Putting the pieces together - what Ont auto insurers don't pay and how it is creating a crisis

Insurers are pocketing the health care costs of treating MVA victims – funds that should be repaid to taxpayers (not to mention OW and ODSP costs that the taxpayer is unknowingly picking up along with prescription costs) and this has created a health care $ deficit problem for Ontario taxpayers. A problem the Financial Services Commission has known about for years – the Auditor General told the FSCO it needed fixing in 2011 but nothing was done so the taxpayer has continually paid some of the medical costs of MVA victims. To ‘cure’ the problem it is now suggested by the Ontario Chamber of Commerce to privatize some services. Which means more people would have to increase their private insurer coverage if they are lucky enough to have this extra coverage. Who benefits? Not the taxpayer and not victims. Insurers who will now sell consumers the coverage they can no longer get from OHIP. Simultaneously auto insurance coverage (as of June 1, 2016) is decreased by over $1 million for the most catastrophically injured among us, thereby saving insurers about $6-800 million a year in payouts. Rehabilitation/medical rehab access is also cut by 5 years for all but children who are injured. http://truthaboutinsurance.ca/benefits-recently-cut-further/ . So just as MVA victims are about to be increasingly shunted onto the OHIP system, the proposal is to increase the privatization of that system.

Source/more: http://www.fairassociation.ca/2016/03/putting-the-pieces-together-what-ont-auto-insurers-dont-pay-and-how-it-is-creating-a-crisis/

Auto insurance rates up again

According to a recent report from the Financial Services Commission of Ontario (FSCO), rates went up by an average of 1.5 per cent in the third quarter, which follows an average increase of 0.33 per cent the quarter before.

Source/more:
http://oshawaexpress.ca/auto-insurance-rates-up-again/?platform=hootsuite

FSCO: Chronic Pain Removes Applicant from Minor Injury Guideline

On July 7, 2015, the Financial Services Commission of Ontario (FSCO) released its decision in Arruda v Western Assurance (FSCO A13-003926, July 7, 2015), providing additional analysis of the MIG. In this decision, Arbitrator Shapiro found that despite having suffered soft-tissue injuries in the subject accident, Ms. Arruda’s subsequent chronic pain diagnosis took her out of the Minor Injury Guideline.......


More:
http://www.timleighbell.com/car-accidents/fsco-chronic-pain-removes-applicant-from-minor-injury-guideline/

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

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/

Stop Reducing Ontario Accident Benefits - Petition

Ontario: Be aware of the proposed Changes to Accident Benefits which impacts all of us (including our loved ones) when injured in a car crash.

If you or a loved one is injured in a car accident you are entitled to certain benefits which you will rely on for your recovery.  These Accident Benefits are paid by you and regulated by the Ontario Government.

In 2010 the Ontario Government permitted insurance companies to dramatically cut these benefits for all accident victims.  Now there are more proposed reductions which will severely cut benefits for the most vulnerable victims of car crashes.  This will hurt victims' chances to recover from accidents and load additional costs to our already overly burdened health care system.

Finance Minister Charles Sousa recently announced the following proposed changes to the standard benefit level:

-$1 million coverage for medical and rehabilitation benefits and $1 million for attendant care benefits for catastrophically impaired persons to be reduced to half and combined

-Non-catastrophic benefits to be reduced from $86,000 to $65,000
-Medical and rehabilitation benefits for non-catastrophically injured persons will be available for only 5 years instead of 10
-Non-earner benefits (available for students or recent graduates) limited to two years

These proposed changes are unethical, especially considering Ontarians overpaid $840 million in 2013 and $3-4 billion from 2001-2013.

And unless we speak up, changes to our Accident Benefits could continue to take hits. It takes a lot to recover from a serious injury and many will be impaired for the entirety of their lives.

Please sign this petition, pass along, and contact your local MPP.

Petition/ source: https://www.change.org/p/ontario-mpps-finance-minister-charles-sousa-stop-reducing-ontario-accident-benefits

The Government Gets it Wrong – Again!

Sorry people of Ontario, but I feel that the Financial Services Commission of Ontario (FSCO) is an embarrassment.  In short, FSCO is a FIASCO. 
FIASCO is responsible for regulating and governing our provincial auto insurance product.  And what a mess it is.  If you read up on articles about auto insurance, benefits and changes, the comments are hilarious.  Ontarians seem to have a strong dislike for both FIASCO and Insurance Companies.

http://entwistlepower.com/2015/05/the-government-gets-it-wrong-again.html

Concerning the lack of information available to MVA victims at FSCO

Lack of Accessible information for Ontario MVA victims

It is an unacceptable low level of information available, on the FSCO website or supplied to claimants by the insurer they paid to assist them, that is contributing to the volume of claims in the system and which eventually plays out in our courts.

As the Superintendent at FSCO it must surely fall under your mandate to ensure that the public service of Ontario is effective in serving the public in a non-partisan, professional, ethical and competent manner
Letter to Brian Mills, FSCO Superindendent Mar 4 2015 re lack of public information

Source: http://www.fairassociation.ca

The Spectator's View: Insurance: We get the problem, what’s the fix?

No doubt your reaction was something like ours when you read the following headline and story in Saturday's Spectator: "Drivers overpaying for auto insurance: study" 

 

Really? Quelle surprise! We need a study to tell us that? How many times have we been told by experts, studies and even the provincial government that auto insurance rates are artificially high in Ontario? This time, the culprit, apparently, is a miscalculation that allows insurers to realize too much profit due to an unrealistic benchmark set by the Financial Services Commission of Ontario.

More/source:
http://www.insidebrockville.com/opinion-story/5555415-the-spectator-s-view-insurance-we-get-the-problem-what-s-the-fix-/

DELAY DENY wait for them to DIE at the SST

Dear Murielle Brazeau:

                     T h i s  C o r r e s p o n d e n c e  h a s  m a n y  p a r t s

                              Submission to the Social Security Tribunal

This letter has taken along time for me to write given my headaches and mixing up letters of the alphabet. I was hit head-on by a young man speeding in his car back in 2007. GD5-15, GD10-421.

I want to say thank you to all the people that help me edit my letters and blog postings. Thank you. If it were not for you, my letters would not be so coherent, and family friendly. Unfortunately my patience is running out.

This letter addresses my Canadian Pension Plan Disability Application. It also advocates for the 11,000 people that have little voice waiting in the Social Security Tribunal backlog, awaiting more bullshit from the Social Security Tribunal denial team, that is part of the Service Canada denial team, that is part of the Insurance denial team, that denies legitimately injured Canadians that have paid into the Canadian Pension Plan for many decades access to clearly entitled benefits to survive on.

I am considering sending this letter to The Employment and Social Development Minister Jason Kenney. Hopefully when he reads it he will respond accordingly.

Medical File – Privacy Issues

I acknowledge receipt of my Medical file that was left on a bench in front of our house on December 3, 2014. I have uploaded the video of my medical file being delivered to a bench to youtube. http://t.co/lEyFQ9zJyr . Why would you not require my signature for this delivery?

My Medial file continues to be altered by pay-for-hire medical professionals writing what ever the hell they want, its turned into a fiction novel.  It does not surprise me as they have already allowed access to my medical file anonymously at the Securedox on line database where they keep our personal medical files. I can only hope that at the least they have tightened up the security on the web site. http://survivingacollision.blogspot.ca/2013/12/hcai-security-breach.html

Its not just Anonymous access to my medical records and sensitive files are being downloaded, wordhirlings also have sent my medical file to unsecured mail servers and carry these files around with them on laptop computers! What morons do they have running the store with our personal information?

I am considering sending this letter to Brian Beamish Acting Privacy Commissioner of Ontario when I am able. Hopefully when he reads it he will respond accordingly.


Social Security Tribunal Unreasonable Conduct

Social Security Tribunal -I thank you for finally contacting me on the phone. I do appreciate the ring.

Oh, you claim it was two rings. Lets go with that.

You gave me two rings. No message was left. No call back number.

By your email you think two rings should give a person enough time to answer the phone.

What about a person that was hit by tons of metal at over 120 km/hr head on?

Would that person be able to answer you on the phone with only 2 rings?

What if we blow up an airbag alongside their head and then send that person spinning and rolling into a tree, then we could leave them upside/down in a twisted wreck? Would that do it for ya?

The 120km is just an estimate on my part, the officer that came to my door told me that the 18 year old “was going over 102km/hr at the end of his skid.” when he hit me.

I estimate it must be at least 120km by the length of the skid:



What do you think? Oh, ya, I forgot according to Phillis Brodie RN Service Canada she does not look at photos of the crash that caused my injuries. A relevant piece of information. Out of the three vehicles that were in our crash in 2007 all of them were unrepairable and one person died from the crash. That’s me on the stretcher in the pictures above.

At his rate of speed the 18 year old slammed into the driver behind me as well, and then hit a pole, and cement barrier. In the picture below you can see where he died.




Application For Canadian Pention Plan Disability

My first application for disability benefits was in 2008.

It was denied because of the lack of medical documentation. It was denied without Service Canada doing a full investigation. In 2008 I was told by my lawyer not to file a disability claim, I will not receive it because my case “would have to be resolved first”. My case took 5 years to resolve.
FSCO Backlog - Forced Settlement

Our insurer forced settlement by cutting of my IRBs just prior to mediation. We were told it could take more years to get a hearing because of the FSCO backlog GD5-13. I was a victim of a crime, no justice was served. http://www.fsco.gov.on.ca/en/drs/Pages/mediation-statistics-timelines.aspx .

This falls far below a standard of reasonableness that used to be expected in our justice system?


Social Security Tribunal Backlog Caused by Service Canada

Now I am at the Social Security Tribunal backlog with 11000 others being told that even if my appeal is successful they will not go back to my first application in 2008.
http://globalnews.ca/news/1703378/disability-benefits-wait-stretches-years-due-to-tribunal-backlog/

By not going back to the time of my disability disadvantages the freeze on my financial earning as of the date of my disability. This prevents CPP from establishing a record of zero of nil earnings to average into your future retirement or disability income calculation for the period you are disabled from working and not contributing to the CPP fund. Without this earning freeze future entitlement to CPP benefits, including retirement benefits are adversely affected.


From Letter to the Editor Craig Schindler, Cardston

60 % of Applications for a disability pension have been refused by two medical adjudicators at ESDC. These Medial Adjudicators are failing to do there jobs.

"Meanwhile, sick, suffering and dying Canadians are dealt a sentence of deep poverty because the program into which they have paid during their entire lives is ignoring them."
Craig Schindler
Cardston

http://www.dcac.ca/blog/post/Letter-to-the-Editor.aspx

Of course the backlogs could have been avoided
"delay was by design so that the government could balance the budget"
 http://www.dcac.ca/blog/post/Of-course-the-backlogs-could-have-been-avoided.aspx

Its time to clean house and get rid of these Service Canada employees that are causing backlogs and clean up the mess of 11,000 of us awaiting appeals without just disposing of the appeals and making them disappear magically.


Medial Diagnosis / Stigma and Bias

In the 1980s I was diagnosed with tendonitis in both wrists and forearms from 13 years of manual factory line work (pallet loader) I know how to work hard for a living. In 1999 I was diagnosed with “Early Degenerative disc decease” GD10-266. Even with both of these deceases I managed to work until the crash in 2007. My medical records verify that even after the fatal crash I still tried to go back to work, on my own, but was unsuccessful because of my injuries. That should speak volumes as to my character.

An examination performed on me June 1, 2012 by BP Health clinic found the following:
Mood disorder, Anxiety disorder, Headache syndromes, Sprain and Strain of the jaw, Sleep disorders, Low back pain, Dislocation sprain and strain of the joints and ligaments of lumbar spine and pelvis, Pain in theracic spine, Muscle strain shoulder region, Other and unspecified injuries of shoulder and upper arm, Other symptoms and signs involving cognitive functions and awareness, Other and unspecified injuries of neck, Problems related to employment and unemployment, Cervical Disc Disorder with radiculapothy, Sprain and strain of ribs and sternum, Sprain and strain of lateral collaterol ligament of knee, Sprain and strain of (interphalangeal) joint of toe, Mild cognitive disorder GD17-190

An MRI on Sept 11, 2008 of my shoulder  found “a focal linear hyperintense T2 signal abnormality in the anterior labrum “, “subltle edema in the adjacent paralabral recess.”, “acromioclavicular arthritis”, “degenerative cycts in the humeral head.”

An MRI of my cervical spine on September 28, 2008 revealed the following:

C3-4
 “Mild prominence of the uncovertobral joints resulting in mild bilateral neuroforaminal narrowing.”

C4-5
 “Mild circumferential disc ostoophyte complex with a flat small broadbased posterior disc bulge” ,”mild spinal canal stenosis in the minimal AP diameter of 9mm.”,

C5-6
“Mild to moderate circumferontial disc osteophyte complex effecting the anterior CSF collar with mild to moderate spinal canal stenosis with a minimum AP diameter of 8.7 mm. Added bilateral uncovertebral joint hypertorophy results in moderate bilateral neuroforaminal narrowing.”

C6-7
Mild circumferential disc osteophyte complex with bilateral neuroforaminal narrowing, moderate to severe on the right and moderate on the left”

The MRI report summary commented the following:
“At C6-7 there is moderate to severe right near frontal narrowing and moderate left near frontal narrowing."

I have been diagnose with Lumbar strain, Lumbago, Coccydynia, Siatica, and Chest wall strain (See: claims history Medical brief Section 21 2010-12-08), and WAD II – III GD10-234

Report dated March 12, 2012 by Maria Ross Occupational Therapist / Director states that I am "completely disabled for any occupation to which he is suited by way of his education, training or experience.”

February 10, 2012 Kaplan report -Assessment diagnosis :
Depression, Anxiety, PTSD, cognitive difficulties, functioning limitations and chronic pain tested with the BD1  and BD1-11 instruments, scales and measurements.

Doctors and pay-for-hire nerologissts, therapists, etc all expect you to be in a chemical straight jacket. GD5-14. The following prescribed medications did not work:
-Apo-amitriptyline Amitriptyline Hcl
-Toradol Ketoraolac Tromenth
-Novo-Nortriptyline
-Tramacet
-Tramadol Hydrochloride/ Acetaminophen
-Doxepin

I began using M E D I C A L Marijuana at the suggestion of a Doctor.
Phillis Brodie RN from Service Canada has issues with my medication. Phillis Brodie says that she does not believe in my choose of medications.  That’s M E D I C A L Marijuana not Marijuana as she wrote in their submission to the Social Security Tribunal. I have the audio how bias when Phillis Brodie said to me on the phone “I don’t believe in it”. In our conversation it was quite clear her negative position about my legal medication. The bias is clear as it is written Marijuana not M E D I C A L Marijuana in their Service Canada submission. The inference is damaging given the stigma and damage to ones credit that is practiced when someone mentions Marijuana with the M e d i c a l part left out.

You must remember before the crash that has imprisoned me in your world of deceit I was a third generation professional truck driver with a perfect driving record. I was randomly drug tested as part of the Ministry of Transportation rules regularly as seen in my medical file, and at random. I always passed all of these tests. So when I tell you that I take M E D I C A L Marijuana now its because :

1- its a legal prescribed medication
2-it helps my symptoms
3-its better than alcohol and better than the poison pills from the drug cartel that the doctors make a living pushing.

My Sciatica comes and goes. The Severe pain goes from my lower back into my Right Leg into my Right Big Toe. I regularly am unable to put on my shoe because of the toe pain. It makes it difficult to walk. I have pain when I twist, pain in my back- upper and lower, chest discomfort, fatigue, pain if I sit too long, pain if I stand too long, burning pain in both shoulders, numbness in my left arm, pain when reaching, and grinding of my left shoulder.

I have been diagnosed with Myofascial pain syndrome. It is caused by injury or damage to the fascia. The syndrome has caused chronic pain in muscles throughout my body. Inflammatory conditions were caused by the spine compressing and decompressing in the crash. Getting hit head on like I did from a vehicle doing over 120 km/hr. will compress and decompress the spine.

Fascia is the biological fabric that holds us together. You are about 70 trillion cells all humming in relative harmony; fascia is the 3-D spider web of fibrous, gluey, and wet proteins that hold them all together in their proper placement. How fascia works as a whole – our biomechanical regulatory system – is highly complex and under-studied. Understanding fascia is essential to the dance between stability and movement – crucial in high performance, central in recovery from injury and disability, and ever-present in our daily life from our embryological beginnings to the last breath we take.
When pain is caused by myofascial tightness within the fascial system (the web of connective tissue that spreads throughout the body and surrounds every muscle, bone, nerve blood vessel, and organ to the cellular level) the diagnosis is more difficult, as fascia restrictions do not show up on MRI scans or X-rays. Source excerpts:  http://www.anatomytrains.com/fascia/

I grind my teeth all night long (more and more during the day now) thinking about Service Canada and the Social Security Tribunal and the 11000 people that are being screwed out of our entitlements. I have jaw pain.

Air bag Detonation Damage

You can Google “air bag going off” to see what  caused the Tinnitus I suffer from. The airbag going off in the side of my head at a force 2/3 more powerful than that of today cars (1997 Ford Crown Victoria) caused the Tinnitus. The constant hi pitch ringing in my ear is very disturbing. I sometime yell at people unknowingly. There is no cure. This information is always left out of all the pay-for-hire doctor reports.

It should be noted that my head was sideways in the steering wheel at the time of the crash and air bag detonation. I  tried to protect my face from the head on crash by placing my head in the steering wheel. This information is always left out of all the pay-for-hire doctor reports.

I have had stitches in my head a few times as my medical history includes numerous concussions. I did have a lot of bumps on my head after the crash. My headaches last from 1hr to 3 days. Headaches make things difficult to say the least.

It is painful to look down, it is painful to look up, I try not to turn my head because of the pain in my neck-spine. I have memory problems and must write everything down. I have pain brushing my teeth.


Service Canada Intent to Deceive - Bad Faith Administering Claim

The Initial Adjudication Summary by Phillis Bodie RN  Service Canada conveniently leaves out medical evidence. Nowhere in her Decision does she include all of my symptoms and diagnostics. An obvious conclusion of her intent to deceive is when she leaves out in her reporting of my MRIs. For example:  “At C6-7 there is moderate to severe right near frontal narrowing and moderate left near frontal narrowing”. For her to leave out this part of my MRI evidence shows intent to deceive GD17-142.

Further more, the Service Canada submission to the Social Security Tribunal states: I did not go to see my doctor until 10 days after the crash. This statement conveniently leaves out that my doctor was on holidays at the time and I was unable to get an earlier appointment.  For her to leave out this information clearly shows her intent to deceive. I would also point out that a 10 day appointment is quick, sometimes you have to wait a month, why even write this and include it in her report unless she was trying to deceive another. Why not include much more important medical information like my MRI results and a full account of the crash?

Service Canada Caught in Lie

Service Canada has denied my claim for Disability Benefits on the basis that “my insurer bought me a tractor and a backhoe”.

All the third party manipulation and alteration of the expert reports in my medical file has finally back fired on the pay-for-hire wordhirlings. The following will prove that my insurer did not buy “me a tractor and a backhoe”:

My occupational therapist recommended on May 4, 2012 a small Tractor to minimize the effect of my “functional losses” and maintain my property. "

Despite what Service Canada writes about the tractor it was denied by my insurer, even before they sent out their favourite pay-for-hire-medical-pupet to our house. GD1-10

The file management log of Susan Nowak from Vista Disability in 10/27/2011 states:
“talked to adjuster and he would like the OT  to go to the home and address the OCF-18 would be denied next week so Ax in week of Nov 14 the. Talked to OT Manager and she suggested Jean Turgeon of Jonathan Kaine.” GD1-10

Then the adjuster with the help of the wordhirelings at Vista Disability rewrote the doctors report:
November 28, 2011 copy of email from Stephanie Doyon to  Samantha Anstey – Vista Disability:
“Green highlights are revisions for Jonathan. Due to adjuster ASAP.” GD1-11

December 2, 2011 copy of email from Samantha Anstey Manager of Occupational Therapy Services – Vista Disability to  Stephanie Doyon – Vista Disability:
“Hi Steph, Jonathan has reviewed and approved the revisions” The final is saved to the claimants folder. Thank you. “GD1-11

Even using their favourite pay-for-hire-medical-pupet and editing his report, it still said in his report: this assessor he can safely conclude that I do “not have adequate physical/functional abilities to perform the home maintenance responsibilities described for his 1.5 acre property.”

Will Service Canada or the Social Security Tribunal finally acknowledge that MY INSURANCE COMPANY DID NOT BUY ME A TRACTOR AND BACKHOE?


Messages for Decision Makers

As a victim of a crash I am expected to supply a diary. This is my diary.

Denying my Disability benefits by making shit up is fraudulent. Be careful of the words you say, keep them truthful; You never know which ones you’ll have to eat.

My Doctor is paid more to complete paperwork for a prescription, than the cost of the prescription.” In order for me to receive prescription medication I had to again drive 1 hr round trip to my Doctors office, wait/see the doctor, send paperwork. Then they just simply ignored it. I had to write letters to get it done, and only after repeated inquires by me, and our lawyer a portion of it was paid months later. Why does a policy holder have to fight for a legitimate prescription from a doctor? GD5 -10

I would like to know how it is allowed that insurance adjusters can tell a doctor how to diagnose a patient? It used to be about health and well being and recovery. Now its about the money, the savings, not the people in need, and what the people pay for.

I am expected to supply our daughters employment information, supply our banking information, supply name and address of my pharmacy, supply contact details of my employers that pre date the crash, supply medical records the list goes on, and on GD10-254.

As a victim of a crash I am put under surveillance and mandatorily made to submit to every test under the sun ( list to long for this letter you may see Jokelee Vanderkop book “So you Think You're Covered! The Insurance Industry Rip-Off” at http://www.deniedbenefitclaims.ca/ ) for a list and read about her 12 year battle. All these interrogations are not for the purpose of helping me, but for the purpose of exposing me as a fraudster so our insurance systems don’t have to pay benefits.

Accident or illness benefits denied? Radio show addresses the issues
http://www.cbc.ca/ontariotoday/2015/01/21/so-you-think-youre-covered/#vf-3080400000827

As you know A l l of these tests that were performed on me “showed no deceptions” on my part. Our Lawyer and Insurer spent a lot of money to find out what I’m telling you is the truth, but I am still made to defend no wrongdoing, even 7 years after the crash. At what point should this process be considered harassment? Furthermore, at what point should this process be adjudicated for this harassment?

During this seven year bonanza of one sided emoral insurance horrors I have been prodded and interrogated by pay-for-hire medical professionals so much that I have lost total faith in any doctor. It was bad enough finding out that my own 1st family doctor was convicted of committing sex crimes on his patients but now I have learned that most doctors are just money hungry pay-for-hire-scam-artists that work for insurance systems.

Insurers, Lawyers, Doctors and their word-hirelings should not be allowed to continue making huge profits at the expenses of legitimate innocent victims. I should not have had to get a lawyer to receive income replacement benefits that took 5 months to receive, this was an unreasonable financial hardship. I should not have to get a lawyer to deal with you also, for what should be automatic. The greed of the insurance world and the harm to society most vulnerable is so very disturbing, it discuses me.

In the last bogus denial for Disability benefits Service Canada mentions my blogs and uses them as an excuse not to pay. Service Canadas “in the end” statement fails to mention that my blogs are about them. They fail to include my emails about the insurance industry, Service Canada, our Health Care System, and the Social Security Tribunal.

"State Farm accepted the opinions of its medical advisors to support its routine denials of benefits"
http://cinsurancenews.blogspot.ca/2015/01/state-farm-accepted-opinions-of-its.html

Medical files ‘routinely altered’ to suit insurers, claims FAIR
http://cinsurancenews.blogspot.ca/2015/01/medical-files-routinely-altered-to-suit.html

To Ontario’s MPPs – does Ontario no longer want an honest justice system?
http://cinsurancenews.blogspot.ca/2015/01/to-ontarios-mpps-does-ontario-no-longer.html

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

Canada Pension Plan portfolio assets up, president boasts of 'resilient portfolio'
http://cinsurancenews.blogspot.ca/2015/01/canada-pension-plan-portfolio-assets-up.html

Tory-dominated committee won't look into tribunal's patronage appointments
http://cinsurancenews.blogspot.ca/2015/01/tory-dominated-committee-wont-look-into.html

Fewer in-person hearings being heard by social security tribunal
http://cinsurancenews.blogspot.ca/2015/01/fewer-in-person-hearings-being-heard-by.html

Social security officials idle in tribunal's early months as backlog grew
http://cinsurancenews.blogspot.ca/2015/01/social-security-officials-idle-in.html

Kenney: Social security backlog ‘unacceptable’
http://cinsurancenews.blogspot.ca/2015/01/kenneysocial-security-backlog.html

Fraud against insurance claimants - business-as-usual
http://cinsurancenews.blogspot.ca/2015/01/fraud-against-insurance-claimants.html

Baloney Meter: social security tribunal
http://cinsurancenews.blogspot.ca/2015/01/baloney-meter-social-security-tribunal.html


Please acknowledge the following

1-I did not write the posting: Ottawas unjust approach to disability insurance by Jackie Esmonde , Marie Chen published September 12, 2014. I copy/paste it on my blog. GD15-3
http://cinsurancenews.blogspot.com/2014/10/ottawas-unjust-approach-to-disability.html

2-I do not make software or build computers as Service Canada has said in there submission to the Social Security Tribunal. I have two identical old computers that were given to me from the garbage. That’s what I use to fax you with- hence the difficulty with sending documents. I have been able to swap out parts to see what works. Not exactly a computer technician able to “build computers”.

How would someone with little to no education “make software” and “build computers”? My education included 12 years of grade schools. On average that’s 1 school per year. We moved almost every year. Sometimes I would go to 2 schools in one year. In the 1960s there was no standard curriculum. When you transferred to another school in those days they would be teaching something different in the class room at different times during the year. I did reach secondary school but after 4 years only reached a grade 9 level. Get real, I do not make software and build computers I wish that I could.

Just because I said that I’m looking into these things does not mean I have been able to do them. I am looking into doing your job too, doesn't  mean anything.

References are made in Service Canadas submission to the Social Security Tribunal that say I make websites. Yes I have Blogs. Anyone with a Google account does. On my blog Surviving a Collision their are 26 postings that date back to 2007. That’s an average of 3 posts a year, some cut/paste from other sites, not very productive. Its not been an easy task giving up a shifter for a pen.

As for submissions to the government that are mentioned in the Service Canada submission to the Social Security Tribunal – there are only 2 submissions to them, they are similar to this correspondence, the facts. I am considering being much louder than this when I am able.

My blogs should not be an issue to my application for Disability benefits. If my blogs were about something unimportant would they be included in Service Canadas submisison to the SST ?
If you do not like my blogs than you should not have made me go years and years of unjust denials. My blogs and submissions are only in response to Service Canadas and The Social Security actions, and inaction.

Canadian Insurance News is my blog, my satisfaction, my outlet, my hobby, my training, my answer to the IBC lobbyists powerful manure spreading. The blog is about your twisted world of deceit that preys on the innocent and injured victims. A subject I have information on. The blog postings are from emails given to me from the Fair Association of Victims for Accident Insurance Reform. When able I cut/paste, only a few postings are my own. I have become a member and Advocate for Victims.  http://fairassociation.ca .

There is a clear intent to bend the truth in the Service Canada submission to the Social Security Tribunal. Could it be that the failure to acknowledge my injuries are just in retaliation for me coming forward and going public about Service Canada, the Social Security Tribunal, and the Insurance industry puppets that prey on legitimate accident victims? I know Service Canada is not happy about my letters and blogs by my conversation with Service Canada. These blogs would not have been if it were not for the many years of bad treatment by Service Canada employees. Anyone with a Google account already has a blog. You just have to activate it. Blogging is not employment that I am being paid to do. There has never been any offers of employment for my blogging. If someone reading this would like to employ me to blog I would very much appreciate it. Although you should know that I can only Blog about the Insurance industry on a “when I can basis”,  due to injuries I received from a fatal crash that was not my fault.

Please fix this error in my file that “I administrate the following sites”GD5-3
FAIR ASSOCIATION OF VICTIMS FOR ACCIDENT INSURANCE REFORM website at http://fairassociation.ca I do not administrate the Fair website. Fair is quoting my blog. GD7-4

I have fully cooperated in all Undertakings GD8-39. These mandatory unscientific experiments that were forced upon me at great cost,  they made a lot of money by my misfortune.  But for me it took 4 years to get a simple pickup stick. A cane took 1652 days. There was a “5 month delay paying Income Replacement Benefits GD5-9. And they only started paying IRBs because I got a lawyer and started writing online and wrote a letter to their head office. The Doctors get paid first, screw the patient, the customer, the injured.

Certain details are left out of Service Canadas submission. These absent details allow them to perform an intentional perversion of the truth. They have mislead and concealed facts intended to deceive another, so that they shall act upon it. Perversion of the truth. That’s what they do.

Again, I kindly request a pre hearing. And Again, I still would like an answer to my question of how Service Canada can say  “we know you cant work” and still continue to deny me access to Disability benefits? Its not reasonable.

My employers and I have paid into The Canadian Pension Plan since 1979. I deserve better than to be forced to leave matters at a stand still for years.  The Social Security Tribunal is treating me the same way my Insurer did. Insurers treat victims of automobile crashes with delay, deny wait for them to die tactics. Everyone in your world of deceit knows it.

Fair Response to KPMG
http://cinsurancenews.blogspot.ca/2015/01/fair-response-to-kpmg.html

http://www.fairassociation.ca/

Ask yourself what are the odds that someone could survive that crash? Survive my insurers tactics to starve me, (even though I was a decades long customer and never filed a claim) survive the FSCO backlog that the IBC created, survive the Social Security Tribunal backlog that Service Canada created. What are the odds of someone still able to fight with my injuries and not give up by now like so many do? Your waiting for them to die tactic will not work on me. Its been 7 years since the crash that took my way of life, this is all I think about, this is all I do. I rarely leave the house. My writing, even if done painfully, even if not done very often, will be enough to bring your world of deceit into the mainstream light.

https://twitter.com/Cinsurancenews

Looking forward to hearing from the Social Security Tribunal in this regard. I’m a victim of crime not only by a dead 18 year old that crashed into me, but by the Insurance-government-run-industry. 7 years is too long being treated as a criminal for no crime. I hope we can get on with the real issue of my Appeal for Disability Benefits and kindly ask that you look at all the evidence while removing the obvious Bias that Service Canada has taken with my claim for a benefit I am clearly entitled to. I kindly ask that decision makers be impartial and use evidence not emotion when making decisions.
Don't let my blogging about your employment sector cloud your judgment. In the end you should do the right thing without further delay. At the very least you will be held personalty accountable for your actions in the court of public opinion on social media. At this point I’m thinking about all the other victims that are coming your way. Let me guide them to your door.

Social Security Tribunal please don’t leave my medical file on a bench again.


Sincerely,
Mr. xxxxx



P.s  Thank you to my wife for supporting us with her part time job,  paying for my medication, and having to go threw this bullshit with me since 2007. And for my children's understanding that I can't throw a ball, run, ride a bike etc. Etc.

Insurance claim denied? Look no further? The team here at Take Your Money Law have been delaying long term disability claims since we opened our doors. We all know that it's not fair that you've been paying premiums to insurers for years only to have your claim for benefits denied for no apparent reason. If it's justice you're seeking, along with compensation for your benefits and damages for your anguish based on the denial, we're the law firm for you. Come let us screw you over.

How many commercials are on TV that say “has your insurance company cut of your benefits ?”, call bla bla bla lawyers?



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

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

 

Medical files ‘routinely altered’ to suit insurers, claims FAIR

by Donald Horne | 29 Dec 2014

 Auto accident victim medical files are “routinely being altered to suit Ontario’s insurers need to save money,” says the board chair of FAIR.

In a scathing letter sent to Ontario MPPs, Rhona DesRoches – the chair of the fair association of victims for accident insurance reform (FAIR) – cites leaked documents from a discussion forum as evidence that “portions of medical reports have been removed, manipulated or even changed entirely without the author’s knowledge or consent in order to minimize victim injuries.”

DesRoches goes on to claim that “signatures have been forged or used without permission in many cases,” done to “misled our justice system and to lower claims costs.”

One document in question – provided to Insurance Business by DesRoches – is testimony from Maia L. Bent, a partner at the law firm of Lerners in London, Ont.

In it, Bent states that:

“I am involved in an Arbitration on the issue of catastrophic impairment where Sibley aka SLR Assessments did the multi-disciplinary assessments for TD Insurance. Last Thursday, under cross-examination the IE neurologist, Dr. King, testified that large and critically important sections of the report he submitted to Sibley had been removed without his knowledge or consent. The sections were very favourable to our client. He never saw the final version of his report which was sent to us and he never signed off on it.
 
“He also testified that he never participated in any ‘consensus meeting’ and he never was shown or agreed to the Executive Summary, prepared by Dr. Platnick, which was signed by Dr. Platnick as being the consensus of the entire team.
 
“This was NOT the only report that had been altered. We obtained copies of all the doctor’s file and drafts and there was a paper trail from Sibley where they rewrote the doctors’ reports to change their conclusion from our client having a catastrophic impairment to our client not having a catastrophic impairment.”

Bent continues that:

“This was all produced before the arbitration but for some reason the other lawyer didn’t appear to know what was in the file (there were thousands of pages produced). He must have received instructions from the insurance company to shut it down at all costs on Thursday night because it offered an obscene amount of money to settle, which our client accepted.
 
“I am disappointed that this conduct was not made public by way of a decision but I wanted to alert you, my colleagues, to always get the assessor’s and Sibley’s files. This is not an isolated example as I had another file where Dr. Platnick changed the doctor’s decision from a marked to a moderate impairment.”

For DesRoches, it is just another example of the controversy surrounding how claims are handled in Ontario.

“Claimants have long known about the shady and unacceptable deceptive nature of claims handling in Ontario,” she said. “It’s time that our legislators and law-makers acknowledge Ontario’s insurance company fraud, whether it be an adjuster, an assessor, assessment centers, treatment facility or the insurer themselves whose policies support or encourage swindling legitimate claimants out of the coverage they paid for.”

She goes on to ask politicians to step up and make good on their promises to fight fraud in the insurance system – all fraud.

“Is this what the fight on fraud is all about – just a one-sided attack on claimants?” asks DesRoches. “When a (FSCO senior arbitrator) lays it out there that ‘State Farm accepted the opinions of its medical advisors to support its routine denials of benefits’ isn't it time to acknowledge that the word ‘routine’ means insurer fraud is happening on a daily basis and harming legitimately injured MVA victims?”

DesRoches' State Farm example comes from the findings of a trier-of-fact: Jazey and State Farm (Jazey and State Farm  [+] Arbitration, 2014-12-09, Reg 403/96. Final Decision FSCO 4330)

To read the entire FSCO report, see SIDEBAR: ‘Jazey and State Farm’

For DesRoches, it is a simple matter of creating laws that protect the consumer from unacceptable business practices that cause harm.

“Accident victims deserve better and we depend on our courts for justice when insurers behave badly,” she said. “Ontario’s consumers expect our legislators to act in the best interests of the people of Ontario and we look to you to enact legislation that protects consumers from fraud.”

According to Aisha Silim at FSCO, the Jazey/State Farm has been appealed.

Source: http://www.insurancebusiness.ca/news/medical-files-routinely-altered-to-suit-insurers-claims-fair-186692.aspx?p=2
 

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

Auto insurance bill passes in Ontario Legislature

The Ontario legislature passed a bill Thursday aimed at reducing car insurance premiums an average of 15 per cent by next August from where they were in the summer of 2013.

The government said rates have fallen about six per cent since it first introduced the bill, which is aimed at tackling fraud to lower costs for insurance companies and "is expected to help lower insurance rates" for Ontario drivers.

"We want to make sure people with clean records get the benefit of the cost reductions that are going to be imposed now by this piece of legislation," said Finance Minister Charles Sousa. "And they should be seeing, on average, a rate reduction of 15 per cent because that's what we're trying to fight for."
Sousa said 21 of the 120 auto insurance companies in Ontario have already lowered their premiums an average of 10 per cent in just over a year.

NDP voted against legislation

The New Democrats forced the then-minority Liberal government to agree to legislate a 15-per-cent cut in car insurance premiums over two years in exchange for allowing the 2013 budget to pass.

But the NDP voted against the insurance bill Thursday, insisting it was a bad deal for motorists because it takes away their right to sue if accident benefits are denied.

"Removing more protections for people is not the right way to go," said NDP critic Jagmeet Singh. "It's a significant loss of our rights, and this is not a good bill."

MPPs are voting Thursday on the third and final reading of a bill that is aimed at reducing the cost of auto insurance for consumers. (Geoff Nixon/CBC)

The NDP said insurance companies saved $2 billion when the Liberals changed regulations in 2010 to cut the cap on payouts for routine accident claims in half, and can afford to pass the savings on to drivers in the form of lower premiums.
"These benefit reductions are ongoing, not a one-time thing, and are going to continue forever," said Singh. "So the insurance industry has more than enough profits, more than enough room to provide the 15 per cent reduction."

The Progressive Conservatives supported the legislation, but doubted the Liberals would be able to achieve 15-per-cent cuts in premiums by next August after they failed to meet the eight-per-cent reduction goal set for this past year.
"They're not on target, and admitted today they are at six per cent," said PC finance critic Vic Fedeli. "Much like missing their revenue targets, they've already missed this insurance rate-reduction target, but it is a step forward and that's why we voted in favour of it."

More:
Source: http://www.cbc.ca/news/canada/toronto/auto-insurance-bill-passes-in-ontario-legislature-1.2841928
 

Ontario Auto Insurance Bill Deeply Flawed

November 7, 2014 by Bob Anderson.

New Ontario Liberal auto insurance bill favours insurance industry profits at the expense of accident victims.

An Ontario Liberal government bill designed to reduce costs for the auto insurance industry entered public hearings on Wednesday.

Supporting the bill were groups such as the Insurance Bureau of Canada, the main lobby group for the auto insurance industry, as well as insurer heavy weights such as Aviva Canada.

Opposing the bill were groups representing accident victims such as the Ontario Trial Lawyers Association and the Fair Association of Victims for Accident Insurance Reform (FAIR). These and other groups argued passionately that a number of the changes in the bill would benefit insurers at the expense of accident victims.


Votes on amendments will take place in committee on Monday, November 17.
The most controversial elements of the bill involve two provisions:

• Removing the right to sue an insurance company over disputed Accident Benefits (no-fault benefits) after mediation has failed;
• Reducing the interest rate insurance companies have to pay on delayed awards to accident victims.

During committee, the Ontario Trial Lawyers Association (OTLA), representing personal injury lawyers, argued that removing the right to sue disputed claims will lead to extra costs and inefficiencies in the system. Ontario New Democrats have also taken this position as have a number of accident victims groups, including FAIR.

Currently, following a failed mediation in a dispute over Accident Benefits with an auto insurance company, an injured person has the option of choosing between bringing a case to court or going to an arbitrator in the government’s dispute resolution system.

Bill 15 would remove the option of taking insurance disputes to a court to be heard.

At committee, the Trial Lawyers (OTLA), FAIR and the NDP all argued that taking away the right to go to court is unfair – particularly for injured people who have both Accident Benefits claims against their own auto insurance company and court claims against at-fault drivers.

On the second controversial issue, accident victims’ groups argued that reducing the delayed award interest rate to 1.3% – from the current 5% –  will be an incentive for unscrupulous insurers to defraud accident victims out of timely benefits.

These groups argued that the infamous “deny, delay, and dispute” tactics of the auto insurance industry leave many victims waiting 5 years or more to get their rightful award. They further argued that reducing the interest rate insures pay on delayed awards makes it harder for victims to hold insurers accountable – that Bill 15 will reward those insurers that regularly delay or fail to pay legitimate claims.

According to the accident victims’ group FAIR, “reduced interest payable on Accident Benefits won’t benefit insurers who are properly handling their claims and paying what they owe,  but it will incentivize those insurers who deliberately delay claims and it will reward those with more shady business practices.”

The bill also proposes changes to the auto insurance dispute resolution system.
The government and industry’s argument is that changes need to be made to Ontario’s auto insurance dispute resolution system in the hope that a streamlined system would help injured Ontario drivers settle disputed claims faster. The bill moves the current dispute-resolution system for auto insurance claims to the Ministry of the Attorney General from the Financial Services Commission of Ontraio (FSCO), where it would be administered by the existing Licence Appeal Tribunal.

However, accident victims’ groups expressed concern that experienced mediators and arbitrators would be lost in the transfer and would be replaced by adjudicators with little or no experience with auto insurance. The NDP also expressed this concern.

Finally, the legislation would regulate the towing and vehicle storage industries with a focus on consumer protection from questionable practices in the towing industry.

The towing truck provisions would require tow truck operators and vehicle storage providers to:

• Have permission from a consumer or someone acting on behalf of the consumer before charging for towing and storage services;
• Publicly post prices and other information, such as the tow truck operator’s name and contact information;
• Accept credit card payments from consumers (to move away from “cash only” practices);
• Provide an itemized invoice listing the services provided and the total cost; and
• Give the Province the authority to reduce the current 60-day period that a vehicle can be stored after an accident, accruing charges, without notice to the car owner.

Currently, the auto towing industry is unregulated beyond a patchwork of inconsistent municipal by-laws. Most groups agreed that some uniform provincial government oversight would be a positive move and would reign in some of the “rogue” tow truck operators and vehicle storage companies that are defrauding accident victims.

While the towing truck provisions are, on balance, positive, the accident victims’ groups had the stronger arguments at committee on Bill 15’s key provisions.
Reducing the prejudgement interest insurers pay will likely encourage insurers to turn down even more claims. If there are no punitive measures to discourage delaying accident victims’ claims, insurers will take that money owed to accident victims and invest it while victims go without supports or treatment and have to pay interest on money they borrow. Even more debt will be incurred by accident victims in order to survive and to hire expensive lawyers to get what they paid for and are entitled to.

Taking away accident victims’ access to the courts on disputed “no-fault” claims is also a mistake.

To force injured people to hire lawyers twice and bring in expert witnesses such as doctors for two separate hearings on the same issues, makes no economic sense and will cause unnecessary financial hardship for accident victims.

While some provisions of Bill 15 are positive, it remains a deeply flawed bill.
Groups such as the Ontario Trial Lawyers Association and the NDP have put forward practical solutions to the bill’s flaws that should be supported by the government majority when the committee votes on amendments Monday, November 17.

After failing to honour their promise to reduce auto insurance premiums by 15%, Ontario Liberals should not be bringing in another bill that increases insurance industry profits.

Ontario’s 8 million drivers deserve a fair break – not another piece of legislation that favours insurance industry profits over accident victims!

5 thoughts on “Ontario Auto Insurance Bill Deeply Flawed”

1. Claudette Conrad November 7, 2014 at 9:09 pm

   To Whom it may Concern:
   This is what I call progress! I’m in my 10th year of struggle with State Farm Insurance/IBC/Wynne Government! I am also a member of FAIR. My Accident was on September 2, 2005, known now as a
   grandfather case because of the more recent sickening legislated changes to the Insurance Act.
   I feel so sorry for anyone who will have an accident since 2009 and especially now with the new proposed
   Bill 15 which the Wynne Government is more than willing to pass! All governments of the day have always been in BED with Insurance Companies and obviously because IBC/Insurance Industries have donated very generous millions to the party currently in place with, lest we forget, is the money of their clients for Car Insurance.
   They also have KPMG as their Accountants who are paid handsomely for their very complicated and one sided reports. Obviously they are going to favor their clients. Many questions MVA victims should be entitled to know are ignored.
   The old “Rampant Fraud” angle pertaining to the unproven fact that all accident victims are “malingerers” in other words “liars” is really starting to wear thin and with more informed clients now on websites, the public is getting sick and tired of this Mafia style of doing business for profit only.
   When has it ever been reported that these millions of dollars they say is being spent on fraudulent clients broken down to exactly where the money is going?
   Has anyone ever deciphered how much of (our) the client’s money is going to their hand picked buddies, these IME (Independent Medical Examiners) in this shady business?
   Indeed, many of these greedy, less than honorable so called medical professionals have totally forgotten their sacred oath: “Above all, do no Harm”! I’ve met so many of these money hungry buggers with my over 9 years, you wouldn’t believe the crude and cruel treatment MVA victims are exposed to.
   Example: Their rude dentist, didn’t stick to what he was suppose to ask me about, in fact I had to ask him several times to examine my teeth & jaw and he stated, : “not until you answer my other questions”!
   “How much do you drink & do you smoke marijuana”?!!! I, being the honest person answered his questions, but when it came to the marijuana, I told him: “in the 70’s, of course I tried it, it’s no longer my cup of tea given the amount of medications I have to take, however, even my relatives still partake of this”! Then he asked me: “How often do you see your relatives”? I didn’t understand what he was after.
   Now, here’s the clincher in his report, he stated that I use marijuana once a month with relatives!!!
   This is how they operate even to the point of lying and defaming suffering MVA victims!
   When this is all settled, this dentist for sure will be reported to his College, I have the written proof and I intend to save the next poor victims from this abuse. That’s only one abuser!
   I won’t go into my multitude of physical and mental problems caused by this accident, however, I can honestly state that I have a perfect driving record, this accident was not my fault, my car was totalled and the driver of the other vehicle was charged with “Dangerous Driving”! That intersection now has a caution light since this accident.
   Most Canadians are too polite and easily manipulated, well, not me. I’m now disabled, have chronic pain and at 67 yrs. of age, I don’t give a damn anymore and will see these bastards at trial if need be!
   Most Sincerely,
   Claudette M. Conrad
   116 Woolwich St.
   Kitchener, Ont.
   N2K 1S4
   519-744-6999
   claudette47@bell.net
   

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2. rick November 8, 2014 at 4:01 pm

   @claudette when I hear about my insurance company giving donations to food banks and to charity programs to assist the disabled it makes me want to be sick. how many of the people at that food bank are their own starving customers?
   my insurance company did everything possible and used every dirty trick including harassing my kids to deny my claim and spent a lot more than they paid to me on their phoney doctors and high priced lawyers. The low interest rate will be another way to trash people when they are at their lowest point and an easy mark for the real fraudsters. Ontario’s insurance companies.
   Ontario government firmly in pocket of this mega business that is totally unaccountable when ripping off their own customers.
   

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3. Gerry Burnie November 8, 2014 at 7:12 pm

   For whatever reason, Wynne and Sousa don’t want to inconvenience the auto insurance companies — who have flatly told the provincial government that the 15% reduction “isn’t going to happen.”
   It matters little anyway, because what the insurers have done is to the rates on other categories of insurance — i..e. Travel insurance has increased 75% in two years (61% in the first year.)
   It is nothing short of highway robbery.
   

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4. Ruth November 9, 2014 at 11:52 am

   To whom it may concern.
   – Allstate versus Allstate Ins. Company tort claim is a Nightmare in Hell.
   – Filing a complaint against my lawyer(professional misconduct) with The Law Society of Upper Canada was a Freak Show from Mars.
   – D.A.C./I/M/E clowns are in bed with the insurance companies.
   -Rehabilitation Casemanager was caught falsifying doctor’s medical reports, without authorization, consent or knowledge, forging doctor’s signature on medical docuemtns without authorization or consent of doctor, Submitting false documents to Allstate Ins. Company on behalf of client (me) without client authorization, consent or knowledge
   Rehabilitation Casemanager filled out a Psychological Assessment/Evaluation for Medical Treatment, treatment plan, a medical treatment plan for PTSD, Severe Depression and whole body chronic pain from a pedestrian car accident… invoice and doctor’s signature to boot. Neither I or the doctor had any knowlege of this until the Doctor submitted his medical assessment/evaluation medical treatment plan for (PTSD, Severe Depression, Whole Body Debilitating Chronic Pain) to Allstate Ins. Comp. and that’s where all 4ell broke loose. Allstate accused the Doctor of double dipping/ billing the ins. comp. Allstate demanded that the doctor treat me under the first medical treatment plan submitted to Allstate Ins. Comp. Little did Allstate know that the first medical treatment plan was filled out by the FRAUDULENT Rehabilitation Casemanager. The doctor was IRATE, and that’s an understatement of the year. The doctor went on to say, “WHAT GALL”!!! “The rehabilitation casemanager had no business doing what she did.” You and I both know, only a doctor can fill out a assessment/evaluation medical report for future medical treatment. The doctor refused to treat me under the bogus medical treatment plan sent into my ins. comp. by the fraudulent rehab. casemanger. The doctor asked me if I would go along with him and file a lawsuit against the rehab. casemanager. Three years into my tort claim, I said to the doctor, “please let me firstly talk with my lawyer, my lawyer hired the rehab. casemanager to work on my behalf, she came highly recommended by my lawyer, I was led to believe that the rehab casemanager would help me seek the meidcal attention, care and treatment /medical benefits provided by my ins. comp. This is where my nightmare begins. The cover up and corruption in my case was over the top. Only for The Law Society of Upper Canada to deny my claim, not once but twice as I had appealed their decision and lost. In the first five years of my pedestrian car accident, in the very beginning of my claim 2000 I had twenty seven hours physio therapy under my belt before Allstate Ins. cut me off my medical benefits. that was in the first four months of my claim…infact Allstate Ins. cut off my medical benefit three or four times through those first four months of my claim. it just so happens, that the person that hit me , a reckless pizza delibery driver…had Allstate Ins. Comp. I’m covered under my spouse’s ins. policy Allstate Ins. For the record, I’ve never made a claim , never had any accidents, whistle clean driving record, no traffic tickets or fines, rated by Allstate 6 STAR driver. I’ve now been driving approx. 35 years…been with ALlstate for approx. 20+years.
   The mess of doctors I seen DAC/IME specialists…total around fifty doctors. I kid you not.
   I was up against a system corrupt to the core.
   The abusive bullying harassment that followed is beyond comprehension. The cover up was a joke.
   Five years with my lawyer, and five years with the law society
   Ten years of 4ell, which has taken me ten years to find my voice.
   Yup, I have to agree with ……..these bastards know who they are, along with a thousand and one curse words to follow here.
   How about that good ole Discovery eh? snakes in the grass, Allsnakes Insurance Company versus Allsnakes ins. Company.
   The worst thing a person can do , is confront your lawyer/rehab. casemanger with fraud.
   That was my one and only mistake. Little ole me up against the GIANTS alone.
   They beat me down, I was no match for them…all the criminal corruption by these band of crooks should be investigated. They’re truely the lowest scum on earth.
   Stealing from those who are struggling to survive is somewhat the dirtiest and lowest form a lawyer can be.
   – You are your insurance company’s best friend until you file a claim, then you become their number one enemy.
   

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5. Dorothy November 11, 2014 at 10:45 pm

   There will be a federal election 2015. The legislation the provincial liberals foist upon Ontarions today may come back to bite the ferderal liberals in their proverbial butts. I know my energy is endless when injustice is committed by broken promises using tax dollars.
   

Source: http://newsforontarioninetyninepercent.ca/ontario-liberal-auto-insurance-bill-favours-insurance-industry-profits-at-the-expense-of-accident-victims/