What's New

Government announces Reform Directions for Auto Insurance Sector

Tuesday, November 03, 2009

Ontario Finance Minister Dwight Duncan has made public the government's strategy for auto insurance reform. Although this remains a high level overview at this point in time, Duncan has announced reforms that will target to stablilize auto insurance premiums by providing for an insurance program that offers consumers choice and flexibility in coverage selection and aims to produce a less complex auto insurance system. Drivers will be able to purchase a new basic level of auto insurance coverage or may opt to purchase increased and optional coverage that provides for additional levels of medica l and rehabilitation coverage.

You can view the Ministry's release by clicking here.

Key proposed changes....

OSOT has had limited time to review the implications of the announced changes for occupational therapy practice and access to necessary benefits for the claimants we serve, however, the following represents a brief synopsis of key changes....

The government will create a basic package of statutory accident benefits that lowers compulsory medical and rehabilitation benefits coverage to $50,000 and attendant care benefits coverage to $36,000 for non-catastrophic injuries.
Persons with catastrophic injuries would continue to have access to $1 million medical and rehabilitation benefits and $1 million for attendant care.
Drivers could purchase $50,000, $100,000 or $1 million of medical and rehabilitation benefits coverage. They would also have the choice to purchase $36,000 or $72,000 in attendant care benefits coverage.
Section 24 assessment costs will now be within this medical and rehabilitation benefit now.
Housekeeping adn Home Maintenance and Caregiving will be optional benefits except for claimants with catastrophic injuries.
Limit of $200 per assessment to complete a form (we need more detail about this)
Limit of $2000 per assessment for Section 24 or Section 42
In-home assessments will be eliminated except for the seriously injured and for assessment for attendant care and home modifications
Attendant Care Form 1s will be completed by only by OTs and nurses
Rebuttals are eliminated
Single limb amputees will be within a new CAT designat ion; further consultation around the CAT definitions are pending
Minor sprains and strains will receive $3500 in treatment; The PAF will be expanded but there will be an "escape clause" for those folks where it is determined that they need more
Gatekeepers will not necessarily be only family doctors
Insurers will have 10 days to respond to an OCF 22
Innocent accident victims get "basic" coverage REGARDLESS of the person who struck them
Tort unchanged unless the consumer buys up to reduce threshold from $30K to $20 K
Costs of future care cost analysis will not be recoverable through the SABS
The government will form a stakeholder advisory committee made up of experts from various sectors of the auto insurance industry, health care providers and legal professionals as well as consumer representation to advise on longer term reforms including improved outcone-based treatment protocols for minor injuries and ways to control med/rehab costs
proposed changes would be in place (for the most part) for implementation in summer 2010.

A chart that compares current and proposed coverage is a useful visual assist and can be viewed here. Further, a complete list of the 41 reforms can be accessed here.

OSOT's Reactions and Positioning....

To date, OSOT has responded to the Minister's announcement in a press release of the Coalition of Professional Associations in Auto Insurance, released yesterday. View this release. Members should be aware of the goals of this release which takes a cautiously supportive approach. It is the Coalition's goal to protect the ability of the Coalition and individual associations to continue to be part of the advisory process as regulations are developed.

OSOT's Auto Insurance Sector Team has already commenced a thorough review of the proposed reforms to aid in the development of OSOT's position. We are concerned in general about;

the reduction in basic coverage benefits to $50,000 and the resulting potential that those with serious injuries will be inadequately covered for the services and benefits they require.
the proposed "buy up" optional framework that relies on the public to pay more to purchase more than a basic package - past practice demonstrates that few individuals purchase optional coverages
the potential impacts of reductions in med/rehab in the auto sector on the CCAC sector and Ontario's publicly funded health care system
making Housekeeping and Home Maintena nce and Care-giving Benefits optional would appear to place the most vulnerable - the elderly, single parents, children and women - at most risk

OSOT will be formulating it's response and positions in the week ahead, however, many of our questions remain unanswered and will only become clearer as the regulations are developed. Government will be developing regulations in the weeks ahead to bring these recommendations to life and written clarity. It is expected this will be complete in the next 4 - 6 weeks. Thereafter there will be a 60 day consultation period and OSOT will need to be poised to respond.

Please watch your email box for further updates and consider our sincere invitation to forward your comments, reactions and feedback to cbrenchley@osot.on.ca so that we may ensure that our positioning is representat ive of our members across the province.

We understand that this reform imposes significant change and potential impact on occupational therapy practice and access to OT services. OSOT will continue to advocate for consumer access to necessary services and benefits, including occupational therapy. To this end, please know that your support and input in the past and now is appreciated.