DAILY NEWS Dec 6, 2011 4:23 PM - 6 comments

Auditor general's report puts Ontario auto insurance in the political spotlight

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2011-12-06

Ontario's auto insurance system came under the microscope in the provincial auditor's annual report for 2011, and the result has been the politicization of the province's 2010 auto insurance reforms.
At the heart of the discussion is the auditor's observation that "Ontario drivers generally pay much higher premiums than other Canadian drivers do," a consequence, the auditor adds, of the fact that in Ontario "the average injury claim in Ontario of about $56,000 [is] five times more than the average claim in other provinces."
The auditor's report goes on to note the concerns about auto insurance fraud expressed by both the insurance industry and the Financial Services Commission of Ontario (FSCO). "[Insurance] estimates peg the value of auto insurance fraud in Ontario at between 10% and 15% of the value of 2010 premiums, or as much as $1.3 billion," the auditor notes. "Unlike many other provinces and American states, Ontario does not have significant measures in place to combat fraud. The government and FSCO are awaiting the recommendations of a government-appointed anti-fraud task force expected in fall 2012."
And herein the auditor's report has been refracted through the lens of politics.
Leader of the Opposition Tim Hudak immediately took to the Twitter airwaves, with @timhudak stating: "Fraud causing auto insurance rates to soar says AG & McGuinty govt doing nothing to stop it."
For its part, Insurance Bureau of Canada (IBC) issued a press release saying the auditor merely acknowledged what the industry and the government have known for years: fraud has contributed to the escalation of claims costs, which in turn have resulted in increased premiums.
According to 2011 Q3 data from the Office of the Superintendent of Financial Institutions (OSFI), Canadian federally regulated insurers have seen their loss ratios - claims costs divided by premiums - significantly improve since Ontario's auto insurance reforms were implemented in September 2010. Even so, recent claims ratios indicate federally regulated foreign insurers are still losing money on the auto product.
A year ago, around the time the reforms were implemented, insurers paid out between $1.25 and $2.20 in accident benefits claims for each $1 of premium they collected under the auto personal accident category, OSFI numbers indicate.
IBC noted Ontario's auditor pointed to the "alarming" example of a 150% increase in claims costs in Ontario when the number of injury claims only increased 30% in the same time period (2005-10).
"Is it reasonable that accidents are down while claims have increased?" IBC Ontario vice president Ralph Palumbo said in a press release. "It just doesn't add up. Too many people are using the auto insurance system as a profit-making opportunity.
"There is a sophisticated network of service providers who use the auto insurance system for their own self-interest. This problem is especially acute in the Greater Toronto Area."
FSCO responded to the auditor general, saying it is already addressing the issue of auto fraud.
"FSCO shares the auditor general's concerns about fraudulent auto insurance claims," the auditor general report notes. "The Ministry of Finance's Auto Insurance Anti-Fraud Task Force will identify measures to combat fraud.
"FSCO supports and is working with the Task Force's steering committee and working groups. FSCO will implement any changes in regulatory responsibilities arising from the Task Force's recommendations."



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Reader Comments

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harry

I agree withMichael Lewis' comments. In all the years that I have been in this industry handling claims, the insurance companies have always cried about losing money and fraud running rampant. If the auto business was such a losing business you would think that all the big brains at the insurance companies would get out of the business and let the government run auto insurance, With respect to claims, it is a rare occasion that anyone is ever prosecuted,. The insurers usually do a quick calculation and decide to pay the questionable claims instead of defending against them or going to the police with the evidence. I have to compliment the few companies who are now suing a number of rehab clinics and their owners. At least it shows that their claim departments are doing a proper job. Obviously there are competent claims people working at those companies.

Posted December 16, 2011 06:50 AM


Michael Lewis

If there is so much fraud out there, where are the investigations,charges and convictions? It is easy to scream fraud. Prove it. I am sure that if $1.3 Billions dollars of fraudulent activity is occurring in Ontario every year without any charges let alone convictions, either our police are high paid useless twits, or this allegation is blarney. It's like the constant claim that the insurance industry is forever going bankrupt, and yet it is in fact expanding. How many insurance executives have taken pay cuts or been laid off. This crying wolf has been going on as long as I have been able to read. If everything is so very bad, and as always, going to hell in a hand basket, I can't understand why anyone writes a policy n Ontario.

Posted December 14, 2011 09:32 PM


harry

I have an idea as to how to eliminate accident benefit fraud. Simply amend the Insurance Act so that there is no longer accident benefits coverage. The right to recover damages will revert to the tort system. I guarantee you that the assessment clinics which sprouted like mushrooms will quickly disappear once the opportunity to make fast money disappears. Claimants will be put to the test to prove their damages. The insurance companies will then be forced to do a proper investigation of the claims that come in. That will mean hiring , training and retaining well trained personnel. If the insurance companies still continue to cry that they are losing money, they can always get out of the auto business and let the government take over auto insurance.

Posted December 14, 2011 08:33 AM


Charles Ward

What would make an interesting exercise in Ontario regarding auto insurance is that all insurance companies would abide by the same underwriting rules when underwriting this coverage. They would have to compete based on their cost of doing business, including claims, and investment returns, plus receive provincial government approval before increasing premiums, all of which the insurance companies are required to do so now. However, the insuring public would have to accept the overall financial result since high risk drivers would not be confined to the insurance companies that currently focus solely on insuring "high risk" drivers. Under this program, the "excessive" high-risk driver should still be required to be assigned to the government-decreed Facility Association Plan.

Posted December 12, 2011 09:43 PM


Brij Goberdhan FIIC ACII

Let's get this AG going on other areas where the public is getting gourged such as Insurers putting brokers under duress with their invisible filed rules so that brokers don't place otherwise eligible business with them. The result is innocent policyholders such as those with no prior insurance being placed with high risk insurers paying $2,000 more than they could have got with supposed regular market reputable insurers. IBC did a nice cover comment. IBAO and RIBO appear to be silent on the matter and brokers risk their bread and butter if they make signed formal complaints. As a broker what do you do? What will happen if the public really finds out about this cosiness and backend operations. I do feel sorry for any corporate bottom line where the intent is to make a profit but the Gov't has to take full blame for just about the most assinine performance ever on auto insurance. mr. Hudak, you had your chance to hear me out on this so don't play but listenned to your handlers instead so your comments are just as typical as any policitians.Come on AG, FSCO is useless and failing the ordinary auto insurance client and you at least have part of the picture. Keep going, there are still fragments of this industry that support the truth. When will Utmost Good Faith become part of this industry again? Where is good old investigative journalism when you need it? Lets "occupy" the Insurance Industry.

Posted December 7, 2011 05:17 PM


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