Welcome to FAIR Association of Victims for Accident Insurance Reform - FAIR

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Web Name: Welcome to FAIR Association of Victims for Accident Insurance Reform - FAIR

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FAIR – supporting auto accident victims through advocacy and educationFAIR – supporting auto accident victims through advocacy and educationFAIR – supporting auto accident victims through advocacy and educationFAIR – supporting auto accident victims through advocacy and education HomeWelcomeAbout UsPhoto GalleryMedia ReleasesBecome a MemberWhat’s NewIn the NewsLatest News ArticlesArchivesMedia ArticlesContact Us Member StoriesOur members share their stories. Why not share yours?Who We Are Activities and ActionsContact Your MPPThe Independent Insurer Medical Examination IME/IEIME Providers Adverse CommentsChasing IME SolutionsMuzzling CriticismUnredacted Health Professions Appeal and Review Board (HPARB) DecisionsWhere Do the Dollars Go?The LawyersThe AdjustersThe Treatment ProvidersSurveillanceChoosing a LawyerResources & LinksBrain Injury with Tammy KirkwoodCorporate Members that Support FAIRThe Blog

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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What to do after a car accident – consumer information about coverage

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)

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What’s New???

Ongoing consultations related to auto insurance:

FSRA releases its revised Proposed Unfair or Deceptive Acts or Practices (UDAP) Rule for public consultation – Due August 11, 2021

The proposed rule will replace the existing UDAP Regulation and is aimed at making the supervision of insurance more transparent, dynamic, and flexible. It also focuses on the need for stronger consumer protections by clearly defining outcomes that are unfair or otherwise harmful to consumers.

https://www.fsrao.ca/engagement-and-consultations/fsra-releases-its-revised-proposed-unfair-or-deceptive-acts-or-practices-udap-rule-public-consultation

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[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

https://www.ontariocanada.com/registry/showAttachment.do?postingId=37747&attachmentId=49356

See responses:http://www.fairassociation.ca/2021/07/what-we-know-so-far-on-the-fraud-and-abuse-consultation-from-minister-of-finance-office/

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FSRA’s First Proposed Insurance Rule Released for Public Consultation – the Unfair or Deceptive Acts or Practices (UDAP) Rule– Due March 18 2021.Unfair or Deceptive Acts or Practices (UDAP):Section439 of theInsurance Actprohibits “unfair or deceptive acts or practices”. O. Reg. 7/00 (UDAP regulation) under theInsurance Actprescribes specific actions that are considered as unfair or deceptive, and may apply to insurers, brokers, intermediaries, adjusters, and goods/service providers engaged in the insurance sector such as health service providers, vehicle repair shops, automobile storage facilities, and tow truck operators. https://www.fsrao.ca/engagement-and-consultations/fsras-first-proposed-insurance-rule-released-public-consultation-unfair-or-deceptive-acts-or-practices-udap-rule See:https://www.fsrao.ca/media/2521/download

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Proposed new regulations under the Insurance Act fromAuto Insurance Policy Unit, Financial Institutions Policy Branch, Ministry of Finance

Auto Insurance “Regulatory Sandbox” due April 2, 2021:Would permit the Financial Services Regulatory Authority’s (FSRA) CEO to exempt insurers from certain requirements under theInsurance Actand / or its regulations, within a “regulatory sandbox” with defined parameters as set byFSRAguidance. This would enable insurers to pilot initiatives that bring new consumer-focused products and services to market more quickly in response to changing consumer needs. https://www.ontariocanada.com/registry/view.do?postingId=36247&language=en

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Optional Direct Compensation – Property Damage (DCPD) Coverage due March 29, 2021:Would permit an insured to decide not to purchase DCPD coverage by providing written confirmation to their insurer. This would enable drivers who may determine that insuring their older vehicle costs more than the vehicle is worth to save on their auto insurance premium. https://www.ontariocanada.com/registry/view.do?postingId=36231&language=en

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Electronic Delivery of Automobile Insurance Notices / Documents due March 29, 2021:Would make it faster and simpler for insurance companies and consumers to do business, including through the delivery of termination notices of auto insurance contracts through electronic means. This would further enable fully digital insurers to operate in Ontario. https://www.ontariocanada.com/registry/view.do?postingId=36230&language=en

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Brain Injury & Auto Insurance Study 2020 ABISS and McMaster

Survey of Auto Insurance Claims Process for Individuals with Communication Disorders After Traumatic Brain Injury
Laura Brooks, Daniella Reid, Yvette Hou, Aileen Zhou
McMaster University
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.

Brain Injury & Auto Insurance Study 2020 Full Report

Acquired Brain Injury Survivor Solutions (ABISS) • www.abiss.ca • McMaster University

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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

http://policyconsult.cpso.on.ca/?page_id=12358

The College recently reviewed itsThird Party ReportsandMedical Expert: Reports and Testimonypolicies.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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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!

LAT AABS Applications (March 2019)

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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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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 Tomlinsoninvestigates

Insurance assessment firms altered, ghostwrote accident victimreports – Globe and Mail

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 Tomlinsonreports

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

Third party assessment reports need strict code

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)

Latest Number of MVA victims waiting for hearings at the Financial Services Commission of OntarioMed-Arb-Timelines 2007-Mar 2016

2015 StatsCan number of auto insurance related cases on Civil Court docket 59,956

Read about how much we are overpaying: The Truth about Auto Insurance

The Canadian Society of Medical Evaluators 2011President’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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‘So You Think You’re Covered! The Insurance Industry Rip-Off – Surviving the Fight for Long-Term Disability Benefits’

byJokelee 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.

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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:

http://www.cbc.ca/player/AudioMobile/Ontario%2BToday/ID/2689763721/

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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…

FAIR Policy question regarding evidence used at FSCO DRS hearingsFAIR response from FSCO JR Richards

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What's New

FSRA releases its revised Proposed Unfair or Deceptive Acts or Practices (UDAP) Rule for public consultation – Due August 11, 2021

July 28, 2021The proposed rule will replace the existing UDAP Regulation and …

What we know so far on submissions to Fraud and Abuse consultation from Minister of Finance office

July 16, 2021[CLOSED] Proposed Fraud and Abuse Strategy for the Auto Insurance …

Ongoing consultations related to Ontario auto insurance

March 6, 2021From the Minister of Finance office: Proposed Fraud and Abuse …

Survey of Auto Insurance Claims Process for Individuals with Communication Disorders

August 20, 2020Brain Injury & Auto Insurance Study 2020 ABISS and McMaster …

What we know so far about submissions on the Jury issue

June 16, 2020FAIR submission to MAG Consult on Civil Juries June 15 …

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