Monday, June 2, 2014

Lawyers, ‘experts’, cashing in when auto insurance claims go to court

Regular readers will know I have locked horns with the Insurance Bureau of Canada on many occasions.

That’s why I’m pleased to say I agree with the statements on the IBC website that “Ontarians deserve affordable, effective insurance and the current system is simply not working in Ontario” along with, “Too much of the money doesn’t actually go to accident victims.”

But the IBC website then goes on to say, “Instead, it pays for other costs like legal fees, fraud and assessments by for-profit medical facilities”, which implies that more money would go to accident victims if these costs decreased.

And with that, I disagree.

The recently reported case of Pamela Mayer (and her husband and daughter) versus Anwar Gewargis Shemon offers a glimpse into the exorbitant world of legal and experts’ fees.

The plaintiffs sued over a motor vehicle accident. Liability was admitted. The only issue for resolution was the financial award.

The plaintiffs initially sought $1.1 million plus interest and legal costs but increased the claim to $2 million plus costs during the trial.

The jury saw things differently and awarded damages of only $140,600 following a four-week trial.

Having won the case, albeit with a minor victory, the plaintiffs sought compensation for part of their legal costs.

The partial legal costs being sought were an astounding $265,393.21, plus $156,662.20 for disbursements.

That’s $422,055.41 in respect of a case the jury assessed as worth only $140,600.

None of these figures include the legal fees charged by the insurance company’s lawyers, or fees paid to the defence experts.

While those fees aren’t fully disclosed in the court decision it’s safe to assume the fees paid to the insurance company’s lawyers and defence experts exceeded $250,000.

Ontario Superior Court Justice Ian F. Leach labelled the legal fees sought by the plaintiffs’ lawyers as being “extremely excessive” and “outlandish”, pointing out the total clerk time of 580.49 hours claimed “is the equivalent of someone working solidly on nothing but this matter, 40 hours per week, ... for approximately 14.5 weeks”.

That, according to Justice Leach, was “quite unreasonable”.

The disbursements included $26,398.27 to an expert epidemiologist witness whom the court said had a “relatively brief appearance” in court, $20,556.93 to another expert witness doctor, $18,851.17 to two occupational therapist witnesses and $30,722.25 to an expert witness who testified on economic losses suffered by the plaintiffs.

Those are just the experts retained by the plaintiffs and the figures demonstrate how lucrative being an expert witness can be.

But not if Justice Leach has his way, as he remarked, “an expert cannot simply charge what he or she considers appropriate and then expect ... that such fee will be deemed acceptable by the court.”

Clearly the plaintiffs’ lawyers did not have a realistic assessment of the realities of the case as determined by the jury and devoted time and resources to the case that were disproportionate to its true worth.

Further, the plaintiffs made no effort to settle the case until the eve of trial, when they sought $1.5 million plus costs.

Based on these and other factors Justice Leach decided to award no costs to the plaintiffs in spite of their victory in the lawsuit. That should present a sobering lesson to plaintiffs’ lawyers who conduct litigation in a similar fashion.

The revelations in this case reinforce the IBC lament of too much money being incurred on costs like legal fees.

But here is where I part company with the IBC.

The IBC implies if less money went to other costs like legal fees, there’d be more money for accident victims.

But based on past history and particularly the reduced money going to lawyers and experts and medical facilities due to the 2010 cap of $3,500 on minor injuries, there’s little reason to believe if less money went to lawyers and experts that more money would flow to accident victims.

source:  First posted:

MORE REDUCTIONS IN AUTO INSURANCE COVERAGE?

We have all experienced or heard about high insurance premiums in the Ontario auto insurance system. Why does this occur? The insurance industry wants us (and the politicians at Queen’s Park) to believe that premiums are high solely because too much money is being paid out in claims. Is this really the case?

In a 2012 report by the General Insurance Statistical Agency, it was noted that the insurance industry took $3.78 billion in accident benefit premiums from Ontario drivers, but paid out only $1.67 billion in claims and adjustment expenses. Since 2010 the Ontario accident benefits regime has been changes in several ways. All of these ways help the insurance industry and reduce benefits for injured people. Some of the changes include:

• Implementation of Minor Injury Guideline which limits medical/rehabilitation coverage to $3,500 for the vast majority of all people hurt in car accidents;

• Reduction of medical/rehabilitation limit coverage from $100,000 to $50,000 for those people who do not fall into the Minor Injury Guideline and who are not catastrophically impaired;

• Elimination of housekeeping and home maintenance benefit for non-catastrophic claims;

• Implementation of the concept of “economic loss” or “incurred expense” for attendant care benefits.

The insurance industry is not satisfied with these changes. The insurers have asked for further changes including eliminating your right to sue your insurance company if it improperly denies benefits to you after an accident. There is a provincial election coming up on June 12, 2014. You should consider whether the candidates in your riding support further reduction of auto insurance benefits before casting your vote.
 
 source: http://oatleyvigmond.com/more-reductions-in-auto-insurance-coverage/#.U4jBMXY9ldg

Ontario Auto Insurance: What are we paying for?

If you drive a vehicle in Ontario, the law requires that you insure your vehicle. Every auto insurance policy includes mandatory no-fault benefits. We pay for these benefits with our premium dollars. While premiums have continued to climb year after year, the no-fault accident benefits for injured victims continue to erode. While benefits have been steadily declining for many years, the changes that were imposed in September 2010 were the most drastic and punitive to date.

The highlight for the insurers and the low point for injured victims was the introduction of the Minor Injury Guideline, commonly referred to as the MIG. Before September 1, 2010, the standard auto insurance policy in Ontario included a limit of $100,000 to pay for reasonable and necessary medical and rehabilitation treatment. This did not mean that every person injured in a car crash in Ontario was entitled to $100,000; however this did mean that provided the injured person needed medical and rehabilitation treatment, those treatments would be covered up to a maximum of $100,000. The insurer still had to approve the treatment, but at least if the treatment was approved there was money to pay for that treatment. The introduction of the MIG in September 2010 dramatically changed the landscape for almost all Ontarians injured in motor vehicle collisions. The MIG caps the payment for all medical and rehabilitation treatments at $3,500. This means that if an insurer puts a person injured in a motor vehicle collision in the MIG, that person can only receive treatment up to a maximum cost of $3,500. This might not be so bad if the MIG only truly captured “minor” injuries. Sadly, insurers in Ontario are classifying up to 75 percent of all auto crash victims in Ontario as MIG injuries and capping all medical and rehabilitation treatments at $3,500. Even if you are in the lucky 25 percent that insurers are not putting into the MIG and capping coverage, your coverage for medical and rehabilitation benefits have been reduced from $100,000 to $50,000.

There can be no question that the insurers are the big winners from the September 2010 auto insurance changes. When premiums remain unchanged or go up and claim costs go down, the insurer’s profits skyrocket. Here’s what one insurance CEO commented after the September 2010 changes to auto insurance benefits:

“We are starting to see the benefits of the 2010 auto insurance reforms in Ontario, which is combining with our recent focus on proactive broker management and underwriting discipline to generate stronger results.”

In two short years since the September 2010 auto insurance changes, auto insurance claims in Ontario were down more than 20 percent or a reduction of $4 billion. In that same two year period, auto insurers have reported more than $3 billion in profits. It should come as no surprise to anyone that insurers will profit when benefits for insured victims are reduced and in many cases eliminated.

In wake of these changes, Ontario now has, in practical terms, the lowest level of no-fault coverage for medical and rehabilitation benefits in the country. Ontario is also the only jurisdiction in the country with a special category of auto insurance for so called “minor” injuries.

These changes not only affect those injured in car crashes but the impact can and will be felt by all Ontarians. As the insurers limit medical and rehabilitation benefits, those injured individuals will have no choice but to seek treatment from the publicly funded OHIP system. The lack of treatment will also lead to more people not being able to recover and return to work and need to look to the publicly funded social security net. Meanwhile insurers continue to report record profits.

These changes are only the latest and most drastic erosion of auto insurance benefits in Ontario. Toronto Sun columnist Alan Shanoff has documented the steady decline in coverage over the years in Ontario. Read his comments here.

He ends his article as follows:

One thing is certain. The current system can’t get much worse for accident victims. Victims need timely, adequate accident benefits even more than they need premium cuts.”

Contributed by Kris Bonn, an OTLA Director and a lawyer practising with Bonn Law Office in Trenton, Ont.

source:  http://otlablog.com/ontario-auto-insurance-what-are-we-paying-for/

Out of Order

Ontario auto insurance is in need of a major overhaul. Tinkering with the already poor system can only serve to make matters worse, and once again, miss an opportunity to make the significant changes required to return the system to efficiency and fairness.

 

 Many stakeholders have voiced their disappointment with the latest review of auto insurance conducted by Justice Douglas Cunningham, former associate chief justice of Ontario's Superior Court of Justice.
The result of the review is just another temporary fix to a broken system. The last thing needed in Ontario automobile insurance is another change to the Dispute Resolution System (DRS), yet another attempt at fixing a bad product.
Ontario must get back to basics. Automobile insurance in the past was intended to provide protection for liability exposures and physical damage to the car.
There has always been insurance coverage available to people who required protection for loss of income, medical expenses or loss of life. These benefits are still available through many insurers for people who need protection and are willing to pay for it.

Many people are also protected through their employer's group plans or private disability and life insurance plans. Retired people do not need loss of income protection and most of their health care needs are provided by government.
That being the case, they should not be required to pay for such benefits under a compulsory insurance plan. Automobile insurance was never intended to provide health, loss of income or life insurance benefits.

Most jurisdictions in the United States have stayed away from no-fault systems and, rather, relied on the tort system to protect innocent people who suffered injuries or vehicle damage from accidents caused by irresponsible drivers. In fact, some states have a provision for minimal protection for hospital and medical benefits regardless of fault.

The tort system is alive and well in the U.S. and helps to keep down insurance costs for motorists. Claims are handled on a low-cost basis with minimal delays. Very few disputes resort to the courts for a resolution.

OVERHAUL, NOT TINKERING REQUIRED

Ontario must return to basics and stop making changes to an expensive system that does not work. Now is the time to accept the fact that the current system must be scrapped and a new plan adopted. The province needs a task force with experienced people to revamp the automobile insurance system, not just modify a bad plan.

In 1986, the Ontario Task Force On Insurance was formed by the Ministry of Financial Institutions. The task force was charged with examining many areas of insurance, not just as it relates to automobile insurance.
The mid-80s offered many problems for the insurance industry that led to a lack of availability for corporations buying general liability insurance, as well as substantial increases in premiums. Automobile insurance was also part of the concern since premiums were being increased at a dramatic rate, partly because the courts did not cap awards.

There was an additional concern that Ontario was beginning to be known as "California of the North," since many high court awards were similar to those in the U.S.

Among the many suggestions presented to the Ontario Task Force on Insurance was information relating to benefits available in New Zealand for injuries, the Accident Compensation Corporation, or ACC, plan. In New Zealand, the government looks after any person who suffers an injury regardless of whether that individual is injured at home, in a car or even when, for example, just falling on the street.

There are a variety of "levies" to fund the plan, including a fee paid when a car is registered and also a fee per litre of fuel. In addition, there are also a number of other assessments and taxes that support the system.
It is not free and fraud naturally exists. Anytime there is a system that is not based on fault, there will be a certain amount of abuse.
Some task force members considered this type of protection to be desirable, since there should not be a preference given to people injured in a car accident.
There are many accidents that cause both minor and serious injuries, and they should be treated equally. However, the majority of task force members felt the system would not be practical in Ontario, and automobile injuries should be separate from other injuries in the same way that workers are dealt with in a special plan.

There are some merits to looking at the needs of people regardless of how their injuries were caused. There is an argument that people involved in a car accident should not be protected and treated any differently than a person who falls on the sidewalk or while walking through a park.
At the same time, it must be recognized that some people do not need the same level of benefits or compensation. All residents of Ontario have benefits provided by the Ontario Health Insurance Plan (OHIP). Seniors also have the majority of their prescriptions covered.

Any retirement benefits will still carry on if seniors are injured. Therefore, most seniors do not need to buy protection for a loss of income.
This then raises the argument that seniors should not be forced to pay for some of the accident benefits under compulsory automobile insurance.
The political parties in Ontario do not seem to be completely satisfied with the current automobile insurance system. The issue always comes up at election time, with some parties promising rate reductions to gain votes.
There have been a number of reviews over the past 30 years, with each one making some changes. In most cases, the individual reviews have concentrated on fraud that is prevalent in most no-fault plans. High costs have also been reviewed, but in most cases, the cost is in connection with generous benefits and fraud.

It makes sense to take a serious look at the benefits that should be provided under compulsory automobile insurance. Then people can decide what protection they need and purchase it as a separate insurance plan.
Most workers already have group plans that cover loss of income as a result of sickness or an accident. Many others who are self-employed buy protection under individual policies.

It is far better for people to purchase tailor-made protection to cover all possibilities, not just protection if they are injured in car accidents.
After all, if these people need income protection, it should be for any situation and not hope that their loss is due to a car accident. Likewise, life insurance is important to protect dependents and is a benefit that people must consider.
The insurance industry has all of these benefits available at competitive rates. Why, then, are these benefits considered under automobile insurance policies?
It is necessary to get back to the concept of basic automobile insurance. Auto insurance in Ontario was never expected to cover injuries and income loss on a no-fault basis.

Under a tort system, only innocent parties are covered for death or injuries. When coverage is provided for people injured in all vehicles involved in an accident, it is only logical that more claims will be paid and premiums will increase.

Why should seniors who have pension income pay for loss of income benefits? They cannot collect under such a benefit. People who need life insurance and income protection can buy the protection. OHIP provides most of the medical benefits that are needed.
There will be an election in Ontario very soon. The party that makes a decision to again have automobile insurance as a basic product will win a majority.
The number of seniors is growing quickly and that party will get the seniors vote.


source:  http://www.canadianunderwriter.ca/news/out-of-order/1003082772/
 By: William Star, President and Chief Executive Officer, Trillium Insurance Group Inc.2014-05-01

FSCO introducing guideline changes next week

An increase to Ontario’s minimum wage won’t be the only change coming June 1, as the Financial Services Commission of Ontario is revising the hourly rate guideline for attendant care benefits in the province's standard auto insurance policy.

FSCO announced it is raising the amount payable for basic supervisory functions to $11 an hour, for accidents that occur on or after June 1 of this year. The rates applicable to accidents occurring on or after September 1, 2010 and before June 1, 2014 are governed by a guideline published in 2010, which had set the rate for unskilled attendants at $10.25 per hour.

According to FSCO, the  Attendant Care Hourly Rate Guideline “establishes the maximum expense that automobile insurers are liable to pay” for attendant care services under the Statutory Accident Benefits Schedule (SABS), also known as Ontario Regulation 34/10.

The rate for routine personal care and for complex health/care and hygiene functions are unchanged from 2010, at $13.19 and $19.35 per hour respectively.

As of June 1, Ontario's minimum wage will rise from $10.25 to $11 per hour.

Ontario auto insurers “are not liable for any administration or any other charges or surcharges that have the result of increasing the effective hourly rate beyond what is payable” under the guidelines, says FSCO, meaning that they are not required to pay surcharges to cover administration costs or overhead.

The maximum attendant care benefit that can be paid under Ontario’s standard auto policy is $3,000 per month, if the victim did not sustain a catastrophic impairment. The maximum is $6,000 per month if the insured person did sustain a catastrophic impairment. Policyholders have the option to purchase additional coverage.

 Attendant care benefits are for "services provided by an aide or attendant or by a long-term care facility, including a long-term care home under the Long-Term Care Homes Act, 2007 or a chronic care hospital."

For policyholders who did not purchase optional additional coverage, the maximum coverage available is $1 million for a catastrophic impairment and $36,000 for other cases. Attendant care benefits are not payable more than 104 weeks after an accident, unless optional additional coverage is purchased.

When attendant care is provided by a family member or someone who is not providing the care in the course of employment, the amount is limited to the economic loss sustained by the caregiver

source:  http://www.insurancebusiness.ca/news/fsco-introducing-guideline-changes-next-week-177987.aspx?p=1

What the Ontario Party Platforms Say About Auto Insurance

The policy platforms for the major parties in the Ontario provincial elections are out.  Here is what you can expect from each of the parties with respect to auto insurance if they should win the election.

Liberals

The Liberal platform for auto insurance was essentially set out in the 2014 Spring Budget which was failed to pass before the election was called. 

The Liberals indicates that the rate reduction strategy is on target and average rates will be 8% lower by August 2014 and 15% lower by August 2015.  However, the Budget document does not point to any specific initiative that will specifically work towards achieving those targets. Average rates are down 5.6% as of the end of the first quarter of 2014.   In addition, the Liberals point to the recently released “Automobile Insurance Transparency and Accountability Report” which highlighted that, without these reforms, insurance rates would have needed to increase significantly.

In March 2014, the Liberals introduced Bill 171, the Fighting Fraud and Reducing Automobile Insurance Rates Act, 2014.  The Bill proposed a number of initiatives to address barriers to rate reductions. The Bill includes legislative amendments for the transformation of the dispute resolution system, and further action to crack down on fraud and abuse, as well as other cost-saving measures. The government is building on the steps it has taken by developing a dedicated investigation and prosecution office on serious fraud, with an initial focus on auto insurance fraud.  The development of this fraud office would be based on the Task Force’s principle that fraudsters should be vigorously pursued and prosecuted where evidence warrants.  The Bill was never passed but would be introduced by the Liberals if they formed the next government.

The Liberals introduced legislation to regulate the towing industry but that Bill also did not pass before the election was called . The Liberals also tried to address storage-fee issues by introducing legislative amendments as part of Bill 171 that would provide regulation-making authority for the determination of vehicle storage periods and fair value regarding daily fees.

The Liberals had retained an independent third party to provide annual Automobile Insurance Transparency and Accountability Expert Reports to assess its efforts to reduce auto insurance costs and rates. An interim report was delivered in April 2014, and annual reports will be delivered in August of each year of the Strategy. The reports will also assess the industry’s efforts to lower costs and pass on savings to drivers. The interim report highlights that further action is needed to support the government’s Cost and Rate Reduction Strategy. The report also concludes it is important that insurers continue working to achieve efficiencies and reduce costs in the auto insurance system through initiatives such as better claim management, more sophisticated pricing methods (such as usage-based insurance) and improved fraud-prevention practices. 

The Liberals would encouraging insurance companies to offer consumers usage-based insurance, which uses technology to identify and offer discounts for safe driving habits.

New Democratic Party

The NDP were slow to get their platform out to the public.  The NDP pressured the Liberal government in 2013 to reduce auto insurance premiums by 15%.  Their position since then is that the government is taking too long to lower rates and that most consumers haven't seen any rate decreases.  They have promised to lower rates by 15% within a year of forming a government.

That promise sounds like a big win for consumers but is not really a big change from the status quo. The Liberals two-year commitment to lower rates ends on August 15, 2015.  If the NDP win the election next month, their commitment would end on June 12, 2015. That only shortens the process by 2 months.  Rate reductions would be effective on renewal which is also the status quo.

The other commitments are to make transparent rate-setting permanent and provide consumers with a voice in the rate-setting process. It's not at all clear how these promises would be implemented.  On transparency, the reference could be to the announced 15% average rate reduction.  Perhaps the NDP would set annual average rate change targets that the regulator would have to meet.  As for consumer input on rate-setting, that might involve rate hearings where consumers could express views on proposed rate changes. Or perhaps the NDP have another mechanism in mind to bring consumers into the process.

Progressive Conservatives

The Conservatives have had an auto insurance action plan for some time now.  They too believe that auto insurance premiums are too high.  The PC plan proposes reforms in four key areas: eliminate red tape, fight insurance fraud, make the dispute resolution system more effective and ensure auto insurers are accountable to customers.

There is a reference to the use of private mediators in the dispute resolution system to expedite the process and reduce costs.  Users could opt for a private mediator instead of a government one in order to reduce wait times.  Although the consensus is that the dispute resolution system needs more reforms than what is in the PC plan. In addition, they would establish an independent peer-reviewed medical assessment system by standardizing assessment procedures and requiring multiple assessments be performed by medical professionals of the same specialization.  This does seem to resemble the former DAC system to a certain extent.

The PC plan calls for moving away from the current rate approval process which requires prior approval and moving to a file-and-use system. The PCs claim that prices in the marketplace would be more competitive if red tape were to be eliminated.  Following large rate increases approximately 10 years ago, several Canadian jurisdictions abandoned file-and-use systems.  The PCs would also like to see more discounts available to consumers.

Another PC auto insurance commitment would be to use the Health Claims for Auto Insurance (HCAI) electronic billing system to identify fraud. As well, they would establish a special office of Crown Attorney to prosecute fraudsters.

Finally, they would increase accountability by making senior insurance executives personally and financially liable for the conduct of their company.

source: Friday, 23 May 2014 http://williehandler.blogspot.ca/2014/05/what-do-ontario-party-platforms-say.html

Bureaucratic nightmares

Forgetting to renew a driver’s licence can be a disaster — as can long-forgotten police charges

Recently, I reported on the sad state of police checks on individuals in Ontario.

Each police service has its own fees, rules and record management system.

Worse, a good deal of prejudicial information is sometimes disclosed relating to incident reports and withdrawn or dismissed charges.

The Canadian Civil Liberties Association has since come out with a report concluding, “Police forces across the country are running millions of record checks per year, and are disclosing information that goes far beyond convictions and formal findings of guilt. Indeed, a wide range of non-conviction information — including records of suicide attempts, complaints where charges were never laid, withdrawn charges and acquittals — is regularly disclosed on Canadian police record checks.”

Such disclosure can have huge negative ramifications for the subjects of the police checks.

One of my readers, Jacob, 36, recently received a positive match for a criminal file.

He had been charged with assault as a minor. It was dismissed but the police check referred to a positive match for a criminal file without mentioning the date, nature of, or dismissal of the charge.

Jacob was told he could have the record destroyed but it would take 12 to 14 months.

In the meantime, he is unable to continue his work as a foreign language teacher outside Canada.

To illustrate the ineptitude of the system, the dismissed charge didn’t show up on Jacob’s 2011 police check.

The CCLA points out that “individuals who have paid their debt to society find that they are facing years of social and economic exclusion due to the stigma of a criminal record.”

Worse, people who have never been convicted, but were the subject of dismissed or withdrawn charges, or even 911 calls, may suffer the same stigma.
•••

Last month, I reported a case in which an insurance company refused to provide coverage for a car owner who had inadvertently neglected to renew her driver’s licence.

The notice to renew came in an envelope reminding her to renew her vehicle sticker.

She was successful in obtaining a court order forcing her insurance company to provide coverage but each case is fact-dependent.

Licence renewal notices are supposed to be mailed by the Ministry of Transportation in advance of licence expiry dates.

However mistakes occur and sometimes the ministry neglects to send out a renewal notice.
That could result in drivers operating their vehicles without valid drivers’ licences and worse, without insurance coverage.

Another reader, Barbara, didn’t receive a renewal notice and only discovered she was driving without a valid driver’s licence after being involved in an accident.

The other driver has sued for $1 million but Barbara’s insurer has denied coverage based on the expired licence.

Is it any wonder we hold insurance companies in such low regard?

Take the time to pull out your driver’s licence and check the expiry date.

If it is within 90 days go and get your licence renewed as soon as possible.
Don’t wait for a renewal notice, which may never arrive.

Otherwise, if you are in an accident while driving with an expired licence, you may find yourself in an expensive coverage dispute with your insurer.
•••

Earlier this month I wrote about a little known deductible that applies to lawsuits against negligent automobile drivers.

There is a deductible of $30,000 that applies to pain and suffering awards of $100,000 or less.

The Ontario Trial Lawyers Association has since called on candidates and political parties in the ongoing Ontario election campaign to restore the rights of auto accident victims by reducing this deductible. It has also pointed out lawyers are not allowed to tell jurors about the deductible in personal injury jury trials.

Treating jurors as children is silly.

Judges who sit on these personal injury cases are aware of the deductible so why shouldn’t jurors be as well?

Better yet, just get rid of the deductible.

It serves no purpose other than to put more money into insurance company coffers. 

source: By ,Toronto Sun First posted:

New videos show common staged accident methods used for insurance fraud


The National Insurance Crime Bureau in the United States, along with the Los Angeles Police Department, has produced several new videos to show the most common methods of staging vehicle accidents used to defraud insurance companies.

“These staged accidents are not only illegal and costly, but they also present a real danger to innocent drivers and to those recruited to participate,” Joe Wehrle, NICB’s president and CEO said in a press release.
“And without knowing what to look for, the innocent victims may not realize they were targeted. These videos help insurers, law enforcement and the driving public spot some of the most common types of staged accidents and may help them put a stop to the scheme before the criminals collect the cash.”
Los Angeles police in particular have reporting seeing an increase in staged accidents on area highways and seeing cases of people deliberately causing an accident in a car, on bikes or on foot.
Staged accidents are also  a major part of insurance fraud in Ontario, according to the Insurance Bureau of Canada, which says that an estimated $1.6 billion a year is added to insurance premiums and health care, emergency services and court costs from such fraud.
The videos were produced at the LAPD’s Emergency Vehicle Operations Center in Granada Hills, where officers receive specialized driver training.
The videos include:

Curb Drive Down


Four Vehicles Fraud


Swoop and Squat

Left Lane Fraud


source: http://www.canadianunderwriter.ca/news/new-videos-show-common-staged-accident-methods-used-for-insurance-fraud/1003077905/?&er=NA

Focus: Bias a hot topic for experts as Getahun debate continues

Bias is once again the hot topic among expert witnesses after an Ontario Superior Court judge banned lawyers from meeting with their experts to review draft reports.

Justice Janet Wilson ignited a firestorm with her January decision in Moore v. Getahun, a ruling currently under appeal. Meanwhile, the Supreme Court of Canada will also tackle the issue of expert independence this fall when it hears arguments in the Nova Scotia case of Abbott and Haliburton Co. v. WBLI Chartered Accountants.

James McAuley, an accountant and senior vice president of KPMG Forensic Inc. in Toronto, says such decisions help emphasize the importance of expert independence in a similar way to the change to Ontario’s Rules of Civil Procedure in 2010. Since then, experts must sign Form 53 that confirms their duty to the court above and beyond the party that retained them.

“That may have forced some people to focus on what’s always been their duty,” he says.

“There was a change in form, but it shouldn’t have been a change in substance. Avoiding bias and independence have always been front and centre in how I approach a mandate.”

Carolyn Seaquist, a principal in the litigation accounting and valuation services group at Collins Barrow Toronto LLP, says it’s “absolutely crucial that we are not perceived as advocates.”

“We are keenly aware, in each and every case, that if our reports are not perceived as being fair, objective, and independent, not only will our expert evidence not be accepted by the court, but our professional reputation will be damaged,” she says.

In Getahun, a medical malpractice case, a defence expert faced questions about alterations made to his report following a 90-minute phone call with counsel. While he claimed the changes were minor, the judge concluded the meeting involved “more than simply superficial, cosmetic changes” and condemned the practice of counsel and experts meeting to “review and shape” reports and opinions.

“I conclude that the changes in Rule 53.03 preclude such a meeting to avoid perceptions of bias or actual bias. Such a practice puts counsel in a position of conflict as a potential witness, and undermines the independence of the expert,” Wilson wrote in the Jan. 14 judgment.

Norm Emblem, a partner at Dentons Canada LLP in Toronto, says he’s confident the Ontario Court of Appeal will overturn the decision because its sweeping nature makes it unworkable in practice. He says most experts, particularly those inexperienced in court proceedings, need help ensuring their reports are helpful to the judge.

“There are some experts who, unguided, wouldn’t have a clue how to properly frame a report that will ultimately assist the court,” he says. “The manner in which a report is structured in certain cases requires assistance of counsel. That is not changing the opinion.”

Darcy Merkur, a personal injury lawyer with Toronto’s Thomson Rogers, says the decision has chilled the medical-legal community and forced him to deal only with experts he has previously used.

“I don’t want to be put in a position where I have to educate them,” he says. “It’s not a good decision for access to justice because it muzzles lawyers and ramps up the costs of litigation by forcing reliance on seasoned veteran expert witnesses.”

Although the decision involved medical experts, Seaquist says it applies equally to accounting specialists like her and is already affecting relationships with counsel. Experts issue draft reports only on demand while defence lawyers are increasingly forgoing that option.

“Once a draft report is issued, we are very cautious about the nature of changes that are made,” says Seaquist. “For example, new information of which we were previously unaware may affect our opinion and therefore changes are appropriate. Alternatively, we will correct a typo or other error that was noticed by counsel.”

On the rare occasions where a lawyer may attempt to influence her opinion, Seaquist says she’s not shy about standing her ground.

“If we disagree with counsel, we simply state so and explain the reasons. In most cases, counsel is very understanding once the reasons are fully explained. In rare cases, we have lost clients because we were unwilling to manipulate the numbers to satisfy a lawyer.”

Seaquist offers these tips for accountants and other experts who don’t want to be the recipient of judicial ire:

•    Never disregard relevant information just because it doesn’t suit your client. “For example, if a plaintiff acknowledges to the accountant that they planned to retire by age 60, the accountant cannot simply disregard this information and assume a retirement age of 65,” she says.

•    Stick to your turf: Avoid straying from your area of expertise and, if you must, ensure the report clearly says so. “As professional accountants, we are unable to provide an opinion as to an injured plaintiff’s ability to work or earn. Thus, we must clearly state that any scenarios provided as to his or her ability to work and earn are based on what appear to be reasonable assumptions rather than our opinion,” says Seaquist.

•    Always acknowledge assumptions: In cases of insufficient information or data, experts have to make assumptions and should note them. Seaquist says this can come up in loss-quantification cases when financial statements are incomplete or inaccurate for tax reasons. “Clearly state this deficiency in information and any assumptions that had to be made as a result,” she says.

•    Play for both teams: “We ensure that we accept both plaintiff and defence assignments,” says Seaquist. “It really just depends on who calls us first. This policy is deliberate, so that we are perceived as unbiased by the trier of fact, but also because working for both plaintiffs and defendants reduces the likelihood that the expert will develop his or her own biases, possibly even unknowingly.”  

Source: Monday, 19 May 2014 08:00 | Written By Michael McKiernan 
 http://www.lawtimesnews.com/201405193970/focus-on/lawyer

OTLA calls on provincial candidates to restore the basic rights of accident victims

On March 4, 2014, the Ontario Liberals tabled Bill 171, which proposed a number of amendments to the Insurance Act, the Financial Services Commission of Ontario Act, the Licence Appeal Tribunal Act, the Motor Vehicle Accident Claims Act and the Repair and Storage Liens Act. At the time of tabling Bill 171, Fair Association of Victims for Accident Insurance Reform (FAIR) and the Ontario PC party criticized the bill for not dealing with claims disputes over insurers’ medical assessments

Bill 171 fell through with the fall of the Liberal government.

Since the election campaign has started, only the NDP appears to have voiced concerns about insurance issues as part of their election message. Ms. Andrea Horwath has locked horns with the Liberals over auto insurance rates. She has alleged that the Liberals have broken their promise to reduce drivers’ rates by 15 per cent. “People are paying too much for insurance,” she told reporters Tuesday at a campaign stop in Scarborough. Ms. Horwath has stated that she believes that there is money owing right now to drivers in Ontario for the changes that the government made in 2010. Insurance companies have cut payouts by billions of dollars over the past several years but motorists have seen little benefit by way of lower premiums.

The Liberals disagree with the assertions from the NDP and say they’ve made good on their pledge. According to MPP Steven Del Duca (Vaughan), in the 2013 budget, the Liberals promised to reduce rates by 15 per cent on average, with a time period to be prescribed in regulation. “In August 2013, we specified that we would meet the target within two years, with an 8-per-cent cut in the first year,” he said in a statement to the Star.

Regrettably, it appears that neither the Liberals, nor the PC party nor the NDP are expressing any concern about the reduced access to justice for injured people who under our existing insurance system either won’t commence litigation to recover compensation for their losses, or will receive no or substantially reduced compensation. Mr. Alan Shanoff, in an article in the Toronto Sun, on May 3, 2014, discussed the restriction of access to justice through the concepts of the threshold and statutory deductible. Mr. Shanoff refers to the deductible as absurd. In his opinion, having both a threshold and a deductible is redundant and only serves to harm accident victims and benefit insurance companies.

The Ontario Trial Lawyers Association has recommended that the threshold be repealed and the deductible be reduced. OTLA has sent out an Election Update to candidates this week. The Election Update explains current restricted Tort rights of victims of car accidents and the fact that lawyers are not even allowed to tell jurors about the deductible. OTLA Election Update calls on election candidates to restore the basic rights of auto accident victims in Ontario by repealing the threshold and lowering the deductible. It will be interesting to observe whether only the NDP continues to raise concern about insurance issues and whether any of the parties will use this election opportunity to move to restore basic rights of victims in Ontario and start worrying about how to treat innocent people fairly.

Contributed by Roelf Swart, an OTLA member and a lawyer practising with Elkin Injury Law in St Catharines, Ont.

Source: http://otlablog.com/otla-calls-on-provincial-candidates-to-restore-the-basic-rights-of-accident-victims/