Some anti-fraud task force recommendations need work: OTLA

The Ontario Trial Lawyers Association (OTLA) has responded the recent final report from a task force on auto insurance fraud in the province, and while it says it’s supportive of most recommendations, some of them could use some work.

Among the recommendations, The Ontario Automobile Insurance Anti-Fraud Task Force suggested the creation of an implementation group for tackling fraud, which would include two co-chairs – the Insurance Bureau of Canada (IBC) and the Financial Services Commission of Ontario (FSCO).  

Other representatives should include the Insurance Brokers Association of Ontario (IBAO), the provincial Ministry of Finance, the Canadian Association of Direct Relationship Insurers (CADRI) and a “consumer representative.”

But that group needs to be broader in its composition, the OTLA has argued. “It absolutely should include the legal community because we are one of the most significant stakeholders,” said Andrew Murray, a civil litigation lawyer based in London, Ont. and current president of OTLA.

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While OTLA includes plaintiff personal injury lawyers, all lawyers should be represented in the implementation group, he said. The Advocates’ Society, for example, has several types of lawyers as its membership base and could also be included, he added.

Other organizations, such as those representing frontline treatment providers, should also be included, Murray said. “I’m a big believer that when you see a problem, you don’t always need to ask the CEO how to fix the problem; sometimes you can ask the guy who’s grilling the hamburgers.”

Another of the task force’s recommendations included implementing a $500 fee for missed medical examinations. The intent is likely to dissuade fraudsters who know their false claims would likely be caught in a defence exam, but there are already measures in place to penalize uncooperative claimants, Murray said.

“We say that the penalties are already adequate and that this would be an unnecessary punitive measure,” he said.

OTLA also said FSCO should “accelerate its current review of auto insurance profits and high premiums levels.” Following industry reforms in September 2010 aimed at reducing fraud, premium levels should logically have changed, Murray said.

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The topic was also touched on by the Auditor General’s annual report for 2011, he noted. It’s important to look at the industry’s premiums and analyze what effect those 2010 reforms have had on premiums, he noted.

What’s critical for OTLA is that legitimate claimants aren’t negatively affected by efforts to target fraud.

“I think generally we all want fraud to be eliminated from the system,” Murray said.“What we certainly don’t want the public to take away as a message is that the whole system is filled with fraud and every claim needs to be eviscerated or scrutinized because that’s really, really doing a disservice.”