‘FAIR – supporting auto accident victims through advocacy and education’
FAIR (Fair Association of Victims for Accident Insurance Reform) is a grassroots not-for-profit organization of MVA (Motor Vehicle Accident) victims who have been injured in motor vehicle collisions and who have struggled with the current auto insurance system in Ontario. Read more »
OR support FAIR and the website through a donation (could sure use the support!) here.
Ongoing consultations related to auto insurance:
[CLOSED] Proposed Fraud and Abuse Strategy for the Auto Insurance Sector- DUE: July 12, 2021
The Ministry of Finance (MOF) and Financial Services Regulatory Authority of Ontario (FSRA) are consulting on a Fraud and Abuse Strategy (F&A Strategy) that will aim to sustainably reduce system costs that drive up auto insurance premiums for drivers.
In the current auto insurance sector, “insurance fraud and abuse” is neither defined in legislation nor regulation, nor is there an accurate quantification in the size and scope of fraud and abuse. Past governments, regulators and industry have attempted different approaches to identify and measure fraud and abuse. As a result, the industry has taken individualized approaches for managing fraud and abuse, which has created further inconsistencies. https://www.ontariocanada.com/registry/view.do?postingId=37747&language=en
Survey of Auto Insurance Claims Process for Individuals with Communication Disorders After Traumatic Brain Injury
Laura Brooks, Daniella Reid, Yvette Hou, Aileen Zhou
Research Supervisor: Sheila MacDonald
Principal Investigator: Dr. Lyn Turkstra
July 26, 2020
Acquired Brain Injury Survivor Solutions (ABISS) is a group of Ontarians who have sustained a brain injury from a MVC. Through conversation, they discovered a number of common experiences with insurance claims processes that seemed to have a significant impact on their recovery. Many of the members experienced breaches of privacy; a sense that insurers were starting from a basic premise of mistrust (i.e., that they were lying about their injury until proven truthful); inappropriate or unfair questioning from insurers, examiners, and insurer-hired medical professionals; duplicative and unnecessary, yet mandatory, insurer examinations; and insinuations that non-injury related life circumstance or history was responsible for their deficits or rehabilitation needs. The discovery of these common experiences led the group to question whether these barriers in the insurance claims process were universal among those with brain injury following MVC.
Acquired Brain Injury Survivor Solutions (ABISS) • www.abiss.ca • McMaster University
College of Physicians and Surgeons of Ontario Consultation
Read what was said about IMEs (Third Party Insurer Medical Examinations aka IEs, DMEs) during recent consultations.
The College recently reviewed its Third Party Reports and Medical Expert: Reports and Testimony policies. These policies set out expectations for physicians who: complete or prepare third party reports, conduct independent medical examinations, and provide medical expert reports and testimony. The reports, examinations and testimony are for purposes other than the provision of health care (e.g. for insurance benefits, or in respect of workplace issues, attendance in educational programs, legal proceedings, or other third party process).
How many of Ontario’s injured car crash survivors have to take their insurer to a tribunal hearing (LAT) to get access to recovery benefits? Lots. Too many.
READ: LAT Stats: Market Share vs. LAT Applications and Decisions https://otlablog.com/lat-stats-market-share-vs-lat-applications-and-decisions/
Which companies have more than their market share of claims in the LAT AABS system? All part of these Stats. The summary tells us that average # of days between application and decision has reached an epic 381 days – far more than promised with a new and streamlined hearings system!
Fixing Auto Insurance -The Agenda with Steve Paikin Feb 7 2019
Will the Ontario government’s decision to launch a public review of the province’s auto insurance system lead to positive changes for drivers across the province?
Do we need a Public Inquiry into the quality of the medical evidence? We think so and here’s why
Doctors are taking in millions of dollars a year by putting their names to accident injury reports for the insurance industry. Some of these reports unfairly discredit injury claims, leaving victims intimidated and exhausted. But because the majority settle out of court, the practice is hidden from public scrutiny. Kathy Tomlinson investigates
Globe investigation finds billion-dollar companies that are paid by auto insurers hire doctors to assess accident victims in a process called independent medical evaluations, and then edit and package those medical reports. In some cases, arbitrators and judges have rejected the assessment reports because the companies altered the medical professionals’ opinions in the insurer’s favour. Kathy Tomlinson reports
The car accident victims, the doctors who testified against her and the judges who aren’t accepting their expertise-for-hire — how insurance companies try to sway claims at trial
Rhona DesRoches, chairwoman of the Association of Victims for Accident Insurance Reform, calls the decision a “game-changer” for personal-injury claimants, an indication that the courts have “had enough of the manipulations of insurers to delay and deny claimants through the use of biased medical evidence.”
WSIB and auto insurance: Birds of a feather – Toronto Sun At the same time that the WSIB is under fire, the Ontario Trial Lawyers Association has called on the Ontario government to conduct a public inquiry into the state of independent medical examinations of injured auto accident victims. The OTLA refers to medical experts who “distort evidence … in a bid to satisfy insurance company clients” which causes “unconscionable delays and unfair denial of coverage.”
Daggitt v Campbell, 2016 ONSC 2742 (CanLII), <http://canlii.ca/t/gpqm3 – see para 26-32
Bruff-Murphy v Gunawardena, 2016 ONSC 7 (CanLII), http://canlii.ca/t/gmr5x – see para 53-125
Latest Number of MVA victims waiting for hearings at the Financial Services Commission of Ontario Med-Arb-Timelines 2007-Mar 2016
Read about how much we are overpaying: The Truth about Auto Insurance
The Canadian Society of Medical Evaluators 2011 President’s Message:
Dear Members & Colleagues,
We have all to realize that times are changing-amateurism, bias and fraud in the domain of IMEs will be tolerated less and less in the future.
In September 2011, at IAFS2011, the International Association of Forensic Sciences, the topic arrogance and lack of formal training of self-declared medical experts in the UK and Canada was covered in detail. At the same meeting, a recent UK Supreme Court decision (Jones v Kaney, UKSC 13, 2011) was discussed: at least in the UK, immunity for medical experts sems to be past history.
The basic body of knowledge to be mastered by medical experts has been defined, is in constant revision and is being offered in Europe and Canada through web-based University Programs.
CSME’s effort to promote excellence in medicolegal activities will be proposed to the Royal College, in 2012, a portofolio to be recognized as an Area of Focused Competence diploma: a new medicolegal expertise diploma; CSME also wants to be positioned as a key player in the Maintenance Of Competence program for all future College-certified medicolegal experts.
For those of you doing IMEs for years, it is time to notice this approaching shift: the cost of litigation, cost of automobile insurance and lack of quality control of IMES, leading to public scandals, might soon lead the parties requesting IMES to be more critical when the appraising medicolegal credentials of an expert before hiring his/her services.
CSME wants to be an active partner with the Canadian stakeholders interested in the medicolegal field, to promote and maintain excellence for all medicolegal opinions given by its members.
Dr. Francois Sestier, MD, PhD, FRCPc
See: Muzzling Criticism
‘So You Think You’re Covered! The Insurance Industry Rip-Off – Surviving the Fight for Long-Term Disability Benefits’
by Jokelee Vanderkop http://www.deniedbenefitclaims.com/index.html
An excellent read, a book that Ontario’s accident victims will benefit from and what Ontario’s auto insurers and the Insurance Bureau of Canada don’t want you to know – the often harrowing process of trying to collect on the policy you paid for.
Auto insurance: What do you get for a million dollars?
CBC Ontario Today – June 1 2016 Ontario car insurance injury benefits are changing, effective today. The payout for catastrophic injuries is dropping from two million dollars to one million, prompting anger on the part of victim advocates. Listen to the show:
What’s in YOUR Legal Bill???
You may not be paying what you think you are for your legal representation. By the time the costs of holding our insurer accountable come due and payable many auto accident victims are on their second or even third lawyer. Often the invoices for legal services are without detail and we are simply told what we are supposed to pay without adequate explanation.
According to the most recent data available 78% of Ontario’s legal bills are reduced at an assessment hearing. It’s a clear indication that something is very wrong when better than half of all legal bills (not just auto accident claims) are found to be excessive. Over 25% of these fees-for service accounts are reviewed and then reduced by 50% or more at a hearing so if you don’t understand what’s in your legal bill it may be worth the trip to court to find out.
It might come as a surprise to most people that it’s legal and accepted by our courts to increase the hourly rate without advising you, or to round up hours to a higher amount, or add on a ‘premium’ for a lawyer’s success in court to a client’s bill. more….
Additional information at: http://www.fairassociation.ca/choosing-a-lawyer/
What’s in YOUR medical file???
There is increasing evidence that Ontario’s auto accident victim’s medical files are being routinely changed to suit the needs of Ontario’s insurers to save money by deflating an MVA victim’s injuries. Portions of reports have been removed, manipulated or even changed entirely without the author’s knowledge or consent. Signatures have been forged or used without permission in many cases. Victims and their legal representatives should be viewing reports and evidence with a critical eye to insurer fraud whether it be an adjuster, an assessor, assessment centers, treatment facility or even your own lawyer’s staff. This abuse of evidence is widespread and should be a major factor in the fight on fraud and yet it isn’t. Accident victims are often re-victimized and defrauded out of the coverage they paid for by the fraudulent acts of others. more…FAIR Policy question regarding evidence used at FSCO DRS hearings FAIR response from FSCO JR Richards