Cracking down on fraud or cutting costs does not mean that cracking the backs of the vulnerable and cognitively impaired citizens is the right thing to do. The interests of big business (profit, profit, profit) should not surpass those interests of the most injured and disabled among us or our society as a whole. Allowing further cuts to benefits to support the cuts to premiums will only shift the responsibilities and costs to our society and to the taxpayers. Surely accident victims deserve better treatment than to be abandoned by those who are supposed to be looking out for them in a time of need – first by the insurer who fails to live up to the promise of coverage and then by the government who fails to act to protect their interests.
News and Views
Examining the examiners
“. . . there is a dark underbelly in the business . . . many patients “are being profoundly mistreated.” This article from 2007 may be old but it sure explains some of what happened to balanced medical assessments – with the demise of rebuttal IMEs the advantage is now in the insurers court.
http://www.ciws.ca/articles_independent_medical_examiners.htm
FAIR submission to Consultation on Modernizing Disciplinary Hearings for Insurance Agents and Adjusters in Ontario September 30 2013
It is odd to consider changing the disciplinary process for adjusters when there is no adequate process in place for hearing those complaints in the first place. In fact, we were unable to find any record on the Financial Services website that documents any complaints at any time about any adjuster. Could this lack of openness about complaints have resulted in no complaints being heard officially by the Advisory Board (AB)?
http://www.fsco.gov.on.ca/en/insurance/Documents/IDRC-2013.pdf
The Three Ps of Insurance – Profits, Protection and Premiums
Ontario Trial Lawyers Association gives Ontario’s insurance industry a FAIL grade on coverage for accident victims.
Profits—More than $3 billion * Protection—You’re getting 96.5% less * Premiums—You’re paying 20% more
FAIR submission to the Ontario Dispute Resolution System Review September 20 2013
“Vulnerable and innocent accident victims, whose treatment and benefits are dependent on the quality of the assessments and evidence, should not be the victims of a lesser degree of the standard of justice in our courts.”
FAIR submission to the Ontario Dispute Resolution System Review September 20 2013
Ontario Rehab Alliance Submission to the Dispute Resolution System Review
“Along with a number of other stakeholders we believe that sub-par Insurer Exams put increased and unnecessary pressure on the DR system. Insurer exams, when properly done and well regarded, play a vital role – providing insurers with insight and expertise to assist them in making difficult decisions from a layperson’s perspective and, in so doing, helping insure that benefit dollars are well used.”
Ontario Rehab Alliance Submission to the Dispute Resolution System Review
OTLA’s Submission to the Review of FSCO’s Dispute Resolution Services
“Although a seeming oxymoron, “compelling good faith” on the part of insurers in the handling of mediation claims is a concept in need of exploring as part of the DRS review.”
OTLA’s Submission to the Review of FSCO’s Dispute Resolution Services
Not slashing benefits
Letters to the Editor, Sept. 22 Insurers stack the deck
Re “Not slashing benefits” (Letters, Sept. 8):
“So, Insurance Bureau of Canada spokesman Ralph Palumbo didn’t like Alan Shanoff calling him out on his statement about reducing “unnecessary costs” to catastrophically injured auto accident victims in order to ensure the money goes “to people who really need it” (“Risky business,” Sept. 1). I’m not sure what those “unnecessary costs” are, unless Palumbo is referring to the tens of thousands paid for substandard, so-called “independent” medical assessments, done by doctors hand-picked by insurance adjusters, which paint their insureds who suffer traumatic brain injuries, major psychological issues (think of the death of a child in the back seat) and other devastating accident-related problems, as malingerers. I’d start there, Mr. Palumbo. The IBC “cut costs” by refusing many of these victims the legislated funding available to pay for their own balanced medical assessments. Maybe the IBC could stop its habit of plying the Liberal leadership candidates with tens of thousands in political donations. That would save money, wouldn’t it?”
Harold Becker, MD Toronto
(A few bucks, yes)
FAIR open letter to Stakeholders – work together for quality independent medical examinations
The credibility of the auto insurers’ preferred IME/IE vendors, whose assessments are often used to deny and delay seriously injured claimants’ access to policy benefits is not only affecting access to treatment, it is affecting our justice system.
FAIR response to The Stakeholder Roundtable on Catastrophic Impairment Sept 5, 2013
Given that “The goal of this review should be to ensure that the most seriously injured victims are treated fairly” then the FSCO must acknowledge that this has not been accomplished with a Panel that lacked the expertise necessary to arrive at a fair definition. No matter how cooperative and interactive the roundtable participants were, it cannot undo the flaws of the original Panel conclusions or the harm it will do to accident victims.
The confusion demonstrated by the FSCO CAT Panel in dealing with this new catastrophic definition should be reason enough to go back to the consultation process. FSCO needs to better accommodate those most severely injured by removing the obstacles to recovery rather than creating new ones. FAIR response to Stakeholder Roundtable on Catastrophic Impairment September 5 2013