The proposals of the Panel unfairly and without any justification reduce access to prompt and valuable medical treatment to the most seriously injured Ontario consumers, those with ‘catastrophic injuries’.
There is no evidence that the current methods of assessing catastrophic impairment are failing Ontario consumers. Despite requests, the automobile insurance industry in Ontario has not revealed any information in support of its reason(s) for changing the insurance product, once again. The proposed changes fall swiftly on the heels of significant insurance changes that were only implemented in 2010 and also dramatically reduced the benefits available to injured people.
The Panel was struck as a result of the 5-year Insurance Review process. The Financial Services Commission recommended consultation with experts to review the definition of ‘catastrophic impairment’. The Financial Services Commission further explained: “The goal for this review should be to ensure that the most seriously injured accident victims are treated fairly”.
The Panel was substantially composed of members who work for the insurance industry. The Panel reached conclusions about an insurance product when they themselves identified that further review/research is required and in a climate where there is no evidence that the current definition of ‘catastrophic impairment’ is a problem. How can this be considered ‘fair treatment of the most seriously injured accident victims’???
The proposals of the Panel are discriminatory to Ontario consumers who have reduced access to hospital and medical services. When benefit entitlement is linked to length of hospitalization, hospitalization in a recognized neurological rehabilitation centre, or in-patient rehabilitation in a public hospital – those Ontario consumers who have less access to hospital services are discriminated against. This is especially troubling to consumers who live outside of major urban centres or who live in cities and towns where medical services are already overburdened.
The proposals of the Panel introduce new uncertainty in the insurance product and increase the complexity of the process to access insurance benefits. The current definition of catastrophic impairment has been in place for 15 years. The definition has been debated, interpreted and clarified by insurance companies, judges at all levels of the Ontario courts, arbitrators at the Financial Services Commission of Ontario and claimants. Having achieved a level of certainty about the definition over a period of 15 years, the new proposals introduce renewed uncertainty about the insurance product, without any justification for doing so.
The Panel recognized the need to find an approach to combine physical and psychiatric injuries when determining the impairment of a whole person. However, the Panel could not define a method of considering these impairments in concert. The Panel lacked the time and resource to identify such an approach – yet proposed that injured people “do without” pending further research.
The Panel has ignored the fact that a catastrophic designation does not entitle a claimant to payment of any benefit. Every claimant, including those with catastrophic designations, must prove that all claims they advance are both reasonable and necessary.
The Panel recommended that chronic pain be eliminated as an impairment. This is despite the fact that chronic pain has been recognized by the Supreme Court of Canada as a legitimate impairment.