• FAIR – supporting auto accident victims through advocacy and education
  • FAIR – supporting auto accident victims through advocacy and education
  • FAIR – supporting auto accident victims through advocacy and education
  • FAIR – supporting auto accident victims through advocacy and education

Welcome to FAIR Association of Victims for Accident Insurance Reform

‘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 »

Become a FAIR member and get on our mailing list here!

OR support FAIR and the website through a donation (could sure use the support!) here.

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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.

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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

The LAT (Licence Appeal Tribunal) Automobile Accident Benefits Service (AABS)

Read the latest LAT decisions

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What’s New?

Bill C-22 update and we are looking for input from the public to support amendments

What happens at the Senate with Bill C-22 will affect millions of ill, injured and disabled people across Canada. We urge you to respond to this call to address the failure to adequately support those Canadians in need by writing in to Senators. So far FAIR has sent in a letter and Addendum to the SOCI, the Committee who is currently hearing from Canadians and organizations and forming the framework legislation.

The SOCI is coming to the end of their clause-by-clause consideration and will soon be moving into their report writing phase . The Senate will enter the Third Reading stage because some amendments have been added to Bill C-22 and there will be a vote.

We urge you to write to the Senators as soon as possible to encourage them to vote YES to passing the Bill with amendments that will, we hope, close the door to insurers benefiting from taxpayer dollars that are supposed to be paid to disabled Canadians. You can access the senators email address here: Senators emails 2023

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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.

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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:

  1. Individual – $100,000
  2. Other than Individual – $200,000

Feedback due by May 31st, 2023 

https://www.fsrao.ca/engagement-and-consultations/consultation-proposed-guidance-administrative-monetary-penalties

https://www.fsrao.ca/regulation/guidance/proposed-guidance-administrative-monetary-penalties

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CLOSED:

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.

View the draft policy and Advice to the Profession document

Post your comments on our online discussion page

Referenced from: https://ontariohealthregulators.ca/public-consultations/

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From the Office of the Auditor General of Ontario November 30, 2022  

Value-for-Money Audit: Financial Services Regulatory Authority: Regulation of Private Passenger Automobile Insurance, Credit Unions and Pension Plans (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

 

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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: 2021: Another Year of the LAT (and it isn’t getting faster)

READ: LAT Stats: Market Share vs. LAT Applications and Decisions   

READ: Tribunals Ontario 2021-22 Annual Report LAT AABS (Tables 3 and 4)   2021-2022 – 15,800 cases filed in one year

READ: Tribunal Watch: Access to Justice in Crisis: Tribunals Ontario in 2022 Statement of Concern 

Current Motor Vehicle cases in Ontario’s civil court system is 49,037 according to Statistics Canada

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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.

http://policyconsult.cpso.on.ca/?page_id=12720

http://policyconsult.cpso.on.ca/?page_id=12720

http://policyconsult.cpso.on.ca/?page_id=12360

 

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).

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Do we need a Public Inquiry into the quality of the medical evidence? We think so and here’s why

Licence to bill – Globe and Mail 

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

Hired gun in a lab coat: How medical experts help car insurers fight accident claims – National Post

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

Experts disqualified for history of bias? – Law Times

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.”

Job One for newly appointed auto insurance Czar David Marshall: Public Inquiry into auto insurance claims medical evidence  

Ontario Auto Insurance in Crisis: OTLA calls on Wynne Government to call a public inquiry into medical assessments of accident victims 

OFL, Injured Workers and Medical Professionals File Official Request for Ombuds Ontario Investigation into the WSIB

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.” 

Cuts to benefits, ‘hired guns’ faulted 

Social Justice: Expert witnesses and access to justice 

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

Trial Lawyers Association calls for inquiry

Fair auto insurance? That’s a stretch   Premiums are too high, benefits are being slashed and insurers are denying valid accident claims 

OTLA Presentation at the 2016 OLA Pre-Budget Hearings 

Proper Use of Experts in Civil Trials – Rastin and Mahony (1)

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

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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?

https://t.co/FFmev45fVc

https://twitter.com/i/status/1093613873435951105

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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/

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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. more…

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