Regulatory
Cost of Goods Guideline in response to a recommendation by the Auto Insurance Anti-fraud Task Force
By Claims CanadaJanuary 09, 2012 - Ontario's insurance regulator, the Financial Services Commission of Ontario (FSCO), has released a Cost of Goods Guideline in response to a recommendation by the Auto Insurance Anti-fraud Task Force.
Catastrophic impairment: Ontario Appeal Court
By Claims CanadaJanuary 04, 2011 - Psychological impairments can be combined with physical impairments for the purpose of determining whether an injured person meets the 55% threshold for a catastrophic impairment of the whole person, the Ontario Court of Appeal has ruled in Kusnierz v. Economical Mutual Insurance Company.
Ontario Anti-Fraud Task Force interim report
By Claims CanadaDecember 13, 2011 - Ontario Anti-Fraud Task Force interim report suggests working groups look into licensing health-care clinics, creating dedicated fraud investigation unit
High rate of claimants in the MIG explained by backlog of arbitrations: plaintiffs' lawyer
By Claims CanadaOctober 26, 2011 - Currently, 75% to 80% of auto accident claimants in Ontario are ending up within the Minor Injury Guideline (MIG), but this should be of false comfort to insurers, said Adam Wagman, a lawyer with Howie Sacks & Henry LLP.
Not licensed to do insurance business in Ontario
By The Financial Services Commission of Ontario (FSCO)October 25, 2011 - The Financial Services Commission of Ontario (FSCO) is warning consumers that NetWealth Capital Inc. is not licensed to do insurance business in Ontario as either an agent or company.
Direction for billing practices
By The Financial Services Commission of Ontario (FSCO)October 25, 2011- The Financial Services Commission of Ontario (FSCO) has provided direction for billing practices when a claimant changes health practitioners within the Minor Injury Guideline (MIG).
A Catastrophic Upheaval
By The Health ProfessionalFall 2011 Issue - Following the decision in Kusnierz v. Economical Mutual Insurance Co., 2010 ONSC 5749 (S.C.J.), the rules for calculating whole person impairment (WPI) ratings in accordance with the definition of “catastrophic impairment” in the Ontario Statutory Accident Benefits Schedule (SABS) are now up in the air.
Arbitrary Insurer Denials Having Serious Consequences
By The Health ProfessionalFall 2011 issue - Since the new MVA laws took effect in September of 2010, patients are routinely and systematically being denied psychological services by insurers, even when clinical intervention is warranted. Many clients who report suffering from emotional distress and clinical symptoms as a direct result of their accidents are being refused psychological intervention they are entitled to receive under the law. Not only is this a grave injustice, but it is also unethical as it is motivated by insurers who exploit the injured based on economic self-interest. What is truly egregious about this practice is that it denies patients the appropriate health care they have a right to for legitimate, substantiated reasons..
SABS, One Year Later
By The Health ProfessionalFall 2011 Issue - It has now been nearly a year since the Ontario government revised the statutory accident benefits regime by passing Statutory Accident Benefits Schedule – Effective September 1, 2010. O. Reg. 34/10 (SABS). This new regulation dramatically reduced the benefits available to Ontario motor vehicle accident victims from their auto insurance companies.
Getting Serious about Auto Insurance Fraud
By The Health ProfessionalFall 2011 Issue - Ontario is cracking down on auto insurance fraud – which will benefit drivers, insurers, health care providers and all other professionals who are affected by the province’s auto insurance system
