Automobile accident victims facing out-of-pocket payments for health care

TORONTO (October 4, 2011) – As a result of the McGuinty government’s ‘reforms’ to the auto insurance system, chances are you will end up paying out of your own pocket for much of your treatment and rehabilitation if you are seriously injured in an motor vehicle accident.

The Liberals passed regulations last year that allowed insurers to slash standard benefits, thereby lowering their claims costs, in the hope that this would help stabilize rates.

“But the real impact has been an erosion of consumer protection,” says Nick Gurevich, President of the Alliance of Community Medical and Rehabilitation Providers.

“Standard auto insurance in Ontario is no longer adequate if you sustain a serious injury. Now you’ll receive only a fraction of the benefits you were entitled to previously. That means you’ll likely have to pay these costs yourself – costs that could amount to tens of thousands or even hundreds of thousands of dollars,” he says. 

And don’t assume you’ll be able to fall back on OHIP – many of the services you may need following an accident are simply not covered by the public health care system. 

Even the Financial Services Commission of Ontario (FSCO), the provincial agency that regulates auto insurers, makes this point. In a brochure titled Understanding Automobile Insurance, FSCO warns that “many health care expenses are not covered by OHIP, or only partially covered, including physiotherapy and chiropractic treatment, mobility devices (crutches, wheelchairs), modifications to your home and car that you may require, and other specialized goods and services. Minor injuries may only require several thousand dollars in treatment. The most serious injuries (brain injuries, amputations) are permanent and may require hundreds of thousands of dollars in specialized goods and services on an ongoing basis.”

The government and the insurance industry argue that consumers can buy up, purchasing additional insurance coverage if they wish. “But few people do,” says Gurevich.

Based on a recent survey conducted by FSCO, only slightly more than 1 per cent of policyholders have bumped up their medical and rehabilitation coverage. Most motorists in the province are sticking with the standard coverage, which now provides only $50,000 in medical and rehab benefits for serious accidents (compared to $100,000 before the Liberal changes).

The FSCO survey findings can be found at http://www.fsco.gov.on.ca/en/auto/newsletters/Documents/AutoNewsletter8-Aug-2011.pdf

By allowing the insurance companies to slash standard benefits, the province has created a situation that puts people at risk. Having to pay out-of-pocket for some of these health care services will jeopardize the recovery of many injured victims, and it will place a heavier burden on lower income families and individuals.

 “The system in Ontario seems designed to protect insurers, not those who have been hurt in accidents,” Gurevich says.

The Alliance is mounting a province-wide campaign to make auto insurance an election issue. It is asking MPPs and candidates to support the following: 

• a thorough and independent review of the auto insurance industry in Ontario
• pending such review, a freeze on premiums and a re-instatement of the benefits that were in place prior to the ‘reforms’
• more openness and transparency, with insurers having to release financial and operations data for their auto insurance lines

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