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Advocates pushing for this temporary accident benefit reform


April 6, 2020   by Greg Meckbach


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Accident benefits clients who are seriously injured could be running into issues with attendant care benefits because of the social distancing precautions in effect with the COVID-19 pandemic.

FAIR Association of Victims for Accident Insurance Reform has heard that some motor vehicle accident victims are reluctant to have a team of healthcare providers at their homes while social distancing precautions are in effect, Rhona DesRoches, FAIR’s chair of the board told Canadian Underwriter. This in turn highlights an existing insurance regulation around how insurance reimburses attendant care by non-professional providers (such as a family member of the victim, for example).

“Insurers should consider temporarily waiving the requirement that the caregiver sustain an economic loss in order to be paid for their services and pay the replacement provider the standard rate,” DesRoches said in an interview, commenting specifically on Ontario auto accident benefits.

As it stands, Ontario’s auto insurance regulation has a rule for reimbursing attendant care providers if they are not health professionals, such as a personal support worker. If it’s a family member, for example, that person would have to sustain an economic loss in order to entitle the claimant to claim attendant care benefit.

FAIR says that during the COVID-19 pandemic, because of the impact of social distancing, the requirement that the caregiver sustain an economic loss in order to be paid for their services should be waived.

Related: How COVID-19 is probably affecting your auto claimants

“We are examining these issues closely to determine how best to serve the health care needs of injured people during the emergency,” an Insurance Bureau of Canada spokesperson told Canadian Underwriter, when asked about several issues affecting accident benefits, including the policy on reimbursing attendant care by non-professionals.

“In approaching the suggestions that are being made by various health care providers, we are having to consider what is feasible within the scope of the standard auto insurance policy, and what is safe and consistent with the social distancing rule. We are focused on what will deliver the best possible outcomes for injured people and for drivers.”

The current pandemic also creates an issue when a person who has been seriously injured in a vehicle accident is about to be released from hospital.

“The occupational therapist or physiotherapist would often be at the hospital to examine them and figure out what [the claimant is] going to need, and the occupational therapist would go to the person’s home and decide all of the things that might need to be changed in the home to make life more comfortable,” said Laurie Davis, executive director of the Ontario Rehabilitation Alliance.

“Maybe you’ve got someone moving on to the first floor. So you’ve got a whole bunch of decisions that are being made right around the time that a person might be leaving the hospital. But now people don’t want that, or they don’t want the physiotherapist in their home, and the therapist does not necessarily want to go to the hospital because now they have to have full [personal protective] gear, and that is in such short supply,” said Davis.