ORA takes aim at proposed benefits changes

by IBO 14 Oct 2014

The Ontario Rehab Alliance says that a proposed regulatory amendment will create an incentive for insurers to deny benefit claims for everyone.

What Nick Gurevich of the ORA calls a ‘seemingly minor technical change’ to basic Accidents Benefits will dramatically reduce the interest rate payable by insurers on disputed claims, and will in fact have far-reaching consequences for buyers of auto insurance.

“By reducing the penalty that insurers pay for inappropriately denied claims this proposed regulatory amendment will create a financial incentive for insurers to deny every claim for benefits,” says Gurevich. “It will further impoverish legitimate claimants trying to get the benefits they paid for when they purchased their insurance.”

Currently, insurers must pay an interest rate of 12 per cent per year for claims that have been inappropriately denied. The current proposal – due to come into effect in November – will see this interest rate reduced to 1.3 per cent per year which is well below insurers return on capital invested.

The authors of the original regulation recognized the importance of checks-and-balances in a system where the insurers are financial Goliaths facing off against their injured customers, and employing every possible strategy to retain and invest cash reserves rather than pay out on claims, says Gurevich, adding that a healthy interest rate is intended to discourage insurers from arbitrarily denying claims or stalling on treatment and settlement.

“The increased number of benefit denials will also flood and overwhelm the already broken dispute resolution system,” he says, “which the government is currently trying to fix through the introduction of Bill 15.”

The ORA says that this change follows on the heels of multiple pro-insurance, profit-driven decisions which according to the General Insurance Statistical Agency (GISA) have resulted in record profitability for auto insurers in the past three years.

The ORA is calling on the government to “act decisively” and protect motor vehicle crash victims by “striking this proposed regulatory amendment in its entirety.”

ORA News Release: Ontario Drivers Will Not Be Thankful For Proposed Changes To Auto Insurance

OCTOBER 14 FOR IMMEDIATE RELEASE

Those injured in auto accidents will have a much more difficult time getting the benefits they need if a proposed regulation is allowed to come into effect next month.

A seemingly minor technical change to the basic Accidents Benefits that dramatically reduces the interest rate payable by insurers on disputed claims will in fact have far reaching consequence for buyers of auto insurance, says Nick Gurevich, of the Ontario Rehab Alliance (ORA).

“By reducing the penalty that insurers pay for inappropriately denied claims this proposed regulatory amendment will create a financial incentive for insurers to deny every claim for benefits. It will further impoverish legitimate claimants trying to get the benefits they paid for when they purchased their insurance.” says Mr. Gurevich.

Currently, insurers must pay an interest rate of 12% per year for claims that have been inappropriately denied. The current proposal will see this interest rate reduced to 1.3% per year which is well below insurers return on capital invested. The authors of the original regulation recognized the importance of checks-and-balances in a system where the insurers are financial Goliaths facing off against their injured customers, and employing every possible strategy to retain and invest cash reserves rather than pay out on claims. A healthy interest rate is intended to discourage insurers from arbitrarily denying claims or stalling on treatment and settlement.

“The increased number of benefit denials will also flood and overwhelm the already broken dispute resolution system which the government is currently trying to fix through the introduction of Bill 15”, says Mr. Gurevich.

The ORA says that this change follows on the heels of multiple pro-insurance, profit-driven decisions which according to the General Insurance Statistical Agency (GISA) have resulted in record profitability for auto insurers in the past three years.

The ORA is calling on the government to act decisively and protect motor vehicle crash victims by striking this proposed regulatory amendment in its entirety.

MEDIA CONTACT:

Laurie Davis, Executive Director, ORA
Toll Free: 866-475-2844 GTA: 647-317-7244 Email: [email protected]

Health Minister Eric Hoskins is introducing sweeping measures to make Ontario’s health system more transparent

Hamilton Spectator

By Theresa Boyle

He told the Star on Saturday that he has put the province's 36 public health units and 23 colleges that regulate health professionals on notice that he wants investigation and inspection reports made public.

The move follows a series of stories in the Star about patients developing life-threatening infections during outbreaks at four Toronto pain and colonoscopy clinics. Toronto Public Health (TPH) investigated the outbreaks and the College of Physicians and Surgeons inspected the clinics, but their reports have been kept secret.

“It is clear that our system must become more transparent,” Hoskins said, adding the new measures will allow Ontarians to find out if clinics have had problems with infection control and whether patients have suffered illnesses or died.

“I see my top priority as minister as protecting the safety and well-being of Ontarians. An important part of that is them having access to information which is going to allow them to make the right decisions for their health and well-being,” he said.

The minister said he has asked Toronto Public Health to immediately make its investigation reports on the outbreaks at four pain and colonoscopy clinics available to the public by posting them on its website. At least 20 patients developed serious infections, including meningitis and hepatitis C, in these outbreaks.

(The Star had asked TPH directly for some of these investigation reports but was told that a freedom-of-information request must be filed.)

Hoskins said he is amending the Ontario Public Health Standards to require mandatory public reporting of inspection and investigation reports.

He also plans to improve oversight of clinics with a view to improving patient safety. He has asked for advice on this from Health Quality Ontario, an independent government agency that assesses and reports on quality in different parts of the health system.

Pain, endoscopy and other community clinics are making up a bigger part of the province's health system as hospitals continue to shrink.

On Saturday, Hoskins sent letters to the 23 health self-regulatory colleges, such as the College of Physicians and Surgeons, asking them to fully disclose information about investigations they conduct. Similar letters were also sent to three transitional councils (for practices, such as homeopathy, that are on their way to becoming self-regulated).

Hoskins asked the regulatory colleges and councils to develop new transparency measures to assist Ontarians in making informed decisions about their care. He wants them to report back by Dec. 1 on specific measures they plan to undertake.

Hoskins also sent letters to the 36 public health units across the province asking them to be fully transparent in conducing investigations and reporting results. They have also been told to get back to him with their plans by Dec. 1.

In recent weeks, a Star investigation has revealed that patients of the Rothbart Centre for Pain Care have developed serious infections, including meningitis and epidural abscesses. A Toronto Public Health probe found nine people were infected from August to November 2012 and that there were 170 infection-control deficiencies.

The TPH investigation report was never made public. The Star obtained it from a patient who developed disabilities after getting infected at the clinic. She received it only after being told to file freedom-of-information request for it.

The Star also discovered that 11 patients have contracted hepatitis C during outbreaks at three colonoscopy clinics since 2011. TPH investigations into those outbreaks were also never made public.

The CPSO inspected the four clinics in question but never made the outbreaks public.

Torstar News Service

Automobile Insurance Benefits Increase

CHARLOTTETOWN – Automobile accident victims will be able to access improved rights to recover for pain and suffering and enhanced accident benefits effective Oct. 1, says Environment, Labour and Justice Minister Janice Sherry.

“We have been working closely with the automobile insurance industry to ensure that Islanders will have both improved rights to recover personal injury damages when they are not at fault, and improved accident benefits under their own policy regardless of fault,” Sherry SAID. “The legislative changes were made last fall and are now coming into effect. We do not anticipate any increase in premium rates in the foreseeable future and we believe Prince Edward Island will continue to have the lowest automobile insurance rates in Atlantic Canada.”

Under the new provisions, there are changes in the definition of minor personal injury, and the cap on court awards for such an injury has been raised from $2,500 to $7,500. Minor personal injuries are strains, sprains and whiplashes that do not cause serious impairment.

In addition, under the automobile policy there are increases for medical and rehabilitation expenses, funeral expenses, death benefits, loss of income, and for the principal unpaid housekeeper. As well, the loss of income age limitations has been removed.

The changes are effective for accidents occurring on or after Oct. 1, regardless of when the policy was purchased.

Source: Journal Pioneer