Toronto Sun: It’s time to focus more on those hurt in automobile crashes, less on the concerns of insurance companies



Isn’t it odd that when we read or talk about auto insurance, we focus on premiums or fraud?

We rarely read or talk about the interests of accident victims.

Maybe that’s because it would be politically embarrassing to discuss their interests.

If we did, we’d have to mention that in 2010, the $100,000 maximum for medical/rehabilitation benefits was reduced to $3,500 for minor injuries (even though many so-called minor injuries are quite significant) and $50,000 for non-catastrophic injuries.

We’d have to mention these benefits are even lower than they appear since the costs of assessments and examinations are now deducted from these reduced benefits, thereby reducing them further.

Prior to 2010, there were additional benefits to pay for necessary assessments to determine entitlement to benefits, or to determine the medical/rehabilitation services required.

We’d have to mention that in 2010 the $72,000 maximum attendant care benefit for non-catastrophic injuries was reduced to zero for minor injuries and $36,000 for non-catastrophic injuries.

We’d have to mention that in 2010 the $100 per week maximum for housekeeping benefits was eliminated, save for the 1% of accident victims who have suffered catastrophic injuries.

We’d have to mention that in 2010 the maximum caregiver benefit of $250 per week plus $50 per week for additional dependents was eliminated, save for those suffering from catastrophic injuries.

While some accident benefits can be topped up via optional coverage for extra premiums, consumers have been ill-served by insurers and government and, accordingly, only about 1% of those who buy insurance purchase additional coverage.

As the Fair Association of Victims for Accident Insurance Reform (FAIR) has pointed out, “consumers remain unaware of the low level of coverage they’ve purchased until it is too late and they need to use it.”

Oddly, even though some accident benefits can be topped up, insured persons aren’t allowed to opt out of any benefits to save premiums.

Many retirees, for example, complain about the mandatory purchase of income replacement benefits.

FAIR is absolutely right when it concludes, “the 2010 reforms were intended to control insurer costs without regard to the outcome for Ontario’s accident victims.”

But it isn’t just the lower benefits that prejudice the rights of accident victims.

It’s the behaviour of many insurance companies in denying payment of accident benefits.

Almost one in every two Ontario accident victims has a dispute with an insurance company.

In 2013, 25,329 injured accident victims applied for mediation to contest accident benefits denied by their insurer.

About 45% of those cases dealt with the denial of medical/rehabilitation benefits.

That means that last year alone, we had 11,399 people claiming wrongful denial of medical/rehabilitation benefits.

A major cause of the large scale denial of benefits rests with the medical assessments purchased by insurance companies.

In many cases, more money is spent assessing a victim’s injuries than the cost of the treatment being sought.

Yet, according to a recent review of auto insurance, there are “no standards or qualifications for assessors in the auto insurance system.”

Then again, why would we need such standards or qualifications? That would just benefit accident victims.

Making matters worse is the 2010 “reform” eliminating an injured person’s right to obtain a rebuttal assessment to counter a denial of benefits brought about by an insurer’s medical assessment.

At one time I was optimistic some in the Ontario government cared about the plight of accident victims.

The Standing Committee on General Government and the Standing Committee on Finance and Economic Affairs held public hearings and heard from groups representing accident victims, as well as individual accident victims.

But here we are more than two years later and we have heard nothing but silence concerning accident victims.

But not to worry. Politicians of all stripes remain interested in auto insurance premiums.

Apparently, the product is of little importance; only the price matters.​

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