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Welcome to FAIR Association of Victims for Accident Insurance Reform

‘FAIR – supporting auto accident victims through advocacy and education’

After an Auto Accident: Understanding the Claims Process  https://www.fsco.gov.on.ca/en/auto/brochures/Pages/brochure_claims.aspx

Insurance Act  R.R.O. 1990, REGULATION 668 FAULT DETERMINATION RULES http://www.e-laws.gov.on.ca/html/regs/english/elaws_regs_900668_e.htm

Ontario Automobile Policy http://www.fsco.gov.on.ca/en/auto/forms/Pages/oap1_forms.aspx

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MVA victims can join FAIR at no cost and get on our mailing list! 

http://www.fairassociation.ca/member-application/

Visit our member ship page at: http://www.fairassociation.ca/become-a-member/

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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.

Our members lives, as a result of these MVAs, have been turned upside down by brain injury, loss of limbs, need for surgery and reparative therapy, long-term debilitating injuries, loss of time from work, loss of jobs and sometimes loss of independence.

FAIR wants to see reforms to auto insurance legislation that will improve the way all MVA victims are treated and cared for under provincial insurance legislation. Not only are FAIR members faced with the challenges of overcoming and adapting to injury, we are also faced with an insurance system that does not fairly provide needed rehabilitation coverage and benefits. Read more »

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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.

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A leaked document from a discussion forum

I am involved in an Arbitration on the issue of catastrophic impairment where Sibley aka SLR Assessments did the multi-disciplinary assessments for TD Insurance.  Last Thursday, under cross-examination the IE neurologist, Dr. King, testified that large and critically important sections of the report he submitted to Sibley had been removed without his knowledge or consent.  The sections were very favourable to our client.  He never saw the final version of his report which was sent to us and he never signed off on it. more…

Burwash v. Williams, 2014 ONSC 6828 (CanLII) 2014-11-25 http://canlii.ca/t/gfdrp

[10]           The Plaintiffs assert that they had no reason to suspect that Cira was involved in the review, revision and editing of draft expert reports until the examination for discovery of Dr. St. Pierre when answers and subsequent productions indicated that Cira may be using third parties to review and revise the Defendants’ expert reports.

[24]           The Plaintiffs provided documents that indicate that there may have been third party manipulation and alteration of the expert reports that the Defendants will rely upon at trial. Relevancy is established since this issue goes straight to the heart of the Plaintiffs’ case and the medical evidence they intend to lead to prove damages. more…

MC v KE, 2013 CanLII 55435 (ON HPARB),  2013-09-04  http://canlii.ca/t/g0c3g

10.              However, the Committee did express concern about the information uncovered during the course of the investigation related to Riverfront having altered the Respondent’s report. The Committee noted the “egregious” impact that these changes could have had on the Applicant’s entitlement to benefits. In the result, the Committee decided to offer advice to the Respondent about the importance of ensuring that she personally reviews and approves any assessment report she completes prior to the report being issued. more…

Macdonald v. Sun Life Assurance Company of Canada, 2006 CanLII 41669 (ON SC) — 2006-12-13 http://canlii.ca/t/1q596

[1]            In the course of this jury trial I ruled that Dr. Frank Lipson, who had conducted a defence medical of the plaintiff, not be permitted to testify as an expert witness on behalf of the defence. Dr. Lipson had testified that a medical report purportedly signed by him had not been signed by him.  He stated that his signature stamp had been affixed to the report without his authority by an individual at Riverfront Medical Evaluations Limited (Riverfront) thecompany who had retained him to conduct the defence medical. I made my ruling based on the evidence before me at the time. The case proceeded and the jury ultimately delivered a verdict awarding the plaintiff damages and that verdict has not been appealed. However, in view of the serious allegations that had been made against Riverfront I felt that Riverfront should be given an opportunity to respond before I delivered the full reasons for my ruling. Subsequent to the conclusion at the trial, counsel for Riverfront appeared before me and called evidence and made submissions. more…

FSCO Minutes - March 25, 2011 – 5. “Doctored” Reports:

http://www.fsco.gov.on.ca/en/drs/counselforum/Pages/2011-03-25.aspx

Senior Arbitrator Nastasi reported that a recent unit meeting arbitrators reported two separate hearings in which in the middle of testimony by a doctor or assessor, it became clear that the report issued / produced by the Clinic or assessor was not the same report created by the doctor / assessor on the witness stand. Liz put the issue out to the group to assess whether this has been a recent issue or new trend that counsel have also experienced. more…

So You Think You’re Covered! The Insurance Industry Rip-Off

by Jokelee Vanderkop  http://www.deniedbenefitclaims.com/index.html

pg 144-146 – ‘Preparing for Court’ – Only with his prodding did I take a closer look and was shocked to see that the signature was not mine although the typed name under it was. I was now more alert. I had never seen this letter despite my name being on it. The content of the letter had, most likely, been innocuously presented by the car insurer’s claims advisor to Mr. K.’s legal clerk to type up and  sign in my name, possibly under the guise of saving me a trip to their office to sign it and speed up my getting the funds. The insurer dealt with her for this transaction, rather than her boss, probably counting on her not being up to speed on the legalities. more…

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Bill 15

Ontario’s insurers are looking to save money by reducing the interest penalty on overdue amounts owed to legitimate injured MVA victims with Bill 15

Before you pass Bill 15    our letter to legislators

FAIR Submission Bill 15 Standing Committee on General Government November 2014

FAIR response to Proposed Amendment to O. Reg. 34 – 10 Reduced Prejudgment Interest Rate

Ontario’s insurers and the IBC are lobbying to reduce pre-judgment interest rates on overdue payments to Ontario’s injured accident victims. We feel that this is an incentive to delay and deny even more claims going forward. After all, it is only those insurers who are incompetent at claims handling or who purposely deny legitimate claims who will benefit from the proposed reduced 1.3%/year interest they will have to pay on overdue amounts – it is an incentive to deny.

Take the time to comment on the reduced pre-judgment interest rate on overdue payments by Ontario’s insurance companies that is part of Bill 15. Review the 3 days of discussion about Bill 15 and auto insurance in the legislature – see links below – as you can see our legislators appear to believe that the interest rate reduction will affect only pain and suffering. The truth is it will affect ALL overdue amounts from insurers including income replacement, costs of treatment, attendant care etc. We cannot borrow money at 1.3% so it will mean that not everyone will be able to cover their own cost of care during a delayed and denied claim. Call your MPP and them them to stop giving away our benefits! Insurance companies in Ontario need to be held accountable, not given incentives to abuse victims through Bill 15.

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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 making a claim and trying to collect on what you paid for.   

‘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

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IMPORTANT – WARNING 

Last year Ontario’s motor vehicle accident (MVA) victims made over 89,000 visits to private medical clinics, assessment centers and private offices for treatment and medical assessments. There is a serious lack of oversight or standards at these facilities. MVA victims are legislated by our government to attend these facilities for third party medical opinion examinations arranged by Ontario’s insurers. We are always at risk and we are without adequate protection from often very shady business operators and a system suffering from a lack of oversight, poor regulations and no enforcement.

Recent articles:

http://www.thestar.com/life/health_wellness/2014/11/02/safety_inspections_find_13_of_private_clinics_dont_meet_provincial_standards.html
 
http://www.thestar.com/news/queenspark/2014/11/03/critics_say_ontario_expanding_too_quickly_into_risky_private_clinics.html
 
http://www.thestar.com/life/health_wellness/2014/11/04/second_gta_physician_no_longer_allowed_to_treat_women.html
 
http://www.thestar.com/news/queenspark/2014/11/04/liberal_government_accused_of_ignoring_sexual_harassment.html
 

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Did you attend the Rothbart Pain Clinic for treatment? If so, you may want to read the recent Toronto Star articles below.

Public not told of infection outbreak at private Toronto pain clinic Sat Sep 20 2014

Infection outbreak at pain clinic sparks calls for greater transparency Tue Sep 23 2014

Pain clinic doctor faces disciplinary hearing after outbreak Thu Sep 25 2014

Rothbart Centre outbreak might have started earlier: lawyer Sun Oct 05 2014

Ontario health minister orders data on clinics made public Sun Oct 05 2014

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    The IME

    (independent or insurer medical examination) 

    Concerned about the current lack of oversight for Ontario’s insurer medical examinations? Third party medical examinations or IMEs are without rules or regulations or meaningful oversight by Ontario’s regulatory colleges – a great advantage for Ontario’s auto insurers who use these poor quality reports to delay and deny legitimate claimants claims for medical treatment and benefits. Fed up? Abused? Take the time to tell the Minister of Health about your concerns and how you feel about the treatment of innocent and vulnerable MVA victims at the hands of Ontario’s third party for-hire medical practitioners at:  ehoskins.mpp.co@liberal.ola.org

    FAIR statement to CPSO consultation on Dec 2 2014

    Current College of Physicians and Surgeons of Ontario CPSO consultations in respect to transparency at:  http://www.cpso.on.ca/Policies-Publications/Positions-Initiatives/Transparency-of-Physician-Specific-Information

    Current comments regarding transparency at:  http://policyconsult.cpso.on.ca/?page_id=4018

    Past comments regarding transparency at: http://policyconsult.cpso.on.ca/?page_id=2420

    From the CPSO website:
    What patients need to know about Ontario doctors to make informed decisions

    Next steps – Phase Two

    The second phase will focus on providing more information to the public about outcomes of the Colleges’ Inquiries, Complaints and Reports Committee (ICRC).

    Categories of information may include:

    • criminal charges (if relevant to practice),
    • licences in other jurisdictions (if known);
    • discipline findings in other jurisdictions (if known);
    • CPSO discipline decisions that have not resulted in a finding of professional misconduct or incompetence;
    • undertakings (in certain circumstances);
    • oral cautions and SCERPs.

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    Not happy about our coverage for most injuries being capped at $3500.00 for rehabilitation? Think you are paying too much (you are) for the low coverage or have you been injured and can’t get the promised benefits? Do you think the process for making claims is abusive? Do you think coverage for the most catastrophically injured should be slashed so insurers can make more money? Write to your MPP at Queen’s Park and let them know that you are aware and watching and tired of being ripped off and abused. http://www.ontla.on.ca/web/members/member_addresses.do?locale=en

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    NOTICE – FAIR has been advised that at least one insurer is sending out notices to their assessors that they are not to share IME reports without approval from the adjuster – even with a signed consent form from the claimant. Assessors are told, “under no circumstances should any assessor be speaking/writing/communicating with claimants/plaintiff counsel.” If this adversarial policy is affecting your access to information about your IME or claim, we’d like to hear from you.

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    If you’d like to donate to FAIR to support us in our efforts to change Ontario’s auto insurance coverage, you can access the FAIR Donation Contribution Form here.