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Reduced auto insurance accident benefits could influence balance between attendant care, treatment: lawyer


May 12, 2016   by Angela Stelmakowich, Editor


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The reduced accident benefits under Ontario’s auto reforms may prove a shock to drivers with non-catastrophic injuries, but perhaps should also elicit concern over the potential for treatment to come second to attendant care, suggests Daniel Strigberger, a lawyer with Samis+Company.

iStock_000058972392_Small“We’re accustomed to a certain system whereby when you get into an accident that there’s a lot of money,” Strigberger said during the Insurance Institute of Ontario’s seminar on auto insurance reforms in Toronto earlier this week.

“I think the biggest shock to the system now is that the government is saying there’s still auto insurance, you’re still paying premium, but we’re just reducing the amount of money that might be available in the system,” he told attendees.

For non-catastrophic injuries, the old scheme allowed for $50,000 in medical and rehabilitation benefits and $36,000 in attendant care benefits. Under the new scheme that takes effect this June, the two have been combined and reduced to a total of $65,000.

If the injured person needs “some attendant care, they need some treatment or what not, there’s a risk of exhausting your $65,000 limits,” Strigberger (pictured below left) said.

Daniel Strigberger, lawyer with Samis+Company

Daniel Strigberger, lawyer with Samis+Company

In addition, he pointed out there could be a risk of abuse by providers. “If they’re pushing a lot of attendant care, that just takes away from the treatment that’s available,” he told attendees.

“It’ll be curious to see how many claims are hitting that $65,000 or coming close to it, because there’s a lot of attendant care versus treatment,” Strigberger said. “The concern I have with that, from a consumer (standpoint), is that attendant care is very different from treatment. Attendant care is there to help you today; it doesn’t necessarily get you better tomorrow.”

Among the key goals of the reforms are to combat fraud and reduce premiums.

Alex Voudouris, senior litigator with Pace Law Firm, told seminar attendees that he has some definite concerns with the reforms that will soon be in place.

Alex Voudouris, senior litigator with Pace Law Firm

Alex Voudouris, senior litigator with Pace Law Firm

Chief among those relates to the definition of catastrophically impaired and the reduction of associated accident benefits. “For some reason, this government, in order to fight fraud, decided to take a million dollars away from” someone who is catastrophically injured, Voudouris (pictured right) argued.

Without the purchase of optional benefits, the former scheme that allowed for $1 million each in medical and rehabilitation benefits and in attendant care benefits for a catastrophically injured person will now allow for $1 million in total.

Noting he has a client in her 20s who requires care 24 hours a day, Voudouris reported that $1 million in attendant care “will run out in about 18.6 years.”

He characterized the changes as terrible. “The government shouldn’t make laws that are good for me or you; they should make laws that are good for the public and I don’t think they have in this regard,” he argued.

Strigberger, for his part, noted “it’s strange to me that they targeted the cat class of people of claimants with the biggest hit in the reduction.” To meet the goals of fighting fraud and reducing claims, “it would have made more sense, to me, to target the non-cat/big members who are the vast majority of the claims,” he said.

“It will be interesting to see how that affects certain tort claims in terms of pursuing hard on the tort side to make up for what the shortfall is on the accident benefits side,” Strigberger suggested. “It just means there’s less money in the playing field to access and how that’s going to certain plaintiffs, when they’re trying to get their cases together, and the avenues that they’re going to pursue.”

More coverage of Insurance Institute of Ontario’s Auto Insurance Reforms Seminar

Ontario adjusters will need retraining on injury definitions as part of auto reforms taking effect in June: Walker

Ontario auto reforms should help cut transaction costs: Cameron


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2 Comments » for Reduced auto insurance accident benefits could influence balance between attendant care, treatment: lawyer
  1. I find it almost comical that the lawyers are so upset at the reduction of the overall benefits under the Ontario Auto reforms. ” For some reason, this government, in order to fight fraud, decided to take a million dollars away from someone who is catastrophically injured, Voudouris argued.”
    In Nova Scotia , most law firms take up to 50% of all of the awards to people who have relatively minor injuries as well the catastrophic injuries. Perhaps the legal firms should reduce their fees and allow the injured parties to keep more of their awards. As an Independent Adjuster I see this on a regular basis and have never seen any concern for the client given the large amount of money made by the Law Firms.

  2. Martin says:

    I agree,
    Whenever I see a large AB I ask the insured if a lawyer was involved.
    100% of the time they say, yes.
    Why is that?
    Let’s let the insurance companies handle the claims, not the lawyers.

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