Canadian Underwriter

IME companies must focus on client service, diversify in face of regulatory changes

May 22, 2013   by Canadian Underwriter

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Ongoing regulatory reform, particularly related to Ontario auto insurance, along with general industry consolidation, means Canadian independent medical evaluation companies must diversify their offerings and continue working with stakeholders, a new whitepaper from Cira Medical Services argues.


Reforms in 2010 to Ontario’s Statutory Accident Benefits Schedule (SABS) have already had an impact on the IME industry, the company says in its whitepaper, Emerging Trends in the Independent Medical Evaluation Industry.

Recent recommendations set out in the November 2012 final report from the Auto Insurance Anti-Fraud Task Force also mean the industry is poised for changes, Cira Medical notes.

Among the 38 recommendations in that report was creating a licensing and regulatory process for health care clinics that treat auto insurance claimants and invoice insurers. The report also said there should be greater emphasis on evidence-based approaches to medical assessments and that insurers should publicly disclose how they choose and assess medical assessment professionals.

“It is clear that to achieve these stated goals, IME service entities and their assessors will need to structure their future activities in a manner that allows for clear accountability and transparency,” the whitepaper says.

The most successful IME companies will be those that adapt quickly to new policies and procedures, and other results of ongoing regulatory reform, it argues.

IME companies must also adapt to ongoing consolidation in the industry, the whitepaper says. Like the property and casualty insurance industry in general, the IME industry has seen increased consolidation over the past few years.

One challenge from that has been insurance companies requesting national fee schedules from IME companies, the paper suggests. Streamlined pricing on a national level can be difficult because of fee caps and other regulatory issues that differ among the provinces, it notes.

However, IME companies can work on streamlining their client service processes and other internal processes to remain successful, Cira Medical argues.

Companies can also work on diversifying their services into new markets and invest in their internal technology platforms to better manage information, the paper suggests.

“Whatever the outcome of these efforts, it remains in the IME industry’s best interest to promote the highest quality practices possible, and this can only be achieved through rigorous standards of service and innovation,” it adds.

“The future of the IME industry will favour those providers who not only possess the ability to adapt quickly to regulatory change, but can also respond to and event set industry trends.”

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