FAIR ? Time to Fix Ontario?s Broken Auto Insurance System Jan 16 13

 By Rhona DesRoches

Whoever wins the Ontario Liberal leadership race should pay closer attention to making our broken auto insurance system fair for injured accident victims and their families.

Too often the Ontario auto insurance system treats seriously injured claimants unfairly and yet this issue still isn’t getting consideration from legislators or regulators at Queen’s Park. Current “fixes” are heavily tilted in favor of protecting the financial health of Ontario’s private auto insurers at the expense of the physical health of injured claimants.

The perception that our government takes Ontario’s insurance industry interests more seriously than public health has been heightened by the news that at least three of the Liberal leadership candidates have accepted sizable donations from the Insurance Bureau of Canada. The question will be asked, is the insurance industry using donations to get the legislation they want passed before an election?

FAIR, the Association of Victims for Accident Insurance Reform is a consumer group. We are accident victims, their families and supporters who think we need to fix our insurance system.

What’s wrong with auto insurance in Ontario? A lot, if you ask FAIR’s members, or anyone of the more than 60,000 people in Ontario who are injured in motor vehicles accidents annually.

Here are just some of the problems:

* In 2010, the provincial government arbitrarily put a $50,000 limit on the amount anyone can claim for basic coverage — cutting in half the upper limit of funds for non- catastrophic injury that people previously could receive from insurers after a debilitating accident. Perhaps worse, a more insurer-friendly method of calculating what counts as “catastrophic injury” has been recommended by a panel of insurer-friendly medical “experts.”

* In 2010 Ontario allowed insurers to limit victims’ claims for so-called “minor injuries” to $3,500, down from the previous level of $100,000. While this may sound reasonable, $3,500 is not enough to cover even basic rehabilitation after an auto accident. Worse, an overly aggressive use of the Minor Injury Guideline has contributed to wrongful inclusion of serious injury cases within the guideline benefit limits.

* Many Ontarians run out of treatment funds within six months, which can compel them to settle for less than what is fair given the insurance premiums they paid and what they’ll need for recovery. Hardball insurer assessors often exacerbate this problem.

* There’s still a sizable backlog of claims in Ontario — some 20,000 claims in the province are reportedly in dispute, with most waiting more than a year for resolution. The Ontario government has put immense resources into cutting hospital waiting times — why is it standing by idly while insurance claim waiting times remain intolerable?

* The wrongful denial of policy benefits to injured claimants based on shoddy insurer assessments through Independent Medical Exams (IMEs) is a central problem in the Ontario auto insurance system. These questionable ‘independent’ opinions often deny or delay victims getting the help they need and drive up costs to both the injured victim and the taxpayer who must shoulder the burden when insurers fail to do so.

*The quality of Ontario’s IMEs has frequently come into question and has become the cause of widespread consumer mistrust of auto insurers. College sanctions of their members, out of sight of public scrutiny, have allowed the ‘independent’ for-hire assessors to ignore the College regulations while pursuing profits from insurers.

*The government is poised to implement a key recommendation of the recent Anti-Fraud Task Force which would impose a $500 fee on victims who miss one of the dubious insurer-ordered examinations. Frankly, there are other measures currently available to deal with people who repeatedly miss appointments. But it must be said that there is a real imbalance of power between insurers and their preferred assessors versus cognitively vulnerable and seriously injured claimants. Imposing a $500 fee for a missed appointment amounts to extortion for not submitting to what often turn out to be substandard assessments performed by “hired guns” masquerading as impartial assessors.

Insurers justify this harsh treatment of victims of serious accidents by saying it’s necessary in order to prevent fraud and keep premiums reasonable for the millions of Ontarians who pay insurance every year and don’t make claims. The result could not be more different: all we get is ever-higher premiums, lower benefits and skyrocketing profits for insurers.

FAIR is neither advocating for or against public auto insurance as a replacement to the current private sector system we now have in Ontario. Consumers should consider the poor performance of private auto insurers – Ontario faces the highest premiums and the lowest benefits in Canada. FAIR believes all options for better coverage ought to remain on the table.

The majority of us will never be in an accident but all of us take our chances on our roads and highways. It needs to be asked —in a province where consumer goods and services are constantly getting better, why is auto insurance one of the only products that seems to perpetually get worse?

It’s something the next premier, our new government — and everyone in Ontario — ought to be asking and our auto insurers need to answer.

Rhona DesRoches is the Chair of FAIR Association of Victims For Accident Insurance Reform http://www.fairassociation.ca/ ([email protected])

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