Ontario Election Issue: Auto Insurance: Fear that Benefit Cuts Will Swamp OHIP, Concern about Insurers Denying Treatment

TORONTO (September 22, 2011) – The Ontario government's changes to auto insurance will have adevastating impact on the public health care system as accident victims run out of privately-funded benefits and are forced to seek OHIP-covered treatment.

The McGuinty Liberals brought in changes a year ago that essentially transferred hundreds of millions of dollars in medical and rehabilitation costs from the insurance industry to public health care. The government did this because insurers were claiming that the province’s ‘overly generous’ system was going to result in even higher premiums.

“Politicians don’t like higher insurance rates, particularly in an election year,” says Nick Gurevich, President of the Alliance of Community Medical and Rehabilitation Providers. “So the Liberal government allowed insurance companies to chop benefits in the hope that this would stabilize rates. The problem is, it hasn’t worked.”

Rates have continued to move up, and at the same time, consumers now have less protection if they’re hurt in an auto accident.

Dr. Peter Rumney, Physician Director of the Brain Injury Rehabilitation Team at Holland Bloorview Kids Rehabilitation Hospital, says that kids with brain injuries need access to rehabilitation services as quickly as possible because early intervention can have a dramatic impact on their recovery. “When a child is injured in an accident, families rely on insurance coverage to get access to appropriate rehabilitation services in a timely manner. Inadequate insurance levels put additional pressure on an already-burdened public rehabilitation system,” says Dr. Rumney.

Some of the injuries will be assessed as catastrophic, in which case they will then be eligible for significantly higher medial and rehab benefits. But it often takes two or more years for catastrophic brain injuries to be identified, during which time patients will now be limited to a maximum benefit of $50,000 instead of the $100,000 that was available before the government changes.

”That’s far below what they’ll need,” says Gurevich.

In another disturbing development, rehabilitation providers in Ontario say insurers are now denying a higher percentage of requests for assessment and treatment. A survey conducted by the Alliance found that more than two-thirds of the respondents report the denial rate is now 30% or more, compared to 10% or less a year ago.

Dr. Donna Ouchterlony, medical director of the Brain Injury Clinic at St. Michael’s Hospital notes: “Since September, we are seeing more and more patients with serious injuries whose insurers are outright denying treatment, and when funding is approved, it is no longer nearly enough.”

The Alliance represents approximately 80 companies and about 3,500 health care providers including physiotherapists, occupational therapists, speech language pathologists, chiropractors, psychologists, rehabilitation therapists, social workers, personal support workers and case managers. It is these individuals who are the primary providers of healthcare and rehabilitative services to Ontarians who are injured in automobile accidents.

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For further information, visit www.ontariorehaballiance.com

To arrange an interview, contact:

Niki Kerimova
PR POST
416-777-0368