BY ALAN SHANOFF ,TORONTO SUN
FIRST POSTED: SATURDAY, MAY 26, 2012 07:20 PM EDT
Ontario’s Standing Committee on General Government is holding public hearings on car insurance industry practices this week at Queen’s Park on Monday and Wednesday.
While it’s too late to be placed on the list of oral presenters, anyone wanting to express their views on car insurance industry practices may do so by sending written submissions to the Clerk of the Committee, Room 1405, Whitney Block, Queen’s Park, Toronto, Ontario M7A 1A2.
While this committee doesn’t have the power to implement changes, it can make recommendations.
The fact we have a minority government means changes favourable to consumers may be possible.
The insurance industry isn’t pleased with the committee’s review.
They point to the work being undertaken by the Auto Insurance Anti-Fraud Task Force formed by the McGuinty government and the report prepared by the Catastrophic Impairment Expert Panel appointed by the Financial Services Commission of Ontario. An insurance industry spokesperson has been quoted as saying there’s no need for another review.
I’d argue the contrary. Too many members of the expert panel and task force have insurance industry ties. Neither body has the mandate of examining abusive practices by the insurance industry.
And there are plenty of abusive practices to be examined.
Why are adjusters wrongly designating injured people as having only suffered minor injuries?
I’ve seen reports that claimants with fractures and complete tears have been placed in the minor injury category.
Why do insurance adjusters have the power to make medical decisions?
They can, and do, reject claims of treating physicians, without obtaining a medical opinion. Why has the denial rate for treatment plans increased substantially in the last three years?
What can we do to eliminate mediation and arbitration backlogs, so injured people can obtain justice and rehabilitation services on a timely basis?
Why do we allow insurers and adjusters to obtain medical opinions from partisan “experts” who earn substantial sums from insurance companies, rather than by treating patients?
Why do insurers require claimants to attend unnecessary and/or multiple assessments, sometimes having to travel large distances to attend appointments?
If you want specifics, take a look at FSCO arbitration decisions and you’ll see plenty.
Let’s hope the committee does a thorough job of investigating the car insurance industry. There’s much to investigate.
Insurance premiums always seem to be increasing while accident benefits decrease.
In attempting to combat fraud, insurers abuse legitimate claimants, turn down increasing numbers of treatment plans and deny legitimate accident benefits payments.
This has led to a huge backlog in mediation and arbitration proceedings before FSCO’s mediators and arbitrators.
Despite legislation requiring mediations to be completed within 60 days of the filing of an application, delays of 10 to 12 months are the norm. Additional delays waiting for arbitration lead to the farcical situation where necessary treatment and accident benefit payments are routinely delayed for two years or more.
Processing of settlement payments has recently been put into jeopardy as two FSCO arbitrators have invalidated mandatory settlement documents approved by the Superintendent of Financial Services.
Instead of revising the settlement documents, the Superintendent has issued a statement that the documents are valid, attempting to do an end run around the two arbitration decisions.
All this is going on as Ontario has imposed a miserly cap of $3,500 on what are deemed to be minor injuries.
Insurance adjusters designate a majority of claims into the minor injury category.
To put this in perspective, Nova Scotia’s minor injury cap is $7,956 –it was $7,500 when introduced but is indexed to inflation and rises each year, unlike the Ontario cap which has remained static since being introduced in 2010.
Ontarians now have an opportunity to have their voices heard.
Make sure Ontario’s Standing Committee on General Government hears your voice.
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