Canadian Underwriter

The hidden cost of Ontario auto accident injuries

December 16, 2019   by Greg Meckbach

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More than half a million Ontarians receive some form of government disability support and an advocate for claimants suggests many of these are caused by motor vehicle accident injuries.

“At the end of the day, unpaid claimants don’t just go away. They end up on public support,” said Rhona DesRoches, chair of the board of FAIR Association of Victims for Accident Insurance Reform, in a recent interview with Canadian Underwriter.

DesRoches was commenting on the annual cost to taxpayers of running the Ontario Disability Support Program. That cost rose 75%, from $3.1 billion in 2008/09 to $5.4 billion last year, Auditor General Bonnie Lysyk wrote in her annual report, released Dec. 4. The province’s population hit 14.56 million this past July.

ODSP is not just for motor vehicle accident victims.

To be eligible for ODSP, an applicant must be considered disabled, in which case they must have a “substantial physical or mental impairment that is continuous or recurrent and expected to last one year or more.” This must result in a “substantial reduction” in either the person’s ability to attend to their personal care or their ability to function in the community and in a workplace.

It is fair to say more than 30% of people who are injured in accidents in Ontario get some form of support from ODSP, said DesRoches.

The auditor general’s report found that the Ministry of Children, Community and Social Services, which runs ODSP, had neither investigated nor studied key reasons why the growth in the number of people on ODSP support has substantially outpaced population growth. While the province’s population grew 12% from 2008 to now, the number of people benefiting (claimants and their families) from ODSP grew from 342,100 in 2008/09 to 511,200 in 2018/19.

“A lot of it can probably be attributed to [motor vehicle] accident victims who are being sloughed off on to ODSP,” DesRoches said.

This is especially true with a series of reforms made in the 2010 time frame, such as the $3,500 cap on coverage for injuries that fall under the minor injury guideline, suggested DesRoches.

FAIR is concerned about clients’ auto accident benefit claims being denied after insurers hire their own medical examiners to conduct file reviews.

“When people can’t get the resources they need for recovery, generally they start off on welfare and then welfare pushes them toward Ontario Disability Support Program,” said DesRoches.

FAIR is concerned about the possibility that in response to the auditor general report, the government might make it more difficult to qualify for ODSP.

“If the government makes it more difficult for accident victims to qualify for ODSP, where are they going to go?” said DesRoches. “The sad part of this is, people end up on ODSP and they also end up at food banks that are sponsored by the insurer who wouldn’t pay them in the first place. It’s an awful thing for accident victims to end up in that circumstance. It could be you or I.”

In its report, the Office of the Auditor General said the Ministry of Children, Community and Social Services did not have a process to “assess the appropriateness of disability approval decisions.” In nearly one in five applications reviewed by Auditor General staff,  it was not clear from the application and the adjudicator’s rationale how the applicant met the definition of a person with a disability, according to the report.

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