A new group is hoping to have some impact on auto insurance reform in Ontario

Thompson’s World Insurance News 

Group formed to advocate fair treatment 

December 10, 2012 Edition 

A new group is hoping to have some impact on auto insurance reform in Ontario.

The Fair Association of Victims for Accident Insurance Reform, or FAIR, is described as a grass-roots consumer organization dedicated to advocating for fair treatment of motor vehicle accident victims.

“Ontario’s MVA victims find themselves without timely treatment or benefits under the current system,” the association’s board chair Rhona DesRoches said.

“Thresholds to qualify for treatment for our most catastrophically injured citizens are making it impossible for many people to get the treatment and care they need to reach maximum possible recovery.

“The (minor injury guidelines) have created a backlog of people waiting for mediation hearings and many of those individuals are unable to access benefits while waiting and — whether the Ontario government admits it or not — this is a crisis for those thousands of injured people in line.”

She said the only way to get the word out is through the media.

“Many are unaware that we exist. We hope to become a loud and powerful voice for insurance claimants in Ontario and improve the quality of the legislated insurance product.”

Responding to the Anti- Fraud Task Force Final Report, FAIR said its members were encouraged to see the panel recognize that any recommendations should not make things worse for legitimate claimants.

CityTV.com – NDP Singh calls for lower auto insurance premiums

12/03/2012  Erin Criger, CityNews.ca

NDP MPP Jagmeet Singh is calling for lower auto insurance premiums in Ontario, something that he said cannot be accomplished unless Liberals recall the provincial legislature.

Singh is part of an all-party committee to discuss consumer protection legislation. Those discussions broke down when Premier Dalton McGuinty prorogued parliament on Oct. 15.

“We’ve not seen that [promised] reduction in premiums,” Singh said at Queen’s Park on Monday.

“What we’ve seen is profits increasing for insurance companies. We need to see those savings passed along to consumers.”

Singh said the government has a “direct role” in overseeing insurance companies, including ensuring fair premiums.

He said the NDP government is not calling for public insurance, like the party proposed in 1990.

“We’re calling on the industry to get it right. If they don’t get it right, we must resort to some other steps.”


Concern for professional reps?

Anti-Fraud Task Force Final Report seems focused on protecting health pros from scrutiny



When I first read the Final Report of the Ontario Automobile Anti-Fraud Task Force I was surprised. The report actually contains consumer-oriented proposals, rather than merely proposals to combat the fraud aimed at insurers which ultimately results in higher premiums for all car drivers in Ontario.

Sure, it is important to combat fraud aimed at insurers but the insurance companies are big boys and should have plenty of resources with which to combat fraud. So they need some help from the government to assist them in reducing fraud. That’s fine with me although you’d think they’d already have ample procedures in place to combat fraud, especially since the extent of fraud is now estimated at somewhere between $768 million to $1.56 billion.

Clearly the task force is mindful of the controversy surrounding insurers’ use of “preferred service providers” to provide independent medical examinations of accident victims. The task force went so far as to say such examinations and assessments are “often regarded with suspicion” and some claimants have accused medical professionals hired by insurers of producing reports that are “callous, unprofessional and biased.”

Regrettably, the task force was unable to “reliably test the veracity of such complaints, nor gauge their frequency.”

Yes, the task force is aware of critical rulings by judges and arbitrators but they say the number of such rulings is “minimal relative to the tens of thousands of claims paid and injuries reported after vehicle collisions each year.”

That’s true, but most claims never reach a courtroom or an arbitration hearing. If you compare the number of critical rulings to the number of reported rulings you find that the percentage wouldn’t be as minimal. And if you consider that each health professional hit with a critical ruling by a judge or arbitrator has likely issued dozens, if not hundreds, of reports that were never scrutinized by a judge or arbitrator, the extent of the problem becomes apparent.

Still, the task force has recommended various proposals in an attempt to “help allay suspicion and protect the reputation” of the health professionals who conduct insurers’ independent examinations.

I can’t help but feel the recommendations are but a way of attempting to make it appear as if real protection is being offered to claimants when the objective may be otherwise.

Why is the task force concerned with the reputations of health professionals?

Also, it would be pretty easy to curb the abuses. Permit audio or video taping of all visits. That will cut down on much abuse. Don’t allow any health professional to conduct an insurer examination unless the professional has a real practice where he or she treats patients.

Professionals who earn a substantial amount of their income from insurers are beholden to the insurance companies and if they aren’t biased they certainly appear to be biased.

Require insurance companies to publicly disclose the names of and total fees paid to every health professional they have retained each year, as does the Insurance Corporation of British Columbia.

If a judge or arbitrator has made critical or adverse comments concerning a health professional make the comments public rather than leave them buried in decisions that few read.

Allow adverse comments made about a health professional to be used against the health professional in subsequent cases and disallow the use of any professional who has been the subject of three adverse comments.

We can get rid of shoddy, biased independent medical examinations — but only if we want to.

Ontario appeal court upholds decision on 60-day limit for FSCO mediation wait

DAILY NEWS Nov 29, 2012

The Court of Appeal for Ontario has upheld a decision by a lower court to dismiss the appeals by insurers, in a case involving the wait time for mediation from the Financial Services Commission of Ontario (FSCO).

The case, Hurst vs. Aviva Insurance Company, involved four individuals making separate but similar claims to their different insurers under the Statutory Accident Benefits Schedule (SABS) after they were in auto accidents.

The claimants had gone forward with litigation against their insurers, citing failed mediation through FSCO, since their claims weren’t mediated within 60 days – a limit set out in FSCO’s Dispute Resolution Practice Code. A mediation attempt through FSCO is mandatory before a claimant can make a court action against an insurer. FSCO hadn’t provided reports to the claimants noting that mediation had failed, since it said the 60-day parameter only applied after the mediation application had been assessed by its staff and found to be “complete.” The insurers involved in the case then argued in court that mediation had not failed because the 60-day limitation didn’t apply in these situations, in line with FSCO’s view. A lower court judge dismissed those motions by the insurers, who appealed to the Court of Appeal for Ontario. In a decision Thursday, the appeal court upheld the previous decision. The decision hinged on wording in various sections of SABS, which the appellant insurers had argued did not set out a 60-day limitation on the mediation wait time. “I do not accept that the 60-day clock does not begin to run until FSCO has assessed an application as complete,” Justice Russell Juriansz wrote in the decision. “…the purpose of the legislation is to make mandatory a mediation process that is timely and effective,” the decision notes. “This has serious repercussions for the tens of thousands of Applications for Mediations stuck in backlog at FSCO,” writes Miller Thomson lawyer Talaal Bond in a blog on the case. “Essentially, all the Applications that were filed in excess of 60 days may proceed directly to litigation should the insured so choose.  This in turn will likely overwhelm the arbitrations unit and devour already limited court resources.”

In a statement, the Ontario Trial Lawyers Association (OTLA), a group of personal injury plaintiff lawyers, said it welcomed the court's decision.

“The Court of Appeal has said that 60 days means 60 days,” OTLA president Andrew Murray said. “This is an important decision to ensure timely access to justice for injured auto accident victims, as justice delayed is justice denied,” he added.

Wait times for mediation from FSCO were also a major issue addressed by the final report from the Ontario Automobile Insurance Anti-Fraud Task Force this month.