resolved by giving the sole adjudicative power to individuals who will be appointed “at the whim of the Liberal Government,” said Campisi.

“No longer will these individuals be allowed to have the assurance of impartiality and independence that is a cornerstone of our justice system when litigating a claim against their own insurance company,” said Campisi. “I could not stand idly by and let this happen.”

These are the same decision makers who jurisdiction on matters ranging from film classification to upholstered and stuffed articles, Campisi went on to say, adding that unlike historical appointments individuals without any specialization or guaranteed independence or impartiality will be ruling on disputes that can run into the millions of dollars and will determine the quality of life that an automobile victim will face going forward.

“This application will challenge Bill 15 on the basis that it violates disabled person’s Charter s.15 (1) right to be free from discrimination,” he said. “Bill 15 is also being challenged based on s.96 of the Constitution which relates to the public’s right to have access to the courts.  The way in which Bill 15 is drafted opens the door to political interference.  The government of the day can choose who will hear any dispute and if the government does not agree with the arbitrator’s decisions, the government can get rid of the adjudicator the next day.  When it comes to lobbying the government there is little doubt as to who has the deeper pockets; automobile insurers or accident victims.  Introducing such laws is undemocratic and detracts from the rule of law.  This legal challenge will fight for disabled individuals’ right to fair treatment and the public’s right to access the impartial court system.”

Barb Taylor, the director of policy at the Insurance Bureau of Canada, had spoken out last Thursday on what she saw as “strong opponents” of those fighting for change in the insurance industry. Click here for the article, 15 per cent target for Ontario auto 'does not compute'

“We have strong opponents. These groups also have the ear of government and will seek media attention. Specifically, I am talking about trial lawyers, medical rehab providers and the NDP,” Taylor told those gathered for the 2015 Crystal Ball conference. “We are asking the (Ontario) government to require personal injury lawyers and paralegals who represent auto insurance claimants to submit to the Superintendent all information about their fees – including contingency fee arrangements, disbursements, court awarded and settled costs, and referral arrangements."

Source: 

Resolving auto insurance benefit disputes stacked against public

By Alan Shanoff, Toronto Sun

First posted: Saturday, January 24, 2015 07:00 PM EST | Updated: Saturday, January 24, 2015 10:47 AM EST  

TORONTO - With last year’s passage of Bill 15, the “Fighting Fraud and Reducing Automobile Insurance Rates Act, 2014”, the handling of accident benefits disputes in Ontario is to be passed from the Financial Services Commission of Ontario (FSCO) to the Licence Appeal Tribunal (LAT).
There are obvious reasons for the public to fear this transition.

FSCO handles about 10,000 applications each year, compared to LAT’s 700.
FSCO arbitrators and mediators have a wealth of experience in a highly specialized area, while LAT members have no experience in accident benefits disputes.

Instead, LAT members have expertise in liquor licence appeals, reviews of medical suspension of drivers’ licences, motor vehicle impoundments and claims under the Ontario New Home Warranties Plan.

Courtesy of Canadians for Properly Built Homes (CFPBH), a national, non-profit consumer protection organization, we have a report analyzing 2006-2013 LAT decisions pertaining to homeowner appeals of Tarion decisions concerning new home warranties.

Tarion is the private corporation created by the Ontario government to protect new homebuyers and administer new home warranties, although its board of directors is controlled by builders.

CFPBH has concluded LAT’s “operations and performance need improvement both in relation to the adjudicators themselves (specifically in relation to self-represented parties) and the LAT’s management and administrative processes.”

The numbers in the CFPBH study present a dire picture for homeowners who dare to enter the LAT’s chambers.

During the eight-year period of the study, LAT gave homeowners a 96% failure rate in relation to major deficiency claims.

The annual failure rate for total issues presented by homeowners in the last three years of the study is 82%, 83% and 94%.

The number of appeals brought before LAT dropped from 119 in the first four years of the study to 69 in the last four.

It’s impossible to know why the numbers have dropped off but CFPBH believes many homeowners have given up and made repairs themselves while some have resorted to what they call “patch and run” tactics.

That is, homeowners patch up the deficiencies and place their homes on the market for resale without disclosing the builders’ defects.

Still others bypass LAT completely and pursue remedies through the courts.
Yet this very avenue has been taken away from those seeking accident benefits arising from vehicle crashes.

Bill 15 removes this option and forces all accident benefit claims to be resolved without recourse to courts.

Karen Somerville, President of CFPBH, believes LAT has “serious shortcomings” and purchasers of new homes urgently need — and deserve — a fair and appropriate appeal process for the largest purchase most consumers make: a home.

LAT’s numbers seem to support Somerville’s contention. Certainly there doesn’t appear to be a level playing field between homeowners and Tarion.
All of which begs the question, why was LAT chosen to administer the automobile insurance dispute resolution system?

Hopefully many current FSCO arbitrators will be moved over to LAT so their expertise won’t be lost.

But that doesn’t change the fact LAT members are part-time (other than the Associate Chair), appointed for temporary terms, receive per diem rates (other than the Associate Chair), and are government appointees.

Reappointment is at the pleasure of the Ontario cabinet, so they cannot be seen as independent.

Current FSCO arbitrators are full-time, unionized, public sector employees.
It is difficult to see how the transfer of jurisdiction from FSCO to LAT will serve to either fight auto insurance fraud or reduce rates, although it is easy to see how the transfer will result in massive new expenditures and may result in injustices.

But shouldn’t we first be fixing LAT and providing purchasers of new homes with meaningful remedies, before we throw 10,000 new auto insurance disputes at it?

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

 

Constitutional Challenge Launched Against Flawed Ontario Liberal Government Auto Insurance Legislation- Discriminatory and Unconstitutional

January 21, 2015

 

Toronto, January 21, 2015 – Joseph Campisi, lawyer and advocate, is launching a constitutional challenge in the Ontario Superior Courts.  Mr. Campisi is seeking a declaration from the courts that parts of the legislation that were recently passed by the Liberal Government are discriminatory and unconstitutional and should be inoperative.

“The right to access the Superior Courts is a fundamental right for Canadians.  I am concerned that the recently proclaimed legislation will deny this right to individuals who have been severely disabled.” said applicant and noted Personal Injury Lawyer Joseph Campisi.  “Historically, the deck has been stacked against collision victims.  The recent amendments to the legislation have turned a bad situation into a worse one for these vulnerable individuals.  No longer will these individuals be allowed to have the assurance of impartiality and independence that is a cornerstone of our justice system when litigating a claim against their own insurance company.  I could not stand idly by and let this happen.”

In the fall, of 2014, the Ontario Government passed Bill 15 which is titled Fighting Fraud and Reducing Automobile Insurance Rates.  One of the legislative amendments changes how disputes between insurers and insured are settled.  Historically, disputes could be brought before the Superior Courts or before sophisticated arbitrators with expertise in interpreting insurance law.  Bill 15 has changed how disputes are resolved by giving the sole adjudicative power to individuals who will be appointed at the whim of the Liberal Government.  These are the same decision makers who have jurisdiction on matters ranging from film classification to upholstered and stuffed articles. Unlike historical appointments, individuals without any specialization or guaranteed independence or impartiality will be ruling on disputes that can run into the millions of dollars and will determine the quality of life that an automobile victim will face going forward.

“This application will challenge Bill 15 on the basis that it violates disabled persons’ Charter s.15 (1) right to be free from discrimination.  Bill 15 is also being challenged based on s.96 of the Constitution which relates to the public’s right to have access to the courts.  The way in which Bill 15 is drafted opens the door to political interference.  The government of the day can choose who will hear any dispute and if the government does not agree with the arbitrator’s decisions, the government can get rid of the adjudicator the next day.  When it comes to lobbying the government there is little doubt as to who has the deeper pockets- automobile insurers or accident victims.  Introducing such laws is undemocratic and detracts from the rule of law.  This legal challenge will fight for disabled individuals’ right to fair treatment and the public’s right to access the impartial court system.”

For more information go to https://www.campisilaw.ca
Source Campisi LLP
For further information contact:
Cesar Carranza  cesar@campisilaw.ca

Source: https://www.campisilaw.ca/constitutional-challenge-launched-against-flawed-ontario-liberal-government-auto-insurance-legislation/

Misplaced exuberance over Ontario's Bill 15

December 20, 2014

Bill 15, the Fighting Fraud and Reducing Automobile Insurance Rates Act, has now been passed and many people sing its praises because they've been told its good but don't really understand why, other than it fights fraud and will save the insurance industry a lot of money, The true implications of this bill on accident victims is anything but good.

People like Bob Verwey  President of the Trillium Automobile Dealers Association (TADA) is exuberant in his praise for this new legislation. This bill is quite comprehensive and only in small part - the part Mr. Verwey talks about -i.e. reforms to the towing industry - actually helps fight insurance fraud. He is correct that the towing industry needed to be regulated and he may be right when he says that "many consumers have been taken advantage of by unscrupulous tow truck drivers and owners. Some tow truck drivers have coerced motorists into signing waivers or consent forms at the accident scene, allowing vehicles to be towed to a repair facility where the tow operator has a vested interest.

In some cases, tow operators will sell a collision repair job to the highest bidder, earning large commissions or kickbacks. All too often, consumers wind up paying expensive towing and storage fees because they didn't understand their options".  I find it odd though when he points out that: "There are roughly 1,200 tow truck operators and 3,000 tow truck drivers in Ontario, ..... and most of them operate with honesty and integrity. But a few bad apples have given the industry a bad name". This begs the question as to why we needed the Ontario government to step in and bring about legislation for just a "few bad apples". We will find a "few bad apples" in every industry, and also among individual claimants. However, Mr. Verwey doesn't see the forest for the trees in his exuberant praise of the Ontario government for throwing its might behind a "few bad apples". He talks about Bill 15 as if it only addressed the tow truck operators and owners and doesn't appear cognizant of what is behind the rest of the bill which is far from praiseworthy. He seemingly has little understanding about how much of the bill will not fight fraud but will rather serve as a gift of hundreds of thousands of dollars to the insurance industry and this at the expense of motor vehicle accident victims who have been seriously injured. And the reason for this is that one of the aspects of the bill reduces the interest rate that insurers had to pay on settlement amounts when they were less than expedient in paying their clients owed income replacement benefits. The rate for income replacement used to be 2% compounded monthly with interest rates for dragged out tort settlements set at 5% annually not compounded. This was to force insurers to expedite legitimate settlements. The government felt this rate was necessary so that insurers would pay what they owed more quickly as there was a tendency for insurers to use funds that were owed claimants as part of their "float" for investment purposes. Insurers knew they could earn much more to bolster their bottom line even with these high interest rates so it was not uncommon for legitimate claimants who didn't give up their fight to receive benefits to only have their cases settled in the eight to ten year range. Meanwhile, claimants received nothing and had to live off their savings or go broke.  The interest rate is now set at the market rate which at present represents penalty payments at a lowly not compounded annual rate of 1.3%. This rate reduction is the gift. Bill 15 has made it even more financially expedient for insurers to delay payment to legitimate claimants. But the legislation doesn't address insurance denials of legitimate claimants, the years of delays with claimants having to hire a lawyer if they want to stand a chance of getting their benefits, the frequent ineptitude of the IME (insurance medical examination) process which uses for hire medical experts to write reports that more often then not favour the insurer, if not in some instances outright change to a diagnosis written by a claimants medical doctor to downplay the injury (see my Dec 9/14 blog). And then, let us not forget the massively reduced benefits since September 2010 and the introduction of the MIG (minor injury guideline) category which ties most seriously injured claimants to $3,500 for rehabilitation, with the insurer being able to take up to $2,200 of that to cover their assessments. Heck,  the 15% premium reduction could easily have been made just on what insurers saved in 2010.

 Bill 15 also revamps the dispute resolution system for accident benefits to the detriment of accident victims by eliminating the right to sue insurance companies for the denial of benefits. Insurers rarely pay benefits unless the claimant hires a lawyer. 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? Your case is medically valid and all your medical ducks are in a row. Yet, not only will you usually not get those benefits on the merit of your medical condition but you will have to hire a lawyer, and probably have to go to court to get what you paid for. Well, if you can no longer sue which is what most of us had to do to get paid, and can only go through yet another insurance mediation process which will rarely rule in your favour, how is it that Bill 15 is being touted as the next best thing to sliced bread for insurance claimants. It is, however, the next best thing to sliced bread for the insurance industry.

Steven Polak, a personal injury lawyer with Lerners LLP says that if this legislation goes through (which it now has) "It would be a victory for multi-national behemoth insurers, at the expense of the most vulnerable injured members of our Province. The publicity of cases when the learned Judges of our Courts have slapped insurers with punitive and bad faith awards for wrongful conduct are one of the only means of defence that we have to keep insurers in check. We should not give that away. We should protect it at all costs". He goes on to say, "I have had more than a few cases where insurers have denied benefits (including a recent car accident injury lawsuit in Oshawa/Whitby) for what I considered to be completely outrageous reasons, and we started a lawsuit claiming for punitives, which then met with a reversal of the position by the insurer. Relegating these disputes to some back-room licensing tribunal that just deals with one benefit is far different than the spot-light that a lawsuit with a punitive damages award shines on an insurer. We should not leave ourselves defenseless".

The biggest insurance coup is having people believe that fraud against insurers is the name of the game so any one who is denied must be scamming because otherwise they would be paid. Go to FAIRAssociation.ca a not-for profit association that represents motor vehicle accident victims and ask Chair, Rhona Desroches how often legitimate claimants dealing with a serious injury and/or brain impairments are denied, intimidated, harassed and belittled with many going broke while fighting their insurer with all the emotional implications of having to fight their insurer and deal with a dramatically-changed lifestyle. Google Alan Shanoff of the SUN or Ellen Roseman of the Toronto Star and inform yourself about the other side of the equation - the side that most of us can't even phantom or read "So You Think You're Covered! The Insurance Industry Rip-Off". Can it be that insurers also deal in fraudulent behavior!? - and let's not even talk about extended health carriers or WSIB. Keep your fingers crossed that you are never in a serious accident that requires rehabilitation and income replacement benefits because you can't consistently work at anything that will pay you a living wage. This is when your insurer and all the premiums you have paid will fail you.

Our legislators have rubber stamped a bill of which they know little and are patting themselves on the back for a job well done. They certainly didn't give much time (15 minutes) for the likes of FAIR to present their case on why Bill 15 isn't a good bill. That lack of input didn't apply to the car insurance industry, IBC and all its insurance cohorts.

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

Bill 15: Further Erosion Of Rights And Benefits For Auto Accident Victims

Last Updated: December 2 2014

 

Article by Andrew C. Murray

Lerners

 

Bill 15, Fighting Fraud and Reducing Automobile Insurance Rates, 2014  received Royal Assent on November 20, 2014.

The entire bill can be found by following this link: http://www.ontla.on.ca/web/bills/bills_detail.do?locale=en&Intranet=&BillID=3007

This Bill amends four pieces of provincial legislation:

1. The Consumer Protection Act, 2002
2. The Highway Traffic Act
3. The Insurance Act
4. The Repair and Storage Liens Act

Additionally, because of the changes to the Insurance Act, it also provides for amendments to the Financial Services Commission Act, 1997, the Licence Appeal Tribunal Act, 1999, and the Motor Vehicle Accident Claims Act.
The Insurance Act changes have not yet come into effect.  These amendments will only come into force on a date, yet to be named, by proclamation of the Lieutenant-Governor.
There are substantial changes afoot for injured motorists:

• Arbitrations, formerly conducted through the Financial Services Commission of Ontario ("FSCO"), will be conducted instead by the Licence Appeal Tribunal ("LAT"), a little known tribunal that has historically arbitrated matters far removed from the volume and complexity of statutory accident benefit claims.  It is unclear how FSCO can be disbanded and the LAT upgraded to handle the volume of disputes that need resolution.  As I have posted in an earlier blog, we currently have an arbitration backlog at FSCO.  It is unclear whether the FSCO arbitrators will be transferred to LAT, or whether a whole new slate of arbitrators will be added to LAT.  It is abundantly clear that LAT could never handle the number of disputes that would need adjudication, absent a significant expansion to its roster of arbitrators.   The existing FSCO arbitrators possess a great deal of specialized knowledge about statutory accident benefits.    It is hoped that their expertise will not be lost with this shuffle.
• Coupled with the diversion of arbitrations to the Licence Appeal Tribunal will be a prohibition on the right to sue in the Superior Court of Justice for any accident benefit dispute.  The appeal path from the LAT will be an appeal directly to the Divisional Court.  It is unfortunate that the government did not heed the unanimous call of such professional organizations as The Advocates' Society, The Ontario Trial Lawyers Association, and the Canadian Defence Lawyers, each of which pleaded with the government not to implement the prohibition on accident benefit lawsuits.
• Currently the prejudgment interest rate on claims for pain and suffering in personal injury actions is fixed at 5% pursuant to Rule 53.10 of the Rules of Civil Procedure.  Bill 15 now exempts motor vehicle claims from the 5% prejudgment rate that would otherwise apply to non-pecuniary claims.  Once Bill 15 comes into force, the rate of interest applicable to the pain and suffering portion of an award will be equal to the prescribed rate as outlined in the Courts of Justice Act, which, is currently 1.3%.  There will be a reduced incentive for insurers to settle claims.  The cost of delay will now be less than the likely yield on investments made by insurers.  No other personal injury claimants are singled out like this.  Injuries that arise from a slip and fall, or an assault, or by any means other than as a result of a car accident will still attract the 5% prejudgment interest rate set by Rule 53.10.
• There will be many details to follow, being outlined in regulations that have yet to be drafted or distributed to the public.  As with much of what the government does "the devil will be in the details".  It is expected that the uncertainty generated by Bill 15 will require litigation for years to come.  One thing that is not uncertain is the continual erosion of the rights of injured motorists and those who have been injured by a motorist

www.lernerspersonalinjury.ca
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

Source: http://www.mondaq.com/canada/x/357478/Personal+Injury/Bill+15+Further+erosion+of+rights+and+benefits+for+auto+accident+victims
 

The wool over our eyes

Nov. 30, 2014

The online magazine, Canadian Underwriter.ca posted a Nov. 24th article wherein the insurer Aviva Canada extols the virtue of the passing of Bill 15 which will come into effect tomorrow. People think this bill will be beneficial to them but it will affect accident victims adversely.  In their article they say the following but you need to read on:

“We are pleased that the Ontario government passed Bill 15 without issue, it is a good first step,” Karin Ots, senior vice president of regulatory and government relations for Aviva Canada said in a statement.

“But to truly affect long-term change for the Ontario auto insurance system, we need to reduce claims costs to be in line with other provinces. The insurer says that for every $1 of premium it earns, $0.65 is paid out in claims costs.
“Claims costs need to come down in order to reduce premiums, especially when 92% of Aviva's policyholders in Ontario do not make a claim,” it said.
In Ontario, accident benefit claims have an average cost of $26,863 compared to $3,628 in Alberta, the insurer also noted, based on 2012 data from the General Insurance Statistical Agency (GISA).

Of those costs, 48% go to non-treatment expenses, such as legal fees and assessments, versus the 52% that go to actually treating of victims, based on Aviva’s own data." But figures quoted below on $ paid by insurers to accident victims  by FAIRAssociation,ca, (Rhona Desroches) are far different than the insurer's figures.

So I put to you, how is it that the insurer is complaining about its costs when it is in the business of collecting premiums to cover individuals when they have a car accident and are injured and 92% of policyholders do not in fact make a claim. 
So if only 8% are making a claim, (chances are  8% of people making claims are not all fraudulent) why did we need legislation to increase insurer's profits? Also, if average claims costs are $26,863 or 48% for non-treatment expenses such as legal fees and assessments, then a whole lot of money is spent by insurers to not pay claimants but to pay their legal representatives and their for hire-medico-experts in order to delay, deny, do surveillance, deny some more, cut off benefits if they were started, deny some more and ignore medical reports by physicians other than IME hires. Moreover, medical and rehabilitation benefits are limited to $3,500 in the minor injuries category, a category which people even with more serious injuries get stuck in unless they fight legally to access the $50,000 they are entitled to under their policies for serious injuries - and then the insurer has the right to deduct their assessment costs up to $2,200 out of this $3,500. One wonders why the insurers are complaining. They seem to have a pretty sweet deal.

Rona Desroches, Chair for FAIR Association of Victims for Accident Insurance Reform points out that "what is most shocking is the fact that any insurer (ie. Aviva) is paying out such substantial sums for defending against claims, 44 million dollars in just 2013 alone. This is just one insurance company paying an average of $7,719.30 in legal defence costs per claim - well above the average amount paid to claimants in 2013. See pg 24 of HCDB report where insurers paid out an average of $4745.00 ($3,934 - $5,557) to injured MVA victims in 2013. The amount paid to victims in the first 6 months of 2014 was a mere $1,790 per claim – meaning that the legal defence costs are now four times as much as the value of what a claimant gets from their insurer. http://www.ibc.ca/en/car_insurance/documents/facts/hcdb%20standard%20report%202014h1%20-%20final.pdf  See pages 58 and 59."

She also adds: "The premium paying public knows nothing of the machine that insurance has become – they all believe that they will be covered if they need it. They will continue to believe this even after the vote on Bill 15 because no one will advise them that on Monday they had certain coverage and on Tuesday the coverage has changed. The public puts its trust in our representatives. Even while coverage is tripped away, people believe that our government is acting in THEIR best interests and not the interest of insurance companies."

Inform yourselves about what you'll be put through if you file after being seriously injured and needing medical and rehabilitation benefits - see "So You Think You're Covered" The Insurance Industry Rip-Off" at www.deniedbenefitclaims.com

Source: http://deniedbenefitclaims.blogspot.ca/2014/11/the-wool-over-our-eyes.html

Committee Transcripts: Standing Committee on General Government - 2014-Nov-05 - Bill 15, Fighting Fraud and Reducing Automobile Insurance Rates Act, 2014

05-NOV-2014_G004.htm  

 

STANDING COMMITTEE ON GENERAL GOVERNMENT

Wednesday 5 November 2014 Mercredi 5 novembre 2014

Fighting Fraud and Reducing Automobile Insurance Rates Act, 2014 Loi de 2014 de lutte contre la fraude et de réduction des taux d’assurance-automobile
Ontario Trial Lawyers Association
Insurance Bureau of Canada
Aviva Canada
The Advocates’ Society
FAIR, Association of Victims for Accident Insurance Reform
CAA South Central Ontario
North American Auto Accident Pictures, Towing Division
Associated Towers Guild of Ontario
Fair Value Committee
Ontario Rehab Alliance
Associated Canadian Car Rental Operators
Ontario Safety League
Towing and Recovery Professionals of Ontario
Canadian Finance and Leasing Association
Code Yellow Towing

Bill 15: New Auto Insurance Legislation Inhibits Access to Justice, Requires Amendment

With Bill 15, introduced in July 2014, the government has brought forward amendments that were initially introduced earlier this year. OTLA welcomes the new legislation which would bring forward Justice Douglas Cunningham’s much-needed reforms to the auto insurance dispute resolution system.

While we welcome the majority of the recommendations, there are two outstanding issues that we ask MPPs to address through amendments at committee:

1. ensuring accident victims have access to the Courts and,
2. setting a fair prejudgment interest rate to ensure timely access to justice.

The Right to Sue

Currently, accident victims have the right to go to Court or to arbitration to dispute decisions made by their own insurance companies that deny them necessary benefits, including income replacement benefits and medical and rehabilitation treatments. But under the proposed Legislation, claimants will only be able to advance claims to the Licence Appeal Tribunal. The removal of access to the court is going to lead to huge amounts of wasted dollars and duplicated efforts.

If a person is injured and it was someone else’s fault, and that person also has a dispute with his or her insurance company about benefits, the injured person will now have to pay a lawyer to handle two different legal claims, in two entirely different systems: a lawsuit in Court against the person who caused the injury, and a totally separate dispute through the Licence Appeal Tribunal for benefits that were wrongfully refused. This dual system is going to add tremendous unnecessary costs to the system. Doesn’t it make sense to allow accident victims the right (that they currently have) to bring the two claims together before the court and to vastly reduce the costs they have to incur? The province will also benefit by allowing victims to use one process instead of paying for the cost of two hearings and two decision makers.

Our complex system of benefits already makes it extremely difficult for people to access the benefits to which they are reasonably entitled. This proposed change that takes away the right to sue and will result in more victims just giving up because they can’t afford the fight. Maybe that’s why the insurance sector wants to push this change through.

Prejudgment Interest for Innocent Victims

Bill 15 also proposes to change a 30-year-old rule that has been so important to those who have suffered injuries in Ontario. “Prejudgment interest” on pain and suffering damages is intended to compensate an innocent victim when the negligent person’s insurance company delays paying those damages. Basically, it ensures timely payment for damages by insurance companies to innocent victims. No one can argue with the fact that timely resolutions are in the best interest of both sides of any dispute, and the Court system.

Currently, insurance companies are required to pay 5% interest on whatever sum injured people are owed for pain and suffering. For example, if an injured person has a serious injury and his or her injury is ultimately assessed at $50,000, but the insurance company delays paying the claim for 3 years, the insurer would have to pay $7,500 in interest. That’s not a lot, but at least it is something to compensate for the delay, and it serves as an important incentive for insurers not to purposely delay settlement of claims!

The Ontario Trial Lawyers Association is urging MPPs to consider changes to this section of the legislation because, as it stands now, the bill would give insurers an economic incentive to delay providing compensation to innocent victims.

Insurers invest their money and, according to the federal regulator, they made about 4% on these investments in 2012, and 3% in 2013. Under the proposed legislation, prejudgment interest would be slashed to 1.3%. The insurance companies would therefore stand to earn 1.7% profit on the innocent victim’s money for every year that they put off settling with that victim. It’s really just simple math! Don’t forget – that money belongs to the injured person. If the prejudgment interest rate is reduced to 1.3%, insurance companies will directly profit from NOT paying injured people the money they are entitled to for years. With the proposed reduction in prejudgment interest, there is no incentive whatsoever for insurance companies to settle cases on a timely basis. If the government wants to look more closely at this issue, it should simply determine how much money insurers have been making on their investments, and set the prejudgment interest rate at a level that doesn’t create any incentive to delay. In comparison, injured people who can’t work and have to borrow money to get by are certainly paying interest at a rate much higher than 5%!

The insurance companies would stand to earn 1.7% profit on the innocent victim’s money for every year that they put off settling with that victim.

It Denies Justice To Innocent Accident Victims!

In addition to continuing to line the pockets of profitable insurance companies, the reduction of the prejudgment interest rate will delay the cases in the system. If you have heard how backlogged some of our Courts are now, imagine what will happen if insurers can delay payments for years with no financial penalty! It means that fewer cases will settle at an early stage, more cases will have to be set for trial, more judges will be needed to conduct extra pre-trial conferences, and this will lead to even longer backlogs in the courts. All of this, of course, will come at a significant cost to our justice system.

We urge MPPs to consider minor amendments to address these outstanding issues in Bill 15. We look forward to bringing these concerns forward again when the bill is referred to committee.

Source: http://otlablog.com/bill-15-new-auto-insurance-legislation-inhibits-access-to-justice-requires-amendment/
 

New auto insurance legislation restricts right to sue, critics say

The Ontario Trial Lawyers Association says the devil is in the details of legislation designed to reduce auto insurance premiums and tackle fraud.

Victor Biro / Toronto star file photo 

The Fighting Fraud and Reducing Automobile Rates Act passed Thursday but the Ontario Trial Lawyers Association says the legislation removes a motorist’s right to sue an insurance company for denying their claims. 

 

By: Richard J. Brennan Provincial Politics, Published on Thu Nov 20 2014

 

 

The Ontario Trial Lawyers Association says the devil is in the details of legislation designed to reduce auto insurance premiums and tackle fraud.

The Fighting Fraud and Reducing Automobile Rates Act passed Thursday but Steve Rastin, president of the OTLA, noted there’s a clause buried in the legislation that removes a motorist’s right to sue an insurance company for denying their claims.

Bill 15 doesn’t actually mention an earlier 15 per cent reduction that was spelled out in the 2013 budget.

“We are profoundly disappointed in the government for what they did today,” Rastin said, noting the government has replaced the right to sue for denied claims with a convoluted arbitration system that, he claims, will be both costly and time consuming.

Rastin said while the association supports most of what is included in the bill, it finds the removal of the right to sue, and reducing the interest rates that injured claimants get on their money from insurance companies — which is kept in a reserve account — from 5 per cent to 1.3 per cent as completely unacceptable.

“The legislation says it’s all about fraud and fighting costs. There is a lot more in there than that that’s been added to it. The legislation ends the right of an accident victim to sue the insurance company in the courts for not paying for benefits,” Rastin said.

Finance Minister Charles Sousa first promised the 15 per cent reduction in August 2013 when the New Democrats made that a condition of supporting the then-minority Liberal government’s budget earlier that year.

As it turned out the NDP voted against the bill Thursday for many of the reasons cited by the trail lawyers, including the fact the reduction in premiums is taking too long. From August 2013 to this August the premiums dropped by an average of only 6 per cent.

Ralph Palumbo, vice-president, Ontario, Insurance Bureau of Canada, welcomed the legislation.

“Everyone — including the insurance industry — is in agreement on one thing: auto insurance in Ontario is far too expensive. We realize the financial hardship it can create for vehicle owners, particularly young people and those in northern and remote communities . . . now we have an opportunity to begin fixing the system once and for all,” Palumbo said.

Source: http://www.thestar.com/news/queenspark/2014/11/20/new_auto_insurance_legislation_restricts_right_to_sue_critics.html