April 3, 2020 by Greg Meckbach
The precautions underway to reduce COVID-19 transmission risk appear to be having a direct impact on auto accident benefits claimants – and not in a good way.
“We have people who are seriously and catastrophically injured who are in their own homes or in community settings and they are vulnerable, by virtue of their often complex constellation of injuries,” Laurie Davis, executive director of the Ontario Rehabilitation Alliance, said Thursday of motor vehicle accident victims.
“They may be paraplegics. They may be quadriplegics. They may have brain injury. They may have all of the above,” Davis told Canadian Underwriter. “They may have severe motor and cognitive impairments, which makes it difficult at the best of times for them to stay healthy.”
So what happens when the social distancing measures, recommended by public health authorities, prevent a claimant from getting physiotherapy or chiropractic treatment?
“People will regress rather than being able to maintain whatever progress they have made past an accident,” said Rhona DesRoches, chair of the board of FAIR Association of Victims for Accident Insurance Reform, in an interview.
“In a sense, it gets more expensive for insurers, so that is an issue,” DesRoches said in an interview. “I think the treatment providers are scrambling to find ways to keep up that contact, keep up that work, keep people progressing.”
When contacted by Canadian Underwriter, the Canadian Insurance Claims Managers Association referred Canadian Underwriter to Insurance Bureau of Canada (IBC).
Auto insurers do understand the disruptions caused by the pandemic, an IBC spokesperson told Canadian Underwriter when asked about the impact on accident benefits claimants. “Our industry is focused on figuring out how best to navigate this unprecedented situation while focusing on balancing our objective to support claimants with our collective goal to protect Ontarians’ health and safety.”
For its part, the OHA is asking the Ontario Financial Services Regulatory Authority to waive the obligation for claimants to sign in ink a paper copy of the Treatment and Assessment Plan (OCF-18).
In 2013, Ontario brought in a new regulation giving insurers the right to request confirmation in writing that goods or services were provided – either when the claimant submits an invoice to the carrier for payment for goods or service, or when someone else submits an invoice on a claimant’s behalf. That was a recommendation made by an Ontario anti-fraud task force in 2012.
But now the COVID-19 pandemic makes it difficult for claimants to sign paper forms, DesRoches told Canadian Underwriter Wednesday. “Policy needs changing and also adjusters need some sort of direction because there are signatures required for things, and a lot of people don’t have printers at home.”
“I am hearing that a lot of victims don’t want to have a team of providers in their house, because it is now risky,” added DesRoches. “If you think about a personal support worker going into a house and needing the full personal protective equipment, they would need that for every single client. So that’s a problem. They don’t have it, as far as I know, and everybody is scrambling to find a way around this.”