ORA Gives Yellow Light to David Marshall’s Report

The Ontario Rehab Alliance commends Mr. Marshall for his thorough and thoughtful review of Ontario’s Auto Insurance: Fair Benefits, Fairly Delivered.

This report rightly focusses on the needs of injured persons and the importance of eliminating obstacles to timely access to treatment. The ORA urges consultation with stakeholders and cautious consideration by government on of how to bring about the suggested changes.

The ORA is particularly heartened by the recommendation that the current no-fault benefits should not be reduced and the report’s:

– emphasis on healthcare rather than settlement;

– recognition that insurer culture must to shift to one in which claimants can be given the benefit of the doubt

– acknowledgment that the focus should be on the non-minor, serious and catastrophically injured as these cases are often unique and cannot be addressed by common treatments.

We fully understand the emphasis on programs of care, evidence based practice and outcome-based treatment but caution that the ‘absence of evidence is not necessarily evidence of absence’. Compared to other aspects of healthcare such as pharmacy or surgery there is much less research into rehabilitation and fewer studies, often with very small and specific sample sizes. Consequently, clinicians in this field rely heavily on evolving best practice guidelines within their disciplines. Highly prescriptive and narrowly described programs of care must be adopted cautiously so that effective treatment is not compromised by a tool meant to facilitate it.

The ORA agrees with Mr. Marshall that there is much to learn from the experience of other sectors and settings, such as the WSIB. However, it must be kept in mind that the mandates of the insurance schemes are quite distinct: return-to-work is a much more straightforward and arguably more measurable outcome than the return-to-daily-life goal following an auto accident, of which employment is merely one component.

We support the call to simplify the legislation and regulations and provide consumer education as key components of a system with enhanced transparency, accessibility and accountability.

We appreciate the vision of the improved system that Mr. Marshall offers and we look forward to working with the government and other stakeholders to explore how best the bring this about.

ORA EDUCATES FSCO

Auto insurance rule change costs injured man millions in rehab support

Ontario’s Deficit and Insurer Accountability

Car insurers and lawyers brawl in public

Two sides point to each other as reason for high insurance premiums. The truth is, they’re both responsible

By Alan Shanoff, Toronto Sun

A slugging match recently erupted between car insurance companies and Ontario personal injury lawyers.

The Insurance Bureau of Canada (IBC) opened by claiming the public needs regulatory oversight of contingency fees charged by personal injury lawyers.

The IBC feels a change is necessary to protect consumers and allow the government to evaluate the impact of lawyers’ fees on the auto insurance system.

The Ontario Trial Lawyers Association (OTLA) countered by releasing a study it commissioned concerning auto insurance premiums.

According to the study, prepared by two professors at York University’s Schulich School of Business, “consumers in Ontario may have overpaid for auto insurance by between $3 and $4 billion over the period 2001 to 2013.”

The OTLA urged an independent “thorough and truly transparent” review of auto insurance by Ontario’s Auditor General.

Reacting quickly, the IBC fired back through a press release, pointing the finger back at personal injury lawyers claiming, “lawyers’ fees are simply too high and have a significant impact on the cost of auto insurance.”

The IBC supported its conclusion by claiming some lawyers charge 40%, while others between 25% and 33% of any settlement or judgment.

I doubt many lawyers would dare charge a 40% contingency fee, although even a 25% to 33% fee may be too high in some cases.

But, the IBC forgot to mention clients don’t pay the entire contingency fee as a good part of the fee is paid by the insurance company.

To rub it in further, the IBC stated, “In 2013, lawyers received an estimated $500 million from injury claimants out of their insurance settlements for bodily injury claims. These are real dollars that never make it to the claimant. IBC will continue to fight for increased transparency so that consumers can actually see where their insurance dollars go.”

But I don’t think insurers want to open the transparency can of worms.

If they want to talk about “real dollars” that don’t make it to claimants, check out the vast sums paid by insurers for their so-called independent medical examinations (IMEs), used to belittle or deny claims.

According to the most recent Ontario Health Claims Database, insurance companies paid approximately $372 million for IMEs for accidents taking place in the last four years.

In some years, insurance companies forced almost half of all claimants to attend IMEs and in each year the average amount paid per assessed claimant for these exams exceeded the average amount paid per claimant for all medical and rehabilitation expenses.

Sending claimants for multiple and expensive assessments to pro-insurer experts is a major contributor to insurers’ costs and takes “real dollars” out of the pockets of claimants.

That’s not to say lawyers are free of blame.

There’s a long history of lawyers neglecting to act diligently to expose insurer experts who file partisan reports, sometimes outside their sphere of expertise, used by insurers to delay and deny claims.

As well, quality control at some law firms is substandard.

The FAIR Association of Victims for Accident Insurance Reform has recently posted an announcement stating, “ALERT – we are hearing about more and more cases where time limitations for filing have lapsed due to plaintiff’s legal representatives failing to meet limitation period deadlines.”

Then again, motor vehicle litigation and accident benefits claims are highly complex and insurance company tactics often lead to increased fees.

And if the insurance industry wants to point fingers at personal injury lawyers, perhaps they ought to make complete disclosure of the money they spend on defence lawyers and adjusters to deny, delay and defend claims.

Furthermore, how much do insurers pay to fund their massive public relations campaigns — including political contributions to those in power — which they effectively use to portray accident victims as opportunistic, malingering or just plain fraudulent?

It seems there is a lot of mud that can be thrown at each side in this messy debate.

But while the debate drags on, insurers continue to exact high premiums and lawyers receive handsome payments for their work.

And accident victims? They’re stuck in the middle.

Car crash victims deserve better deal

Ontario Minor Injury Guideline a limit but not exclusion to Statutory Accident Benefits Schedule: Court

Hundreds rally against cuts to auto insurance benefits

Bad news for crash victims

Advocacy groups to hold rally protesting very shady industry practices