.... years after being rear-ended in a car accident, Liese
Bruff-McArthur saw a small army of medical professionals. Most agreed
the crash had left her with chronic pain, depression, PTSD and other
troubles, making a return to work untenable.
Then she met Dr. Monte Bail.
Hired by the insurance company she was suing, the psychiatrist spent
an hour and a quarter with the Ottawa-area woman — the kind of work that
earned Bail as much as $77,000 a month — and concluded Bruff-McArthur
was essentially faking it..........
And such cases are likely just the tip of the iceberg, say lawyers
representing accident victims, the plaintiffs. Judicial criticisms arise
only in the five per cent or so of cases that get to trial, they note,
so most instances of bias stay under wraps as lawsuits are settled out
of court.
“It’s clear from the (reported) cases that it is far too prevalent,”
says Adam Wagman, a plaintiff lawyer and president of the Ontario Trial
Lawyers Association. “That attacks the very foundation of our system of
justice.”.....
Source/more:
http://news.nationalpost.com/news/hired-gun-in-a-lab-coat-how-medical-experts-help-car-insurers-fight-accident-claims
CIN is a non-profit Advocate for Insurance and Health Care Reform. Postings are cut/paste from other sources. @Cinsurancenews #rally4accidentvictims #ABPetition #CPPbacklog
Showing posts with label fair association. Show all posts
Showing posts with label fair association. Show all posts
Sunday, January 8, 2017
Wednesday, December 14, 2016
So we ask - why is the Ontario government gifting auto insurers with our healthcare dollars?
For 11 years the
Ontario government has known that the taxpayers are paying too much
for the healthcare of MVA victims post accident. The Auditor General
has told them so in more than one report. The Minister of Finance
recently put out the HSPRN report that acknowledges that the actual
cost to OHIP was $383 million in 2013/14. This is a shortfall of $241
million in just one year. The loss to the taxpayer, who is paying
while insurers aren't, is well over $1 billion in just the last 5
years alone.
Assessors Medical opinion evidence, libel and public interest case
The latest stories in the media:
https://www.thestar.com/news/gta/2016/12/08/md-who-wrote-misleading-insurance-report-under-investigation.htmlhttp://news.nationalpost.com/news/ontario-doctor-misrepresented-views-on-catastrophic-injuries-to-benefit-insurer-judge-rules
The original media story: http://www.insurancebusiness.ca/ca/news/auto/medical-files-routinely-altered-to-suit-insurers-claims-fair-186692.aspx?p=1
more info see: http://www.fairassociation.ca/the-independent-medical-examination-imeie/ and http://www.fairassociation.ca/ime-providers-adverse-comments/
Monday, December 12, 2016
Rhona DesRoches, FAIR: 59,000 cases on docket in Ontario
Ending the use of jury trials in personal injury cases doesn’t have much to do with restricting freedom of speech for insurers who will undoubtedly continue with their fight to reduce claims costs under the guise of a fight on fraud.
The constant maligning of MVA victims over decades by the IBC/insurers in advertising has had the intended consequence of negatively influencing the public and that has included potential jurors. This is not just one case.
In Bruff-Murphy v Gunawardena, 2016 http://canlii.ca/t/gmr5x there’s an acknowledgement that the expert evidence that the Judge found questionable may not have been viewed in the same way by the jury. Juries are made up of ordinary people with the ordinary expectation that the evidence they are presented with is honest. Anyone working in the personal injury field knows that this is often not the case when it comes to Ontario’s ‘experts’ whose medical opinions are relied on by insurers to delay and deny legitimate claims
Auto insurance is a dirty game played out in our courts and if the flawed evidence is going to be allowed in the door you can’t expect the ordinary jurors to filter out the junk medicine replete with biased or flawed opinions and come to a just decision.
According to StatsCan there are over 59,000 (2015) auto insurance related cases on the docket in Ontario; aside from pointing out that this is indicative of an unaddressed problem with Ontario’s auto insurance, it’s a massive amount of money being laid out by taxpayers when 50% of claims are denied and end up in hearings.
Source/more:
http://www.slaw.ca/2016/10/26/wednesday-whats-hot-on-canlii-188/comment-page-1/#comment-948175
Juries swayed by big $ spent on IBC fraud campaigns
It would seem that David Cheifetz, a now retired defence lawyer, can be as insulting to auto insurance claimants via his incredibly ignorant statements to the Chair of FAIRAssociation.ca (not-for-profit motor vehicle accident victim group seeking insurance reform) as so many of the rogue IME assessors are to claimants they assess, whom they deny in order to keep their lucrative insurer-paid jobs.
More: http://deniedbenefitclaims.com/blog.html
Sunday, June 5, 2016
Inquiry into Medical Evidence petition
Link to: Inquiry into Medical Evidence petition
FAIR has put together a paper version of the petition calling for a Public Inquiry into the medical evidence used in our courts and administrative tribunals. It is the same as the one we have asked you to sign online.
The Ontario Legislature ONLY accepts ORIGINAL petitions, on paper, with ‘hand signed’ signatures. There are strict rules for petitions so NDP MPP Jagmeet Singh’s office has generously agreed to receive the paper petition in his office and present it at Queen’s Park.
If you or a loved one were injured in an auto accident, at work or elsewhere wouldn’t you want an honest, unbiased and qualified medical opinion/report of your injuries? That’s just not happening in Ontario for injured and disabled individuals who make a claim for benefits through their private or public insurers. What if it was your fault that something happens to someone else? You’d want them to have the best chance at recovery wouldn’t you?
Please print, sign and circulate the petition because quality and qualified medical evidence shouldn’t be something we need – it should be something we already have because there is no real justice without it.
Make a copy and mail the ORIGINAL copies to: MPP Jagmeet Singh, Room 172 Main Legislative Building, Queen’s Park 111 Wellesley St. Toronto, ON M7A 1A5
Other On-line petition: https://www.change.org/p/the-legislative-assembly-of-ontario-support-a-public-inquiry-into-medical-evidence-in-ontario-s-courts-and-tribunals (these
signatures are also important to make our point elsewhere and it gives
those on-line the power and opportunity to use their voice)
Source: http://www.fairassociation.ca/
FAIR has put together a paper version of the petition calling for a Public Inquiry into the medical evidence used in our courts and administrative tribunals. It is the same as the one we have asked you to sign online.
The Ontario Legislature ONLY accepts ORIGINAL petitions, on paper, with ‘hand signed’ signatures. There are strict rules for petitions so NDP MPP Jagmeet Singh’s office has generously agreed to receive the paper petition in his office and present it at Queen’s Park.
If you or a loved one were injured in an auto accident, at work or elsewhere wouldn’t you want an honest, unbiased and qualified medical opinion/report of your injuries? That’s just not happening in Ontario for injured and disabled individuals who make a claim for benefits through their private or public insurers. What if it was your fault that something happens to someone else? You’d want them to have the best chance at recovery wouldn’t you?
Please print, sign and circulate the petition because quality and qualified medical evidence shouldn’t be something we need – it should be something we already have because there is no real justice without it.
Make a copy and mail the ORIGINAL copies to: MPP Jagmeet Singh, Room 172 Main Legislative Building, Queen’s Park 111 Wellesley St. Toronto, ON M7A 1A5
Thanks for being part of the collective voice needed for change!
Source: http://www.fairassociation.ca/
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
Accident Benefit Coalition Victim Survey
Accident Benefit
Coalition Victim Survey is for Accident Victims who were injured in
Ontario Motor Vehicle Collisions (MVCs). The purpose is to collect
information regarding victims’ experience in regards to obtaining
Ontario Accident Benefits from insurers. Absolutely no personal
information is collected or shared.
The Accident Benefit
Coalition (ABC) consists of a membership of Ontarians concerned with
issues surrounding the provinces’ mandatory Accident Benefits. It
was founded by NeuroConnect and FAIR Association and is committed to
advocating for Accident Victims in Ontario.
Survey for
claimants: https://www.surveymonkey.com/s/AutoInsurer
Please share this
survey with others you know who have gone through the claims
experience!
The petition is
still going
https://www.change.org/p/ontario-mpps-finance-minister-charles-sousa-stop-reducing-ontario-accident-benefits
Sunday, July 12, 2015
CPP Disability take a number now serving appeal 200,000
What are the number of appeals backlogged at the Social Security Tribunal?
The following comment was made by Fair Association of Victims for Accident Insurance Reform on the Toronto Sun site back in November of last year.
 |
In February of this year Minister Jason Kenney pledged to wipe out the Social Security Tribunal backlog of 11,000 by this summer.
The backlog was also discussed later in the house by Mr. Robert Aubin (NDP).
He said: "Mr. Speaker, on Tuesday the chair of the Social Security Tribunal confirmed that there are significant delays in the processing of cases: 14,677 cases are languishing on her desk."
So what are the numbers now?
More importantly, how would you get rid of such a backlog of appeals...fairly?
The Tribunal Chair refuses to acknowledge or respond to my letters as an appeal applicant, or as an advocate for these disabled Canadians that have been waiting for years at the tribunal backlog.
Knowing that these disabled Canadians can't respond our government has reaped the $$$ in withholding these benefits. Appeals in the take-a-number-lineup because of bad decisions by Service Canada and their policy of delay, deny, wait for them to die.
In my case these benefits that my employers and I have paid into mandatorily since 1979.
http://survivingacollision.blogspot.ca/2015/01/delay-deny-wait-for-them-to-die-at-sst.html
http://survivingacollision.blogspot.ca/2015/05/where-do-victims-go-when-insurers-dont.html
And what of my appeal that was launched back in 2008?
Will it be fairly heard after my blogging about the Social Security Tribunal and advocating for the unknown thousands of Appellants?
What do I have to do to be heard and what will It take to at least acknowledge my correspondences by the Social Security Chair Ms. Brazeau.
Sincerely,
Mr. xxxx xxx
Surviving a Collision: http://survivingacollision.blogspot.ca/
Crash Survivor 2007.
Social Security Tribunal says more than 14,600 Canadians are now waiting for a hearing:
http://survivingacollision.blogspot.ca/2014/11/social-security-tribunal-says-more-than.html
Sunday, June 14, 2015
Car insurers and lawyers brawl in public
Two sides point to each other as reason for high insurance premiums. The truth is, they’re both responsible
By Alan Shanoff, Toronto Sun
The Insurance Bureau of Canada (IBC) opened by claiming the public needs regulatory oversight of contingency fees charged by personal injury lawyers.
The IBC feels a change is necessary to protect consumers and allow the government to evaluate the impact of lawyers’ fees on the auto insurance system.
The Ontario Trial Lawyers Association (OTLA) countered by releasing a study it commissioned concerning auto insurance premiums.
According to the study, prepared by two professors at York University’s Schulich School of Business, “consumers in Ontario may have overpaid for auto insurance by between $3 and $4 billion over the period 2001 to 2013.”
The OTLA urged an independent “thorough and truly transparent” review of auto insurance by Ontario’s Auditor General.
Reacting quickly, the IBC fired back through a press release, pointing the finger back at personal injury lawyers claiming, “lawyers’ fees are simply too high and have a significant impact on the cost of auto insurance.”
The IBC supported its conclusion by claiming some lawyers charge 40%, while others between 25% and 33% of any settlement or judgment.
I doubt many lawyers would dare charge a 40% contingency fee, although even a 25% to 33% fee may be too high in some cases.
But, the IBC forgot to mention clients don’t pay the entire contingency fee as a good part of the fee is paid by the insurance company.
To rub it in further, the IBC stated, “In 2013, lawyers received an estimated $500 million from injury claimants out of their insurance settlements for bodily injury claims. These are real dollars that never make it to the claimant. IBC will continue to fight for increased transparency so that consumers can actually see where their insurance dollars go.”
But I don’t think insurers want to open the transparency can of worms.
If they want to talk about “real dollars” that don’t make it to claimants, check out the vast sums paid by insurers for their so-called independent medical examinations (IMEs), used to belittle or deny claims.
According to the most recent Ontario Health Claims Database, insurance companies paid approximately $372 million for IMEs for accidents taking place in the last four years.
In some years, insurance companies forced almost half of all claimants to attend IMEs and in each year the average amount paid per assessed claimant for these exams exceeded the average amount paid per claimant for all medical and rehabilitation expenses.
Sending claimants for multiple and expensive assessments to pro-insurer experts is a major contributor to insurers’ costs and takes “real dollars” out of the pockets of claimants.
That’s not to say lawyers are free of blame.
There’s a long history of lawyers neglecting to act diligently to expose insurer experts who file partisan reports, sometimes outside their sphere of expertise, used by insurers to delay and deny claims.
As well, quality control at some law firms is substandard.
The FAIR Association of Victims for Accident Insurance Reform has recently posted an announcement stating, “ALERT – we are hearing about more and more cases where time limitations for filing have lapsed due to plaintiff’s legal representatives failing to meet limitation period deadlines.”
Then again, motor vehicle litigation and accident benefits claims are highly complex and insurance company tactics often lead to increased fees.
And if the insurance industry wants to point fingers at personal injury lawyers, perhaps they ought to make complete disclosure of the money they spend on defence lawyers and adjusters to deny, delay and defend claims.
Furthermore, how much do insurers pay to fund their massive public relations campaigns -- including political contributions to those in power -- which they effectively use to portray accident victims as opportunistic, malingering or just plain fraudulent?
It seems there is a lot of mud that can be thrown at each side in this messy debate.
But while the debate drags on, insurers continue to exact high premiums and lawyers receive handsome payments for their work.
And accident victims? They’re stuck in the middle.
Source: http://www.torontosun.com/2015/06/13/car-insurers-and-lawyers-brawl-in-public
FAIR comment on FSCO Draft Statement of Priorities 2015
Why is it that there is so little mention of the priorities/concerns of the injured victims the system purports to serve?
If it is truly the mandate of the FSCO and the “measurement of providing regulatory services that protect the public interest and enhance public confidence in the regulated sectors” then shouldn’t the quality of the coverage and access to that coverage be of utmost importance?
If people had confidence in the quality of the coverage and access to benefits as promised, would over 20,000 people be signing a petition?
When hundreds of people rally at Queen’s Park to protest the cuts to benefits to the most catastrophically injured of Ontario’s auto accident victims; is that not a clear signal that consumers (in this case people who have used the product) have lost confidence in our coverage?
Read more at: FAIR submission to FSCO Statement of Priorities 2015
Car crash victims deserve better deal
Ontario’s car insurance system seems to work well except for
consumers who need it and accident victims who make legitimate claims
under it.
After all, the insurance industry is making good money.
Lawyers are amply rewarded acting for plaintiffs and insurance firms.
Doctors earn significant sums preparing insurer-requested medical reports.
Treatment providers receive good compensation for treating the injured.
Premier Kathleen Wynne received generous financial support from the car insurance industry when she ran for the Liberal leadership.
The Liberal party receives significant campaign donations from it.
But here’s the problem. Two problems, actually.
The first is fraud by people trying to rip off insurance companies with phony claims. We agree it happens and it’s a serious problem.
But what we don’t understand is why the amount of fraud -- to hear it from the insurance companies -- never, ever, seems to decrease.
Fraud, we’re told, is the main reason auto insurance premiums in Ontario remain stubbornly high, no matter how many times the government cuts back benefits to all accident victims at the behest of the insurance industry, as it did again in its latest budget passed last week.
We also think there’s another kind of fraud in the insurance industry that needs to be addressed by government.
That fraud happens when people who have faithfully paid their auto insurance premiums year after year are hurt in serious accidents and, when they make legitimate claims for the benefits promised in their policies, are denied them.
It happens when car insurers fight against paying genuine claims from accident victims, falsely making them out to be the enemy and going to absurd lengths in and out of court to deny them the benefits to which they are entitled.
Last week, hundreds of demonstrators at Queen’s Park protested this kind of fraud as the Liberals passed yet another piece of legislation favoured by the insurance industry that will cut in half benefits for people who sustain catastrophic, life-changing injuries in car accidents.
Prior to the passage of the budget, Finance Minister Charles Sousa boasted, “Ontario is the most generous in Canada when it comes to providing coverage for auto insurance.”
Last week, Sun legal affairs analyst Alan Shanoff, demonstrated conclusively in his column how this statement was inaccurate.
In fact, Ontario doesn’t provide the most generous benefits for either catastrophic injuries or for so-called “minor” ones, which can include dislocation of joints, partial tears of tendons and ligaments and whiplash not exhibiting neurological symptoms.
As the FAIR Association of Victims for Accident Insurance Reform put it: “The budget does nothing to ensure that insurer claims management practices are fair and there has been no action (to deal with) ... the biased and corrupt insurer medical examination reports that are disqualifying innocent and legitimate accident victims.”
We agree. It’s time to end this type of insurance fraud, as well.
Source: http://www.torontosun.com/2015/06/06/car-crash-victims-deserve-better-deal
After all, the insurance industry is making good money.
Lawyers are amply rewarded acting for plaintiffs and insurance firms.
Doctors earn significant sums preparing insurer-requested medical reports.
Treatment providers receive good compensation for treating the injured.
Premier Kathleen Wynne received generous financial support from the car insurance industry when she ran for the Liberal leadership.
The Liberal party receives significant campaign donations from it.
But here’s the problem. Two problems, actually.
The first is fraud by people trying to rip off insurance companies with phony claims. We agree it happens and it’s a serious problem.
But what we don’t understand is why the amount of fraud -- to hear it from the insurance companies -- never, ever, seems to decrease.
Fraud, we’re told, is the main reason auto insurance premiums in Ontario remain stubbornly high, no matter how many times the government cuts back benefits to all accident victims at the behest of the insurance industry, as it did again in its latest budget passed last week.
We also think there’s another kind of fraud in the insurance industry that needs to be addressed by government.
That fraud happens when people who have faithfully paid their auto insurance premiums year after year are hurt in serious accidents and, when they make legitimate claims for the benefits promised in their policies, are denied them.
It happens when car insurers fight against paying genuine claims from accident victims, falsely making them out to be the enemy and going to absurd lengths in and out of court to deny them the benefits to which they are entitled.
Last week, hundreds of demonstrators at Queen’s Park protested this kind of fraud as the Liberals passed yet another piece of legislation favoured by the insurance industry that will cut in half benefits for people who sustain catastrophic, life-changing injuries in car accidents.
Prior to the passage of the budget, Finance Minister Charles Sousa boasted, “Ontario is the most generous in Canada when it comes to providing coverage for auto insurance.”
Last week, Sun legal affairs analyst Alan Shanoff, demonstrated conclusively in his column how this statement was inaccurate.
In fact, Ontario doesn’t provide the most generous benefits for either catastrophic injuries or for so-called “minor” ones, which can include dislocation of joints, partial tears of tendons and ligaments and whiplash not exhibiting neurological symptoms.
As the FAIR Association of Victims for Accident Insurance Reform put it: “The budget does nothing to ensure that insurer claims management practices are fair and there has been no action (to deal with) ... the biased and corrupt insurer medical examination reports that are disqualifying innocent and legitimate accident victims.”
We agree. It’s time to end this type of insurance fraud, as well.
Source: http://www.torontosun.com/2015/06/06/car-crash-victims-deserve-better-deal
Update: rally against insurers deemed “a great success”
by
Jill Gregorie |
07 Jun 2015
Last week, Insurance Business reported on a rally that was being planned in protest of “shady” industry practices and the liberal government’s call for reduced MVA benefits as part of the provincial budget.
A spokesperson for reports with one of the rally’s organizers, FAIR Association of Victims for Accident Insurance Reform, reports that the event was “a great success with hundreds of people attending, either victims or their supporters.”
New Democratic Party MPP Jagmeet Singh addressed the crowd to lambaste the cuts as well, arguing that they hurt society’s “most vulnerable people.”
“It was a lively and vocal crowd who came out,” FAIR Board Chair Rhona Desroches said. “Many of the participants and certainly the auto accident victims who gave speeches were in various stages of recovery and I'm especially grateful that they came to speak for future victims who won't have the level of coverage that they themselves did post-accident.”
Desroches is referring to a little known provision where MVAs who sustained injuries prior to 2010 coverage reductions receive a greater share of benefits than MVAs injured recently, further exacerbated by the fact that “insurers made some benefits more difficult to access last year, i.e. qualifying for attendant care costs.”
The group hopes that this rally will incite a more vocal public outcry against Ontario’s treatment of MVA victims, who they believe are neglected in favor of insurance companies.
“The message is that MVA victims are not worth their time or the effort of the legislators who continue to assist Ontario's wealthy insurers profit margins rather than ensuring that Ontarians have coverage enough to recover. It's shameful,” Desroches said.
Last week, Insurance Business reported on a rally that was being planned in protest of “shady” industry practices and the liberal government’s call for reduced MVA benefits as part of the provincial budget.
A spokesperson for reports with one of the rally’s organizers, FAIR Association of Victims for Accident Insurance Reform, reports that the event was “a great success with hundreds of people attending, either victims or their supporters.”
New Democratic Party MPP Jagmeet Singh addressed the crowd to lambaste the cuts as well, arguing that they hurt society’s “most vulnerable people.”
“It was a lively and vocal crowd who came out,” FAIR Board Chair Rhona Desroches said. “Many of the participants and certainly the auto accident victims who gave speeches were in various stages of recovery and I'm especially grateful that they came to speak for future victims who won't have the level of coverage that they themselves did post-accident.”
Desroches is referring to a little known provision where MVAs who sustained injuries prior to 2010 coverage reductions receive a greater share of benefits than MVAs injured recently, further exacerbated by the fact that “insurers made some benefits more difficult to access last year, i.e. qualifying for attendant care costs.”
The group hopes that this rally will incite a more vocal public outcry against Ontario’s treatment of MVA victims, who they believe are neglected in favor of insurance companies.
“The message is that MVA victims are not worth their time or the effort of the legislators who continue to assist Ontario's wealthy insurers profit margins rather than ensuring that Ontarians have coverage enough to recover. It's shameful,” Desroches said.
-
Brian on
2015-06-07 9:58:11 AM
When will the dubious "preferred vendors" of the Ontario auto insurers' "proof" of massive opportunistic fraud be put under scrutiny? Systemic, bogus accusations of malingering churned out by pro-insurer medico-legal
'experts' are first used (on a case by case basis) to deny benefits and then, in turn, trotted out by the Liberals as proof, on a policy level, that quad/paraplegics and brain inured accident victims are being treated "over-generously" and getting money "that needs to go to the people who really need it". We need to look at the long trail of sketchy "medical authorities" that Ontario governments have used to attack the credibility of the injured and the honesty of all Ontario motorists - a trail reaching all the way back to Dr. James N. Sears (aka Dimitri the Lover) - the insurer's "medical authority"
behind the Harris "Rate Stability Act". And here we are: deja vue all over again!!! -
Brian on
2015-06-07 10:28:09 AM
In terms of cause - one can draw a straight line between these latest cuts to the catastrophically injured back to the Liberal/IBC cherry-picked Panel of Experts on Catastrophic Injury which concluded that what counts as "catastrophic" injury is too generous and that the criteria needs to be made tougher for the most seriously injured to "thread" the catastrophic injury definition "needle". The Liberals have decided to double-down on that insurer-friendly report and use at not just to come up with a more narrow definition of catastrophic injury - but also to justify cutting in half the treatment and attendant care benefits of the handful of injured claimants who will ever be able meet the upcoming stricter/tougher/revised catastrophic injury definition. All this thanks to a Panel of "preferred" insurer IME vendors and a couple of epidemiologists who never have and never will meet (much less treat) a catastrophically injured auto accident victim.
-
Rick on
2015-06-07 7:31:56 PM
So coverage will be cut in half. I guess there's a refund on its way to everyone. Fat chance of that ever happening. Good on this group of concerned citizens for getting out there and making some noise about the evaporating coverage Ontario has. They've forgotten that they are selling, we are buying so we expect something for all those $billions we pay for coverage besides converting our policy dollars to Liberal campaign contributions.
-
Brian on
2015-06-07 11:38:10 PM
Ironically, the editorial position in today's Sunday Sun has some choice words to say about the Ontario auto insurers' "shady practices":
http://www.torontosun.com/2015/06/06/car-crash-victims-deserve-better-deal
Prior to the passage of the budget, Finance Minister Charles Sousa boasted, “Ontario is the most generous in Canada when it comes to providing coverage for auto insurance.”
Last week, Sun legal affairs analyst Alan Shanoff, demonstrated conclusively in his column how this statement was inaccurate.
In fact, Ontario doesn’t provide the most generous benefits for either catastrophic injuries or for so-called “minor” ones, which can include dislocation of joints, partial tears of tendons and ligaments and whiplash not exhibiting neurological symptoms.
As the FAIR Association of Victims for Accident Insurance Reform put it: “The budget does nothing to ensure that insurer claims management practices are fair and there has been no action (to deal with) ... the biased and corrupt insurer medical examination reports that are disqualifying innocent and legitimate accident victims.”
We agree. It’s time to end this type of insurance fraud, as well.
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Brian on
2015-06-08 1:34:55 PM
The insurers say they won’t tolerate auto insurance fraud. Nor should they. So was this National Claims Manager (below) prosecuted – or not? If not – why the double standard? Is insider fraud tolerable?
http://www.lawtimesnews.com/201012062960/inside-story/monday-december-6-2010
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LAWYER HELPED IN $1.5M FRAUD
A Toronto lawyer has had his licence revoked for his part in a $1.5-million insurance fraud.
Pradeep Bridglal Pachai admitted to taking part in a scheme that saw a senior employee at an insurance company client authorize higher payments to settle litigation than was needed and the two men pocketing the difference.
Pachai claimed he was pressured into the scheme by Vinti Sansanwal, national claims director at HB Group Insurance Management Ltd., fearing he would cut him off from legal work defending the company, which had become his largest client.
Initially, Pachai said he thought the arrangement was for one time only, but between 2005 and 2007, the scam snowballed, netting the pair $1.5 million from 11 files with the lawyer keeping $675,000 of the spoils for his role.
The scheme came crashing down after an anonymous tip led to an investigation and Sansanwal’s dismissal. The insurance company then launched a civil action to recover the funds that named Pachai as a defendant. After he made restitution, the claim against him was dismissed.
Close family and four lawyer colleagues acted as character witnesses for Pachai during the hearing. They labelled his actions as being out of character.
In the meantime, Pachai asked the Law Society of Upper Canada to impose a lengthy ban, but the panel disagreed, noting the mitigating circumstances weren’t sufficient “to justify a second chance.”
“There is no satisfactory explanation for his misconduct; it was a self-interested, economic choice which was not forced upon him, even if it was devised and initiated by Mr. Sansanwal.
Nor was it unavoidable, in the sense that it was out of character because it was caused by a disability, addiction or any similar factor,” wrote Bencher Raj Anand on behalf of the three-person panel.
The panel awarded no costs, noting Pachai had co-operated fully and wouldn’t be able to pay since having voluntarily ceased practice in 2008. -
Claire Laforest on
2015-06-08 5:18:59 PM
The proposed reductions in auto insurance coverage are outrageous!! Unless you have walked a day with Sara and the family during the last 19 months, you have no idea what catastrophic injuries stemming from a brain injury caused by the MVA can do to someone emotionally, physically and financially. You may think that the proposed $500,000 for each of nursing care and medical/rehab therapy over a lifetime is a lot of money but it's not! We have so far spent close to $150,000 to $200,000 on Sary Buckley's injuries with nursing care and rehab and were not even at the 2 year anniversary yet. Home health care agencies charge between $25-$55/hr for PSW and RPN care while the current insurance coverage allows for $15/hr for 400 hours/mth or 150 hours/mth at the industry rate. Therapists charge between $100 and $150/hr plus mileage and report writing. Sara requires a physiotherapist 3X/week, a speech therapist once to twice a week, a rehab therapist every day and an occupational therapist every week. You think that's a lot? Well, it's not when someone like Sara requires 24/7 care; she cannot walk, talk, feed, bathe or dress herself nor maintain continence. All this at 18!! And then add to that the expenses related to the drugs and tube feed not covered by extended health private insurance and the cost of accommodating the accessibility to her home. The proposed changes will reduce the current $2M in total allowance by half. And this total $2M is not even what a survivor receives upon settlement because of lawyer fees. These changes must be protested. Proposed changes are going to be devastating. On behalf of all future MVA victims, the proposed changes have to be stopped. Please sign petitions!! Please participate in protests!! Contact your MPPs!! And the Ontario Government should be ashamed of what they are putting forward, in effect Sept. 2015!!
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Griswald G on
2015-06-08 9:30:24 PM
The public has no concept of what rehabilitation and recovery can cost. Very few of us could afford what we might need if we were brain-injured or catastrophically impaired. The sense of urgency in Claire's posting is what most people feel when faced with coping with injured loved ones. Our government has failed us on many fronts when it comes to auto insurance and has allowed the IBC to misinform us of the coverage we have with their constant propaganda that everything is fine here, nothing to see, move along, we just need a few more dollars to keep us going and hey look - we can just get it from the victims - especially the worst off ones because they are least likely to be able to complain about it. Maybe there is something to see, and it all played out at the Rally last week when severely injured people showed up to help others they don't even know. And that's a darned sight more than our insurance companies do when we get injured in a crash. What do we get - shipped off to some assessment mill and a denial letter in the mail. Time to consider other possibilities like public auto insurance in Ontario.
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Brian on
2015-06-08 11:06:52 PM
Who to believe? That is the question. We can believe the picture being painted by the IBC lobbyists. They would have us believe the insurers money is spent on people who only pretend to be catastrophically injured - and who - even if they are catastrophically injured - are getting to much treatment and too much attendant care. Twice as much in fact. Or, we can listen to the decisions of triers of fact (the judges and arbitrators) who scrutinize the way in which the insurers too often "treat" their most vulnerable claimants. You be the judge. Here (excerpts below) is a case. Who would you trust - the IBC's version of the story or this Arbitrator's decision. The Ontario auto insurance litigation landscape is littered with cases like this one chronicling all manner of insurer abuses. This case manager ought to be ashamed for her implausible (falsified?) reports submitted time and again and used to justify denial of care. Isn't falsifying reports in this way a crime? If not - it ought to be.
Michalski and Wawanesa [+] Arbitration, 2005-12-13, Reg 403/96.
Final Decision
Each of the case manager's subsequent reports to Wawanesa, in March, April, May, June and July, 2002 state in the body of the report that Dr. Dobrowolski continues to report further improvement. I find each of those comments at significant odds with the contents of Dr. Dobrowolski's notes, records, reports to third parties, and an implausible summary of his opinion....
...I do not know why Wawanesa preferred the opinions of the occupational therapists and the case manager, flawed and deficient as they were, to the opinions of its own psychiatrist and psychologist, whose greater expertise in assessing Mrs. Michalski's cognitive function Wawanesa sought. I find Wawanesa failed to act with sound and moderate judgment in reassessing evidence from its own assessors. I find Wawanesa's actions and defaults overlap and compound each other.
...I believe the sanction should reflect that Wawanesa failed to meet its contractual obligations, and is entirely to blame for the manner in which this claim unfolded. I agree with the submission of counsel for the Applicant that it is difficult to find a more vulnerable Applicant than Mrs. Michalski, who, as a result of her injuries, functions like a two year old, was unrepresented by counsel and whose primary language was not English. She could not be safely left alone. Wawanesa repeatedly put her at risk. Fortunately, her husband and children provided her with care. I believe the award should also reflect that Wawanesa took advantage of Mrs. Michalski's children, and should encompass the need to deter Wawanesa and other insurers from engaging in similar conduct. Nothing indicates that Wawanesa is likely to be subjected to any additional penalty as a result of its misconduct. I agree with the view that interest is remedial C not a penalty. -
R DeKramer on
2015-06-09 7:09:40 PM
Here's what a well-known insurer medical assessment doctor told his college when called to task for his poor quality medical report:
There are three types of patients:
1.Patients with nothing wrong with them who are “pulling the wool over everyone’s eyes”
2. Patients with no problem who think they have a problem. These patients actually believe that there is something wrong with them, even though there is not.
3. Patients with minor problem who have exaggerated this problem into something much bigger than it is.
Do mva victims even have a chance? Not if there's no room to even consider an injury. A blindness caused by the insurers handpicking and handsomely paying their medical experts so they deny injuries even exist. This is the system and what victims face every day.
ACCIDENT BENEFIT COALITION - why not join?
The
Accident Benefit Coalition (ABC) consists of a membership of Ontarians
concerned with issues surrounding the provinces' mandatory Accident
Benefits. It was founded by NeuroConnect and FAIR Association and is
committed to advocating for Accident Victims in Ontario.
The
Accident Benefit Coalition (ABC) is comprised of organizations
concerned about the proposed reduction to Ontario's Accident Benefits.
Please click here to sign the Petition asking the Government to Stop Reducing Accident Benefits.
Thank you to everyone who attended the #rally4accidentvictims on June 3rd.
Please click here for pictures of the event.
Hundreds rally against cuts to auto insurance benefits
By
Maryam Shah, Toronto Sun
TORONTO - Changes to auto insurance benefits for motor
vehicle accident victims passed in the Ontario legislature Wednesday
as part of the provincial budget.
“God help us all,” Tammy Kirkwood said upon hearing the news. “We’re getting a lot less coverage for a lot more money and I’m not sure why.”
Kirkwood was one of hundreds of protesters at Queen’s Park rallying against reductions in auto insurance benefits which they say will have the most effect on victims with catastrophic injuries.
The 47-year-old Orillia woman said protesters were “flabbergasted” that the provincial government “was trying to disable our resources and our funding to recover.”
Part of the changes to auto insurance rules under the new budget mean that combined coverage for medical, rehabilitation and attendant care benefits for the catastrophically injured will be cut in half from its current cap of $2 million to $1 million.
Kirkwood survived a 2008 collision when a dump truck hit her car. She had to be pried free from her vehicle by firefighters, and was deemed catastrophically injured.
She says she was only able to move forward because she had access to the services she needed.
Unable to return to work, Kirkwood now volunteers as an advocate with FAIR Association of Victims for Accident Insurance Reform.
New Democratic Party MPP Jagmeet Singh spoke at the rally in support of their cause.
The cuts affect “the most vulnerable people,” such as people with brain and spinal cord injuries, he said.
“They need benefit coverage ... to live an at least somewhat decent life,” Singh pointed out.
A spokesman for Finance Minister Charles Sousa said the government is “working hard to create a fair and affordable insurance system” for the province’s 9.4 million drivers.
Ontario is “the only province in Canada to offer exclusive catastrophic coverage,” Kelsey Ingram said in an e-mail.
“Catastrophically impaired claimants will also continue to be able to sue an at-fault party to recover damages for health-care expenses and potentially other claims,” she added.
The provincial government is also committed to making sure any savings from these changes do not result in “excess profits” for insurance companies, Ingram said.
“This is about lowering premiums while providing support and protection for all Ontario drivers,” she said.
maryam.shah@sunmedia.ca
“God help us all,” Tammy Kirkwood said upon hearing the news. “We’re getting a lot less coverage for a lot more money and I’m not sure why.”
Kirkwood was one of hundreds of protesters at Queen’s Park rallying against reductions in auto insurance benefits which they say will have the most effect on victims with catastrophic injuries.
The 47-year-old Orillia woman said protesters were “flabbergasted” that the provincial government “was trying to disable our resources and our funding to recover.”
Part of the changes to auto insurance rules under the new budget mean that combined coverage for medical, rehabilitation and attendant care benefits for the catastrophically injured will be cut in half from its current cap of $2 million to $1 million.
Kirkwood survived a 2008 collision when a dump truck hit her car. She had to be pried free from her vehicle by firefighters, and was deemed catastrophically injured.
She says she was only able to move forward because she had access to the services she needed.
Unable to return to work, Kirkwood now volunteers as an advocate with FAIR Association of Victims for Accident Insurance Reform.
New Democratic Party MPP Jagmeet Singh spoke at the rally in support of their cause.
The cuts affect “the most vulnerable people,” such as people with brain and spinal cord injuries, he said.
“They need benefit coverage ... to live an at least somewhat decent life,” Singh pointed out.
A spokesman for Finance Minister Charles Sousa said the government is “working hard to create a fair and affordable insurance system” for the province’s 9.4 million drivers.
Ontario is “the only province in Canada to offer exclusive catastrophic coverage,” Kelsey Ingram said in an e-mail.
“Catastrophically impaired claimants will also continue to be able to sue an at-fault party to recover damages for health-care expenses and potentially other claims,” she added.
The provincial government is also committed to making sure any savings from these changes do not result in “excess profits” for insurance companies, Ingram said.
“This is about lowering premiums while providing support and protection for all Ontario drivers,” she said.
maryam.shah@sunmedia.ca
Bad news for crash victims
Finance Minister Charles Sousa’s claim Ontario has the most generous auto insurance benefits is nonsense
The reductions are most significant for those suffering from catastrophic injuries.
Since 1996, these victims were entitled to reasonable and necessary medical and rehabilitation services up to $1 million, in addition to up to $1 million in attendant care benefits.
That combined coverage of $2 million will now be cut by 50% to a combined $1 million.
It’s puzzling why the government would want to cut back benefits to those who need it most, especially since only 1% of accident victims suffer catastrophic injuries.
Ontario Finance Minister Charles Sousa stated, “Ontario is the most generous in Canada when it comes to providing coverage for auto insurance.”
I guess he isn’t aware Manitoba, Saskatchewan and Quebec provide medical rehabilitation benefits in excess of Ontario’s $1 million, when medically warranted, for any motor vehicle accident victim.
At the other end of the spectrum, dealing with so-called minor injuries suffered by approximately 80% of accident victims, Ontario’s “generous” limit for medically necessary treatment is $3,500, including the cost of assessments, examinations and reports.
No other province mandates a cap on minor injuries.
Don’t think these “minor” injuries are insignificant.
They include dislocation of joints, partial tears of tendons, ligaments and muscles, contusions, abrasions, lacerations and whiplash not exhibiting neurological symptoms.
For serious injuries — neither minor nor catastrophic — medical and rehabilitation benefits are capped at $50,000 in Ontario. That compares favourably to Nova Scotia, PEI, Nunavut and the NWT, which each have a limit of $25,000, and equals the limit in Alberta and New Brunswick.
But it falls short of the limits in British Columbia, Manitoba and Saskatchewan.
So, the most generous benefits in Canada? Hardly.
The lowering of benefits for catastrophic injuries is only one of many prejudicial changes to auto insurance coverage announced in the budget.
There’s also enhanced barriers imposed on plaintiffs suing for negligence arising out of auto accidents.
Most people are unaware of two barriers on the right to sue for damages resulting from harm suffered in an at fault auto accident.
First, there is a threshold test that must be satisfied before anyone can succeed in winning a lawsuit.
This law, introduced in 1996 and made more stringent in 2003, bars successful lawsuits unless plaintiffs can establish they suffer “from permanent serious impairment of an important physical, mental or psychological function.”
To meet this test, various stringent conditions must be satisfied.
The threshold often prevents injured people from recovering damages for serious injuries that fail to meet its definition.
Second, there is a deductible that applies only to lawsuits against negligent auto drivers. It was increased from $15,000 to $30,000 in 2003 and applies to damages for pain and suffering of $100,000 or less.
The budget would index the deductible to inflation as of 2003.
According to personal injury lawyer Darcy Merkur, that would impose a deductible of about $37,000 on damage awards of about $123,000 or less. As an example, a damage award of $100,000 would be reduced to $63,000!
Having both a threshold and a deductible is redundant and only benefits insurance companies.
And why would the government choose to index amounts that favour insurance companies, while not indexing amounts that favour accident victims?
I didn’t see any proposal to index the minor injury cap of $3,500 or the medical/rehab cap of $50,000.
As FAIR Association of Victims for Accident Insurance Reform says, “The budget does nothing to ensure that insurer claims management practices are fair and there has been no action (to deal with) ... the biased and corrupt insurer medical examination reports that are disqualifying innocent and legitimate accident victims.”
The government also announced it intends to amend the catastrophic impairment definition.
Does anyone doubt that these amendments will only serve to benefit insurance companies by restricting the number of victims who would otherwise qualify for the enhanced benefits applicable to the catastrophically impaired?
Wednesday, June 3, 2015
Friday, May 29, 2015
Advocacy groups to hold rally protesting “very shady” industry practices
by Jill
Gregorie | 29 May 2015
In response to last
week’s advancement of Bill 91, Building Ontario Up Act, two
advocacy groups are organizing a public protest to be held on June
3rd at Queen’s Park, Toronto called
#Rally4AccidentVictims.
FAIR Association of Victims for Accident Insurance Reform and the Accident Benefit Coalition are not just protesting provincial government, however.
The groups feel that insurance companies also unfairly benefit from the legislation, and allege that provincial government’s proposals to reduce coverage for the catastrophically injured is uncalled for, given the industry’s profit margins.
“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,” reads a release from FAIR.
Among these practices, FAIR contends, are insurance companies employing "for-hire physicians who provide insurers with the medical reports used to decide whether or not an injured claimant is entitled to treatment and benefits.”
In addition, the non-profit association alleges that this arrangement allows insurance companies to place severely injured victims in numerous social services programs, forcing taxpayers to cover their expenses instead of insurance payouts.
“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 the same drivers looking for a break on insurance premiums,” FAIR said.
The groups are also calling for supporters to sign an online petition.
FAIR Association of Victims for Accident Insurance Reform and the Accident Benefit Coalition are not just protesting provincial government, however.
The groups feel that insurance companies also unfairly benefit from the legislation, and allege that provincial government’s proposals to reduce coverage for the catastrophically injured is uncalled for, given the industry’s profit margins.
“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,” reads a release from FAIR.
Among these practices, FAIR contends, are insurance companies employing "for-hire physicians who provide insurers with the medical reports used to decide whether or not an injured claimant is entitled to treatment and benefits.”
In addition, the non-profit association alleges that this arrangement allows insurance companies to place severely injured victims in numerous social services programs, forcing taxpayers to cover their expenses instead of insurance payouts.
“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 the same drivers looking for a break on insurance premiums,” FAIR said.
The groups are also calling for supporters to sign an online petition.
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.
SOURCE FAIR Association of Victims for Accident Insurance Reform
For further information:
Media Contact: Rhona DesRoches, 705 543-0574, fairautoinsurance@gmail.com
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.
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/
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/
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