‘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.
FAIR is pleased to share with you our latest project to promote safe driving.
It is printable and we hope you’ll share it with your family and friends and commit to safe driving practices.
What to do if you have a claim: FSRA page on Understanding the Claims process
If you were in a car accident and no one had auto insurance, you may be eligible for compensation. Apply to the motor vehicle accident claims fund
Bill C-22 update:
Canada disability benefit bill passes but the amendment to block insurer claw-back has been removed
How does this matter to Ontario drivers?
If you are seriously injured you will likely end up on Ontario Works (OW), Ontario Disability Support Program (ODSP) and Canada Pension Plan Disability (CPP-D).
Though consumers are led to believe their insurance company will cover the costs of a car accident including income replacement, that isn’t the whole story. Insurers are payors of last resort which translates to the injured person must exhaust all other sources of income, including Employment Insurance (EI), workplace Long Term Disability (LTD), ODSP, and CPP-D and then your private auto insurer tops up those funds. They pay last and often pay the least.
Private insurers use public dollars to cover accident costs, its as simple as that when they keep the money they ought to be paying out. Every year our premiums go up while insurers pay less and taxpayers pay more for accident costs. Provinces appear to have made deals with private insurers and each of these agreements will have to be addressed individually before the Canada Disability Benefit (CBD) will be a reality. It’s unlikely auto insurers won’t try to take advantage of taxpayer dollars so removing the amendment to block the insurer claw-backs was important to taxpayers in general who could see their hard-earned dollars flow directly into insurer coffers.
The Minister, Carla Qualtro, has indicated that consultations will start soon to move the plan forward and $21.5-million has been set aside to begin work on regulation for the Canada Disability Benefit.
Launch of Canada Disability Benefit about a year-and-a-half away, Qualtrough says – The Globe and Mail
“However, senators Marilou McPhedran and Kim Pate voiced concern that the federal government rejected a “key” proposed change to the legislation that they said would have protected the disability benefit from potential private insurance claw backs, due to “concerns over provincial jurisdiction over the regulation of the insurance industry.”
“Time will tell how this private insurance loophole may be exploited. If—and when—it is, Parliament will have a second chance to correct it. But, it will come at the expense of the disabled community, who will be made to suffer because the government failed to act courageously at the outset,” said the senators in a joint statement.”
NOTE: House of Commons (HOC) will be closed until Monday, Sept. 18/23
Updates on C-22 by some advocacy groups:
Canada’s Parliament Finally Passes Bill C-22 – But Impoverished People with Disabilities Still Don’t Know Who Qualifies for the new Canada Disability Benefit, How Much the Benefit Will Be, or When the First Cheque Will Come – AODA Alliance
Update on Bill C-22 (Canada Disability Benefit) – June 2023 – Income Security Advocacy Centre
Find your MP address here.
Individuals, advocacy groups, Senators, MPs, everyone worked hard and pulled out all the stops to get to this step toward a better Canada. We should all be celebrating that we’ve reached a point that marks some success. And we did it together. It’s not ideal, it will not put a plate in front of the person who needs it, or a roof over their head but it does tell us we can get there, we can get to a better country that treats everyone equally and with dignity if we all work together.
Rhona DesRoches, FAIR Chair
Failure to Heed Auto Insurance Consumers: The need to Include Representation in the TAC
Why this petition matters
Auto Insurance Companies once again reached record profits during the COVID-19 Pandemic and continue to do so. Premiums continue to remain high and insurer profits excessive all while consumers are denied the benefits that they are legally obliged to buy into.
Very concerning is FSRA’s recent formation of an auto insurance reform committee, the Technical Advisory Committee (TAC) for Transforming Auto Insurance Regulation. The TAC’s mandate includes “evaluating consumer benefits and harms related to policy issues, such as fairness, profitability, operational risk management, scope of rate regulation/coverage, and transparency”.
If the goals are to be “consumer centred” and to “protect consumers”, as Tim Bzowey, executive vice president for auto insurance products at FSRA, states, the goals of the committee will not be achieved unless the committee is immediately reconstituted to include consumers, their legal representatives and rehabilitation professionals.
MORE and link to the petition: Petition · Failure to Heed Auto Insurance Consumers: The need to Include Representation in the TAC · Change.org
Check out the new Blog post from Ninette Ibanez Silverio Pereira about Section 44 of the SABs and insurer compliance with legislation here.
The highest court in Canada, the SCC, should acknowledge and recognize the public importance of the following two main issues raised in Silverio Pereira v Aviva:
[i] the insurers’ notice obligations in the SABS (question of law) and
[ii] the Tribunal’s inconsistent or lack of correct examinations of insurers’ duty of notice and its process breaching the rules of procedural fairness.
This is a timely piece since FAIR recently brought forward an Unfair or Deceptive Acts or Practices (UDAP) complaint to the Financial Services Regulatory Authority of Ontario (FSRA) on this very issue. Current decisions at the Licence Appeal Tribunal (LAT) show a significant number of cases where regulations were ignored and improper notices for coverage denials and for medical examinations fall far short of legislative requirements.
Financial Services Regulatory Authority of Ontario (FSRA)
is now consulting on proposed Guidance designed to improve consumer protection by appropriately sanctioning persons and entities not in compliance with sector statutes, regulations and FSRA rules and requirements.
The Guidance sets out when Administrative Monetary Penalties (AMPs) are imposed and how the amounts are determined. This approach supports transparency, fairness and consistency.
Currently Ontario insurers are subject to a Maximum Imposable General AMP of:
- Individual – $100,000
- Other than Individual – $200,000
Feedback due by May 31st, 2023
The College of Physicians and Surgeons of Ontario want to know what YOU think about their draft Conflicts of Interest and Industry Relationships policy before it’s finalized. https://policyconsult.cpso.on.ca/?page_id=14433
The draft policy retains the core expectations of the current Physicians’ Relationships with Industry: Practice, Education and Research policy and includes a new section related to conflicts of interest under the Medicine Act, 1991, General regulation.
The draft Conflicts of Interest and Industry Relationships: Advice to the Profession document has been updated to clarify and further explain the draft policy content.
Referenced from: https://ontariohealthregulators.ca/public-consultations/
From the Office of the Auditor General of Ontario November 30, 2022
Even though Ontario has one of the lowest accident rates in Canada, it has the highest private passenger automobile insurance rates in Canada. Auditor General Bonnie Lysyk’s 2022 Annual Report says the regulator, the Financial Services Regulatory Authority of Ontario (FSRA) could evaluate several initiatives for applicability in Ontario, that are in effect in other provinces, that may reduce rates. https://www.auditor.on.ca/en/content/news/22_newsreleases/2022_news_AR_FSRA.pdf
The FSRA, which reports to the Minister of Finance, is the primary regulator of several financial services in the province, including about 310 insurance companies, 67,000 insurance agents, 60 credit unions and 4,600 pension plans.
18 recommendations, with 60 action items, to address audit findings
The LAT AABS – why isn’t it working for consumers?
Is this a system ‘under the influence’ of insurance companies who are paying for the costs of hearings that too often sides with insurers? A ‘startling turn of events’: Judge rules case points to improper influence in Ontario auto insurance disputes
READ: Licence Appeal Tribunal Automobile Accident Benefits Service (LAT-AABS) recent decisions on Canlii
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 589 days in 2021-2022 Q4 – far more than promised with a new streamlined hearings system!
READ: Tribunals Ontario 2021-22 Annual Report LAT AABS (Tables 3 and 4) 2021-2022 – 15,800 cases filed in one year
Current Motor Vehicle cases in Ontario’s civil court system is 49,037 according to Statistics Canada
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).
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
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
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?
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…