A new, scathing report released by the Ontario Trial Lawyers’ Association (OTLA) focuses on the need for drastic reforms in the auto-insurance industry. Conducted by two independent American experts from the York University Schulich School Of Business, the study reveals several insights that far-reaching implications for this sector.

The primary areas of concern expressed by OTLA included impending cuts to victims’ benefits and biases in medical evidence used to assess injuries/disabilities etc suffered by motor-vehicle accident victims.

President of OTLA, Maia Bent, opines, “After years of changes designed to placate the insurance industry, the government needs to turn its attention to the plight of victims.”

She further remarked that Ontario’s insurance system was in crisis, coverage was being steadily eroded, premiums remained stubbornly high and insurer profitability was allowed to continue without limits. Injured accident victims and their families usually bear the brunt of the punitive changes that have been recently instituted in insurance regulations.

OTLA has called upon the government of Ontario to set up “a commission to conduct a public inquiry to examine the current state of independent medical assessments of injured auto accident victims.”

Additionally, David Marshall, the newly-appointed auto insurance advisor has opined that his task will be “identifying additional opportunities for auto insurance reform…. leading to better health outcomes, lower costs and more affordable insurance premiums.”

Reforms Needed

FAIR, the organization that advocates for insurance reforms for victims of accidents, has welcomed this move. FAIR has deemed that the auto insurance industry urgently needs reforms. Some of the important areas require detailed inquiry into:

• Lack of diligence by Ontario court system and judges to make sure that medical experts are not “hired guns.”
• Failure to ensure that medical experts are in compliance with the Rules of Procedure
• Delay of payments to legitimate applicants – more than 50% claims are routinely denied by insurers
• Wasteful and exorbitant rates paid by insurers on creating medical reports to counter the claims of legitimate applicants
• Lax application of standards
• Ontario regulatory colleges failure to meet their public obligations
• Ontario taxpayers bearing the burden of motor-vehicle accident victims
• Ontario insurers commissioning poor quality or partisan medico-legal reports

Medical Evaluations Under Scrutiny 

Rhona DesRoches of FAIR refers to the troubling use of “bogus medical reports and testimony….. the unsavory aspect of auto insurance.”

Currently there is a backlog of more than 60,000 insurance claims in the courts in Ontario, while another 20,000 are held up in arbitration. Studies reveal that insurers pay nearly 70 cents to every dollar they pay victims on gathering evidence to counter the claim.

Unlike other patients, accident victims have no choice regarding the physician who conducts their Independent Medical Examination (IME). In many cases, it is found that the physician provides unqualified, shoddy or biased report. This becomes part of the victim’s medical file and the basis for all further action. Rehabilitation benefits are often denied based on such faulty reports.

Victims and their representatives have no access to the IME physician’s previous history, track record, professional qualities, complaints regarding conduct etc. Another issue is the intended $500 fine for failure to appear at the IME.

If you have been injured in a motor-vehicle accident, consult our experienced, knowledgeable car accident lawyer for a genuine, swift and comprehensive assessment of your claim.