On April 11, 2019, Ontario’s government released their first budget for the province. For those of us with automobile insurance policies, it’s a bit of a mixed bag.
We’ll start with the good news.
The amount of treatment available to an individual through their accident benefits will not change for those designated as non-catastrophic or those in the Minor Injury Guideline. Non-catastrophic injuries will continue to be eligible for up to $65,000.00 in treatment and attendant care funds. Individuals in the Minor Injury Guideline will continue to have access to $3,500.00 in treatment as well.
A particularly bright spot in the budget is found in the changes to the treatment and care funds which are to be made available to those who suffered catastrophic impairments as a result of a motor vehicle collision. In 2016, individuals with catastrophic injuries had their available treatment and care benefits slashed from $2,000,000.00 to $1,000,000.00. Under the new budget, the $2,000,000.00 in benefits would be restored. This is excellent news as it ensures substantially more treatment is made available for the most grievously injured.
The Ontario government has also pledged to reform the Insurer Examination process to ensure greater credibility and accountability from the assessors hired by the insurance companies to determine an insured’s need for specific treatment. The government has also pledged to lower treatment fees charged by treatment providers.
For those people who find themselves in the Minor Injury Guideline, the Ontario government is seeking to improve access to early treatment with a specific focus on treating mental health issues arising from less severe collisions.
The government is also looking to initiate an online claims process to ensure injured individuals can see how their accident benefits are being used.
While the features mentioned above certainly seem to be an improvement on the previous system, there is reason to be cautious regarding some of the other proposed changes.
To tackle the rising cost of premiums, the Ontario government has suggested giving insurance companies more autonomy in how they structure their policies. This would include the ability to offer cheaper policies where the insured person agrees to use the insurer’s “preferred providers” of car repair and health care services. The obvious concern with such a program is that people would opt for the cheaper policy without knowing that they are being significantly limited in their ability to receive treatment from the healthcare provider of their own choosing. There is also a potential conflict for these “preferred providers”. These providers rely on insurance companies for ongoing business and if faced with choosing between the best interests of the insured versus the insurer, they may well opt for the latter.
The Ontario government is also suggesting that a “Care Not Cash” default clause be included in all standard automobile insurance policies in Ontario. This clause will prevent injured individuals from settling their accident benefits claim for a lump sum. It would require the insured to remain in a time-consuming and emotionally taxing process whereby every session of treatment they receive must be approved by the insurance company in advance. This often results in delays in treatment and injured parties being sent for multiple medical examinations to determine whether the treatment is regarded as “reasonable and necessary”. While it is possible to opt out of this clause, it is widely expected that insurers will charge more in premiums should you choose to forego this option.
Overall, the budget certainly contains some positive developments for Ontario drivers. The restoration of $2,000,000.00 in benefits for those who are catastrophically impaired is a particularly welcome change. However, the changes also present some potential problems for Ontario drivers who opt for the cheapest coverage without doing their research into what they are giving up in choosing such a policy.
While the government has pledged that these changes will help to lower insurance premiums overall, they have not provided any precise rate-reduction targets or timelines for implementation. Keep an eye on the Oatley Vigmond blog for updates as more specifics become available.
Nick first joined Oatley Vigmond as a law student, and later an articling student, prior to joining the team as an associate lawyer. He has a Law Degree from the University of Kent, a Master of Laws...