Queen’s Park Update: Auto insurance bills may have to wait

June 26, 2014 at 7:58 pm by Willie Handler

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A surprise majority for the Liberals in the recent election is expected to set a different tone in Queen’s Park after almost 3 years of minority government.  A minority government is all about survival, there is no long-term planning. The Liberals could not focus on deficit reduction, job creation, pensions or stabilizing the auto insurance product without the confidence of having the support of the Legislature.

Despite campaigning under an activist agenda, the Liberals are now signalling that they are serious about deficit reduction. Deb Matthews has been appointed President/Chair of Treasury Board/Management Board which traditionally has been a responsibility of the Ministry of Finance. Treasury Board is not well known outside of government but it is a powerful central agency that manages the fiscal plan of the government including all government spending and approving labour agreements.  A very powerful body.

Charles Sousa continues as Minister of Finance and appears to still be responsible for the auto insurance file.  His Deputy, Steve Orsini has been promoted to Secretary of Cabinet which is head of the Ontario Public Service.  His appointment is intended to also signal that the Liberals are serious about deficit reduction.  He replaces Peter Wallace also preceded Orsini as Deputy Minister of Finance.

There has been some restructuring in the Ministry of Finance.  The Insurance and Cooperatives Policy Unit (which includes auto insurance policy) and the Deposit Taking Institutions Unit of the Industrial and Financial Services Branch will be reconstituted as the Financial Institutions Policy Branch. They will continue to be led by Alvaro del Castillo. Tthe Financial Institutions Policy Branch will join the Securities Reform Division (SRD) reporting to Assistant Deputy Minister Frank Allen who replaces Pat Deutscher. To better reflect its broader mandate the SRD will be renamed the Financial Services Policy Division.

Next week, new MPPs will return to Queen’s Park to elect a new Speaker of the Legislature (July 2), hear a new Speech from the Throne (July 3), then debate a re-introduced provincial budget on July 14. It is expected that shortly after that the Legislature will recess for the summer.  That might mean that the reintroduction of industry supported bills such as Bills 171 and 189 might have to wait until the fall.

 Source: https://www.blogger.com/blogger.g?blogID=8201435313300764139#editor/target=post;postID=6637068326969657732

Mental Stress Claim Upheld By Workplace Safety And Insurance Appeals Tribunal

By ILSTV Staff on Jun 27, 2014

 

In a ground-breaking decision, the Workplace Safety and Insurance Appeals Tribunal has found that a provision in the Workplace Safety and Insurance Act (the “Act“), which denied benefits to workers suffering from non-traumatic mental stress, is unconstitutional.

Background

The Act is designed to provide benefits to employees who have sustained personal injury in the course of their employment. However, the Act provides that employees are not entitled to benefits for mental stress unless the stress is “an acute reaction to a sudden and unexpected traumatic event” in the course of employment.

This is seen by many as unjust. The Ministry of Labour has indicated that approximately 30% of disability claims involve mental illness. Nevertheless, employees suffering from workplace stress, unlike employees who have suffered physical injury, are denied access to workers’ compensation benefits.

The Decision

This decision involved a claim by a nurse who worked at the same hospital for 28 years. For 12 of those years she claims she was subjected to mistreatment by a doctor who worked with her. She claimed the doctor yelled at her and made demeaning comments to her in front of both colleagues and patients. Coworkers brought her mistreatment to the attention of management, but no steps were taken to deal with the issues and the doctor’s behaviour continued.

After a particularly difficult incident, the nurse complained to management about her treatment by the doctor. The hospital responded by demoting her. The worker was so distressed that she sought medical attention. She was diagnosed with an adjustment disorder with anxiety and depression attributable to the stress she suffered in the workplace.

The WSIB denied the claim because the nurse’s condition was not the result of an “acute reaction to a sudden and unexpected traumatic event.”

The case was appealed to the Workplace Safety and Insurance Appeals Tribunal. The Tribunal concluded that the nurse would have been entitled to benefits but for the restriction on awarding benefits as a result of mental stress.

The Tribunal went on to find that the provisions of the Workplace Safety and Insurance Act which deny benefits for mental stress violated the guarantee of equality under the Charter of Rights and Freedoms.

Implications of Decision

Although the Workplace Safety and Insurance Board is not bound to follow the decisions of the Tribunal it is expected that this case will form the basis of a new policy by the WSIB to accept claims based on mental stress.

In 2011, the WSIB allowed 677 claims for traumatic mental stress. The potential claims arising out of “non-traumatic” mental stress will no doubt greatly exceed this number. The Government of Ontario has stated that 1 in 5 Canadians are affected by mental illness every year. Certainly not all mental illness arises because of workplace stress. However, if the WSIB allowed 677 claims for traumatic mental stress in 2011, it is a reasonable assumption that there are many more “non-traumatic” claims for workplace mental stress.

Concerns have been expressed that the increased number of claims expected as a result of this ruling will result in sky-rocketing increases in WSIB premiums at a time when employers are already complaining about the high cost of WSIB coverage.

The Appeals Tribunal addressed those arguments. It noted that there was little evidence regarding the cost of mental stress claims in Ontario. It also noted that any argument that people with mental stress claims would put an unjustified burden on the workplace insurance system merely served to “exacerbate the historical disadvantage faced by persons with mental disabilities” because it assumes that they are not deserving of benefits and places the burden on society.
It is likely that the Ontario government will challenge this ruling in the Divisional Court. In the meantime, applications for benefits based on non-traumatic mental stress are likely to be entertained.

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

Article by Elizabeth J. Forster

Blaney McMurtry LLP

http://www.ilstv.com/mental-stress-claim-upheld-by-workplace-safety-and-insurance-appeals-tribunal/

 

Case of vanishing insurance

Don’t let insurers cancel your policy retroactively, or take away your right to sue

By Alan Shanoff, Toronto Sun

First posted: Saturday, June 21, 2014 07:00 PM EDT | Updated: Saturday, June 21, 2014 09:19 PM EDT

 

Motor vehicle insurance is compulsory in Ontario.

Driving without insurance can lead to fines, licence suspension and vehicle impoundment.

It’s also financially risky.

Uninsured drivers are personally responsible for any accidents they cause.
But what isn’t so obvious is that they also forfeit the right to sue other car owners or drivers.

The purpose of this law is simple.

We don’t just want to keep uninsured drivers off the road.

We also want to prevent those who haven’t paid into the pool of insurance premiums from suing or obtaining money from insurance companies and drivers who have paid into that pool.

This law makes sense.

What doesn’t make sense occurs when an insurance company tries to use the law to retroactively void an insurance policy, to take away an injured driver’s right to sue.

That’s what happened to Wayne Radwan Alof.

Alof obtained car insurance in Nova Scotia, where his car was registered.
He moved to Ontario and had his car registered in Ontario in February, 2010.
He had a discussion with his insurance company after moving to Ontario, advising it he didn’t know if the move was going to be permanent.
Alof had the misfortune of being in an accident in Mississauga in July, 2010.
He apparently suffered serious injuries and sued the other driver.

One month after reporting the accident his insurer, TD Insurance, notified Alof his insurance had been retroactively voided as of the previous February, due to a failure to advise the insurance company that his car had been registered in Ontario.

So, Alof had insurance as of the date of the accident, but his insurance company retroactively withdrew the insurance after the accident, leaving Alof in a precarious position.

Could this “now you see it, now you don’t” insurance policy result in a retroactive forfeiture of his right to sue to recover compensation for the injuries he suffered in the July accident?

That’s precisely what the other driver’s insurance company argued in a court motion to dismiss Alof’s lawsuit.

The motion was argued in January with a decision released in April.
Superior Court Justice Wendy Matheson ruled the lawsuit could proceed.
She applied some common sense, ruling that regardless of TD Insurance’s attempt to retroactively void Alof’s policy, the fact remained that at the time of the accident Alof did have insurance coverage, so he did have the right to sue.
I can’t help but think insurance companies and their lawyers stay up all night trying to dream up ways of defeating valid claims.

Fortunately, we have many good judges who stand ready to protect our rights.
But there are some lessons to be learned in this case.

Any move, from one province to another, to a different city or town, or even within the same city or town, can trigger a change in risk for your auto insurance.

Changes in the use of a vehicle and vehicle modifications, even some cosmetic ones, can also lead to a change in risk.

Changes in ownership and the addition of a new driver also trigger changes in risk.

It’s important that any potential changes in risk be reported to your insurance company.

Ask for an email address so you can send an email and obtain a record of your disclosure.

Your insurance company may decide to modify the premium — up or down — but you will have the peace of mind of knowing your coverage is intact, as is your ability to sue others for your losses.

Failure to report a change in risk can lead to the cancellation or voiding of your policy.

If you are in an accident your insurer may deny coverage.
Do the right thing. Even if in doubt, report all changes.

Source: http://www.torontosun.com/2014/06/21/case-of-vanishing-insurance
 
 

Next steps in auto insurance: What action will our MPPs take to increase access to justice for accident victims?

Tomorrow is Election Day in Ontario and many of us will be off to the polls to cast our votes.

On June 3, 2014, we saw the election debate between the three major party leaders. While a number of issues were addressed, including scandal, the deficit, and job creation, auto insurance reform was not one of them. It is unfortunate that the topic did not attract more attention from the candidates as the issue will affect most Ontarians.

While the candidates proposed changes to auto insurance in their policy platforms at the outset of their campaigns, it has not been a prevalent topic of discussion as we near the polls.

The Liberals promised a drop in average insurance rates by 15%, which has yet to be achieved. Earlier this year, they introduced Bill 171 that proposed amendments to the Dispute Resolution System (“DRS”), a crackdown on fraud, further regulation for the towing industry, and a reduced rate for pre-judgment interest. Due to the call for an election, Bill 171 was not passed.

As part of the NDP platform, Andrea Horwath, stated she would achieve a 15% insurance premium reduction within the first year of government and would “drive some changes in the auto insurance industry.” However, she failed to elaborate on exactly what the changes might include or explain how they would be achieved.

According to the Financial Services Commission of Ontario, a 6% premium reduction has already been realized.

The Conservatives criticized Bill 171 when it was initially introduced and responded with their own plan for DRS reform. They propose to increase accountability from insurers and reduce fraud by further utilizing the Health Claims for Auto Insurance (HCAI) electronic billing system. Similar to their opposition, they also call for reduced premiums but have not stated how much of a discounted rate the public could expect or when it would take effect.

While the platforms have outlined each of the parties’ goals, the candidates have done little to explain how they will be obtained.

As an Ontarian and insurance consumer, I am interested to know what the candidates will do to ensure that premiums do not continue to increase, especially when accident benefits continue to be slashed.

As a personal injury lawyer and OTLA member, it is important to me that the elected government does not ignore this issue and continue to allow my clients to face systematic unfairness.

Will the candidates make efforts to eliminate the threshold or reduce the deductible? What action will they take to increase access to justice for accident victims? It appears these questions will remain unanswered as we head to the polls. However, the election is only the beginning, and I will continue to write to my MPPs and assist OTLA in raising public awareness to ensure these issues are given the consideration they deserve.

Contributed by Michael Giordano, an OTLA member and a lawyer practising with Sal Guzzo LL.B. Professional Corporation.

Source: http://otlablog.com/next-steps-in-auto-insurance/
 

Not reasonable for insurance companies to waste money fighting policy holders

By Alan Shanoff, Toronto Sun

First posted: Saturday, June 14, 2014 07:04 PM EDT | Updated: Saturday, June 14, 2014 12:55 PM EDT

 

Reasonableness and common sense go a long way in preventing disputes and litigation.

Those are attributes we sometimes find in short supply at insurance companies.
Take the case of Grzegorz Zaprzala who was injured in July, 2009.

He had disability insurance through his employer, Hooper Welding Enterprises.
His disability application was approved with benefits of $3,000 per month commencing in November, 2009.

Every disability insurance policy has an offset provision. Certain specified sources of income are required to be offset or deducted from the disability benefits.

Among the many offsets are CPP disability benefits.

It is customary for disability insurance policies to require those receiving disability benefits to apply for CPP disability benefits.

Any CPP disability benefits obtained are then deducted from the insurer’s disability payments.

If the person receiving benefits doesn’t apply for CPP disability benefits, the insurance company is entitled to reduce its disability benefits by the estimated amount of the CPP benefits that could have been obtained.

In this case, Zaprzala’s application for CPP benefits was denied.

He requested reconsideration of the decision but once again his application was denied.

His insurance company, Manulife Financial, told him he had an obligation to appeal the denial to the CPP Review Tribunal, even though there wasn’t anything in the insurance policy that specifically spelled out such an obligation.
Before the appeal was launched Manulife prepared a document and told Zaprzala to sign it.

The document stated Manulife would continue to pay the disability benefits without deduction of any estimated CPP benefits, provided that Zaprzala agreed to reimburse Manulife for any subsequent CPP benefits award.

But Manulife had an obligation to continue making the disability payments pending the appeal.

They had no right to deduct estimated CPP disability benefits after his applications had been rejected.

Zaprzala hired a lawyer to handle the appeal to the CPP Review Tribunal. The appeal was successful and Zaprzala was awarded about $34,000 in retroactive CPP benefits.

But his lawyer charged him about half that amount, leaving Zaprzala with a net gain of about $17,000.

Zaprzala offered to pay the net amount of $17,000, to Manulife.

Sounds reasonable to me.

After all, Manulife told Zaprzala to appeal and they received the benefit of the legal work.

No one told him not to retain a lawyer and it was certainly foreseeable he would have to hire a lawyer.

But Manulife wanted the full benefit of the $34,000 CPP payment.

And since they controlled the disability benefit payments, they stopped making payments to Zaprzala until they recovered the full $34,000.

They say that was their contractual right because the insurance policy didn’t say anything about allowing Zaprzala to hire a lawyer and the offset provision of the policy allowed them to deduct the entire CPP payment.

Zaprzala sued, seeking punitive damages, claiming Manulife shouldn’t have deducted the full CPP benefit.

Manulife responded to the lawsuit with a court motion seeking to dismiss it prior to trial on a summary basis, arguing it was plain and obvious the lawsuit could not succeed.

The motion was heard before a judge of the Ontario Superior Court of Justice in February and a decision was released earlier this month dismissing the motion.
Justice Theresa Maddalena ruled the lawsuit could continue, that it wasn’t plain and obvious the lawsuit couldn’t succeed.

A ruling on the amount of Zaprzala’s legal fees to be paid by Manulife has not yet been released.

Whether the lawsuit will continue or be settled remains to be seen, but it is clear Manulife has or will soon have incurred expenses far in excess of the initial amount in issue, $17,000.

A little dose of common sense or reasonableness could have avoided this legal mess.

But as has often been said, common sense isn’t so common.


Source: http://www.torontosun.com/2014/06/14/not-reasonable-for-insurance-companies-to-waste-money-fighting-policy-holders
 

 

 

How Insurers use Social Media (Facebook, Twitter, Instagram) against you

June 18, 2014  

By Goldfinger Personal Injury Law

 

You know what's fun?
Posting status updates on Facebook.
Posting pictures on Instagram.
Posting videos on Vine.
Posting your day to day thoughts on Twitter.
Posting your new job on LinkedIn.
Social media is FUN.

But just because something is fun or popular, doesn't mean that it's right for you, particularly when you're in the middle of a litigation battle against a large, deep pocketed insurance company.

The purpose of this Toronto Injury Blog Post is to show you how insurers can and WILL use social media against you to defeat your credibility and to defeat your personal injury case.

If you didn't already know, insurance companies will do everything in their power to defeat your claim.

If that means spending $50,000, to avoid paying you $10,000 on a claim which they deem to be without merit, then they certainly will. Our lawyers have seen accident benefit files where insurers refuse to pay an injured accident victim who cannot work a $400/week income replacement benefit, but instead, send them to countless assessments which cost between $7,000-$15,000. The cost of the medical assessments were 7-10 times the cost of the weekly benefit.

Source and the rest of the story: http://www.torontoinjurylawyerblog.com/2014/06/how-insurers-use-social-media-facebook-twitter-instagram-against-you.html
 

Province takes slow approach to reforming liability legislation

By: Darren MacDonald - Sudbury Northern Life

 | Aug 20, 2014 - 7:41 PM |

There will be no quick relief for Ontario municipalities who are having to shell out millions due to the rising number of lawsuits filed against cities -- and the climbing damage awards that accompany them. The province has said it's open to reform, but change will take time. File photo.

Current rules driving double-digit increase in municipal insurance rates

 Hopes the province would act quickly to help cities stem soaring insurance costs were dashed at this week's meeting of the Association of Municipalities of Ontario.

What's known as 'joint and several liability' rules in the province often force municipalities to pay the bulk of multi-million dollar damage awards in lawsuits. Under the 'one per cent rule,' even when cities are found to have played an extremely minor role in an accident, judges can order them to pay most of a damage claim if the other defendants don't have the resources. That's because cities are viewed as having deep pockets when it comes to compensating accident victims.

In one case a few years ago in southern Ontario, a man who had been drinking – even had a beer in his lap while he was driving – blew threw a stop sign and caused a serious accident. The judge in the case ruled the municipality had to pay the bulk of the award because was partially responsible since the signage alerting drivers about the stop sign was inadequate.

Joint and several liability is particularly costly in Ontario for municipalities because of no-fault vehicle insurance rules. With lawsuit awards usually capped at $1 million for car insurance companies, plaintiffs often will include cities because there's no limit in place on what they can be forced to pay.

That's driving up municipal insurance costs across the province, including Sudbury. Premiums are up this year by 40 per cent in the city's police budget, almost 55 per cent in building services, 37.1 per cent in waste collection, 48.6 in Ontario Works, 40.3 per cent in children's services and 29.1 per cent in emergency services.

In dollar terms, rising premiums cost local taxpayers $300,000 in added costs this year alone. AMO has long lobbied for reform, and there was hope the new Liberal majority government would be receptive.

But in his remarks to delegates meeting this week in London, AMO president Russ Powers said they had been informed that change was not coming any time soon.

“This week the Ontario government informed AMO that it would not act on this,” Powers said, describing the current rules as “immoral and wrong.

“Other provinces have introduced sensible limits on municipal liability and protections for property tax payers. We won’t stop until we get that done.”

While not ruling out changes, Attorney General Madeleine Meilleur told the Ontario Legislature in July the government wants to ensure that whatever changes they make won't end up hurting victims or have other unintended consequences.

That's what happened under the no-fault insurance rules, which were aimed at slowing the rise in automobile insurance rates. Another example is a Supreme Court of Canada ruling that capped general damage awards at $100,000, and tied it to inflation. That prompted judges to look for other parties who could pay compensation to accident victims. So reform will take time, Meilleur said.

“Legal liability reform is an important and complex issue,” she said, in response to a question from PC MPP Randy Pettapiece. Whatever the province does, she said “there will be winners and losers. It’s a very complex matter, and we want to make sure that we have it right before we move forward.”

Ontario is reviewing rules used by Saskatchewan, she said, to see whether they could work here. Under that model, “if there is a shortfall because one defendant is insolvent and the plaintiff’s own negligence contributed to the harm, the shortfall is divided among the remaining defendants and the plaintiff, in proportion to their fault,” says a post on AMO's website.

“Another model will limit municipal liability for negligence in road maintenance to two times the proportion of damage,” Meilleur said. “It could look very simple for some of us, but it’s a very complex issue. Indeed, if this bill is passed, (as I said) there will be winners and losers, and that’s what we have to consider before moving forward with it.”
 

Source: http://www.northernlife.ca/news/localNews/2014/08/20-insurance-sudbury.aspx

NDP: Liberals must choose between Ontario drivers and auto insurance industry

April 22nd, 2013

NDP: Liberals must choose between Ontario drivers and auto insurance industry

QUEEN’S PARK - Today in the legislature, Bramalea-Gore-Malton MPP and Consumer Services Critic Jagmeet Singh asked Finance Minister Charles Sousa when Ontario drivers can expect to see some relief with their premiums.

 “In 2010, this government made changes to Ontario’s auto insurance system that slashed Statutory Accident Benefit payouts by 50% across Ontario and 70% in the GTA,” explained Singh. “Last week in committee, the IBC admitted that these changes resulted in up to $2 billion in annual savings to the insurance industry. Yet, in the past 2 years, premiums paid by drivers went up 5%.”

Singh noted that on April 12, FSCO released its report on premiums for the first quarter of 2013 and once again, there is no reduction in premiums for Ontario’s 9 million drivers.

 “In the upcoming budget, this government has a choice: it can either pass on a portion of the $2 billion in annual savings from the 2010 cutbacks to Ontario driver, or it can continue to allow big insurance to slash benefits and pocket the savings,” said Singh. “Which is it going to be?”

Source: http://www.jagmeetsingh.ca/post/62727871149/ndp-liberals-must-choose-between-ontario-drivers-and 
http://www.fairassociation.ca/2014/08/liberals-must-choose-between-ontario-drivers-and-auto-insurance-industry/

 

Accident Benefit Reporter Updater, Issue 20

Cost Proportionality Not Always Kind to Injured Plaintiffs

By:

Darcy R. Merkur Partner Thomson, Rogers

When it comes to the issue of legal costs, the proportionality concept is a welcome feature in civil litigation but it can serve to penalize personal injury plaintiffs with modest personal injury claims.

For example, in Mayer et al v. Shemon et al, the plaintiffs were awarded $140,600 by a jury at trial, but had their partial indemnity cost claim of $422,055.41 denied by the Honourable Mr. Justice Ian F. Leach of the Ontario Superior Court of Justice in his decision released April 28th, (2014) ONSC 2622 (S.C.J.).

In his reasons denying costs to the plaintiffs, Justice Leach reviewed all of the Rule 57.01 factors in relation to cost awards.

Justice Leach highlights the overriding principle of reasonableness when it comes to the issue of costs. He then proceeds to review in detail the conduct of the trial and raises various criticisms of plaintiffs’ counsel’s approach – for example holding plaintiffs’ counsel largely responsible for the extended length of trial, estimates by plaintiffs’ counsel at 2 weeks and lasting close to 4 weeks.
The undercurrent to the court’s reasoning in denying costs to the plaintiffs in Mayer, appears to be the fact that plaintiffs’ counsel believed the case was a sizeable one, and pursued it as such, when defence counsel and the jury felt otherwise. For example, Justice Leach in reference to the plaintiffs’ unwillingness to comprise from their settlement position, states that, “the plaintiffs seem to have engaged in no meaningful risk-analysis whatsoever, nor any corresponding willingness to compromise their claims in any degree, for the purpose of resolving the parties’ dispute without trial.”

In Mayer, plaintiffs’ counsel had made a formal offer to settle for $1.5 million in damages after having successfully moved before trial to increase the quantum claimed. Defence counsel, on the other hand, made an all-inclusive offer of $200,000 as well as an offer for damages totalling $150,000 (broken down as $115,000, $15,000 and $20,000 to each of the various plaintiffs), plus partial indemnity costs.

Despite an unwelcome modest jury award, the plaintiffs claimed partial indemnity costs of $265,393.21 for fees inclusive of tax, and $156,662.20 for disbursements inclusive of tax, for a total all-inclusive cost claim of $422,055.41.
Claiming that they beat their offer to settle, defence counsel claimed their partial indemnity costs in the amount of $181,406.76.

In considering defence counsel’s request for costs, Justice Leach ruled that defence counsel failed to establish they beat their formal offer given that their initial offer was improperly framed as an all-inclusive one and given that their subsequent offer did not state whether the offer was severable so as to allow each plaintiff to accept the amount offered.

In the end, Justice Leach ruled that justice would be best served in this case by denying costs to both sides and, accordingly, no cost order was made.
The Mayer case must not been seen as a precedent for denying cost claims of this magnitude in personal injury cases were the damage amounts involved are far less than the amount claimed for costs.

Personal injury litigation is extremely expensive. Even the simplest case is expensive to properly present at trial. With recent court decisions challenging the admissibility of treatment reports that do not formally comply with the expert report rules,  disbursements costs have increased drastically.
Access to justice requires personal injury claimants to be able to access the courts. For cases were the amounts involved are expected to be in the $100,000 to $250,000 range, the partial indemnity costs claimed will often fairly and properly exceed the amounts awarded.

The offer to settle rules are there to keep litigants acting reasonably. Defence counsel and insurers know the costs of trial and should not be surprised when cost claims exceed the amounts recovered. The solution is for defence counsel to make more reasonable offers and to make them earlier.

While improvements to the Rules of Civil Procedure to help reduce the cost of trial are welcome, until such rules are in place the cost of a medium size personal injury trial will continue to be out of proportion to the cost of the damages claimed and this reality must not serve to prejudice or constrain access to justice for personal injury claimants.

Darcy Merkur is a partner at Thomson, Rogers in Toronto practicing plaintiff’s
personal injury litigation, including plaintiff’s motor vehicle litigation.
Darcy has been certified as a specialist in Civil Litigation by the Law Society of
Upper Canada and is the creator of the Personal Injury Damages Calculator.

Source: http://www.thomsonrogers.com/accident-benefit-reporter-updater-issue-20?utm_source=2014+TR+In-House+List&utm_campaign=4e5d691309-ABR+Updater+Issue+20&utm_medium=email&utm_term=0_5acf6d43a2-4e5d691309-410815605
 

What about victims?

It’s time to focus more on those hurt in automobile crashes, less on the concerns of insurance companies

 By Alan Shanoff, Toronto Sun

First posted: Saturday, August 16, 2014 07:00 PM EDT

 

 Isn’t it odd that when we read or talk about auto insurance, we focus on premiums or fraud?

We rarely read or talk about the interests of accident victims.

Maybe that’s because it would be politically embarrassing to discuss their interests.

If we did, we’d have to mention that in 2010, the $100,000 maximum for medical/rehabilitation benefits was reduced to $3,500 for minor injuries (even though many so-called minor injuries are quite significant) and $50,000 for non-catastrophic injuries.

We’d have to mention these benefits are even lower than they appear since the costs of assessments and examinations are now deducted from these reduced benefits, thereby reducing them further.

Prior to 2010, there were additional benefits to pay for necessary assessments to determine entitlement to benefits, or to determine the medical/rehabilitation services required.

We’d have to mention that in 2010 the $72,000 maximum attendant care benefit for non-catastrophic injuries was reduced to zero for minor injuries and $36,000 for non-catastrophic injuries.

We’d have to mention that in 2010 the $100 per week maximum for housekeeping benefits was eliminated, save for the 1% of accident victims who have suffered catastrophic injuries.

We’d have to mention that in 2010 the maximum caregiver benefit of $250 per week plus $50 per week for additional dependents was eliminated, save for those suffering from catastrophic injuries.

While some accident benefits can be topped up via optional coverage for extra premiums, consumers have been ill-served by insurers and government and, accordingly, only about 1% of those who buy insurance purchase additional coverage.

As the Fair Association of Victims for Accident Insurance Reform (FAIR) has pointed out, “consumers remain unaware of the low level of coverage they’ve purchased until it is too late and they need to use it.”

Oddly, even though some accident benefits can be topped up, insured persons aren’t allowed to opt out of any benefits to save premiums.

Many retirees, for example, complain about the mandatory purchase of income replacement benefits.

FAIR is absolutely right when it concludes, “the 2010 reforms were intended to control insurer costs without regard to the outcome for Ontario’s accident victims.”

But it isn’t just the lower benefits that prejudice the rights of accident victims.
It’s the behaviour of many insurance companies in denying payment of accident benefits.

Almost one in every two Ontario accident victims has a dispute with an insurance company.

In 2013, 25,329 injured accident victims applied for mediation to contest accident benefits denied by their insurer.

About 45% of those cases dealt with the denial of medical/rehabilitation benefits.

That means that last year alone, we had 11,399 people claiming wrongful denial of medical/rehabilitation benefits.

A major cause of the large scale denial of benefits rests with the medical assessments purchased by insurance companies.

In many cases, more money is spent assessing a victim’s injuries than the cost of the treatment being sought.

Yet, according to a recent review of auto insurance, there are “no standards or qualifications for assessors in the auto insurance system.”

Then again, why would we need such standards or qualifications? That would just benefit accident victims.

Making matters worse is the 2010 “reform” eliminating an injured person’s right to obtain a rebuttal assessment to counter a denial of benefits brought about by an insurer’s medical assessment.

At one time I was optimistic some in the Ontario government cared about the plight of accident victims.

The Standing Committee on General Government and the Standing Committee on Finance and Economic Affairs held public hearings and heard from groups representing accident victims, as well as individual accident victims.
But here we are more than two years later and we have heard nothing but silence concerning accident victims.

But not to worry. Politicians of all stripes remain interested in auto insurance premiums.

Apparently, the product is of little importance; only the price matters.​

Source: http://www.torontosun.com/2014/08/16/its-time-to-focus-more-on-those-hurt-in-automobile-crashes-less-on-the-concerns-of-insurance-companies