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.