FSCO 5 Year Review Strategies for Health care providers Presentation by Claire Wilkinson Rob Deutschmann (July 15, 2009) Presented by Claire Wilkinson

FSCO 5 Year Review FSCO 5 Year Review Strategies for Strategies for Health care providersHealth care providers

Presentation by Claire WilkinsonRob Deutschmann(July 15, 2009)

Presented by Claire Wilkinson and Rob Deutschmann 2009 1

BackgroundBackground2003 was the last significant change

in auto insurance legislationAutomatic 5 year review inserted in

legislationIntervening years – “tweaking”:

◦Designated Assessment Centres (DACs) to Independent Medical Assessments (IMEs)

◦Treatment provider rates slashed by 1/3◦Lease company and employer liability

limitedPresented by Claire Wilkinson and Rob Deutschmann 2009 2

FSCO ReportFSCO ReportEconomic / Political climateEconomic / Political climate

Loss costs (the costs to provide) for accident benefits saw the largest relative increases during the past five years.

Accident benefits rose by 16.3% since 2003 but since 2004, the increase has been 34.6%.


Loss RatioLoss RatioMeasure of performanceMeasure of performanceThe loss ratio is a fraction where

the numerator is the claims paid plus loss reserves and the denominator is the premiums collected.

Two types of loss ratios:◦Accident Benefits; and ◦Bodily Injury claims


Loss ratiosLoss ratiosIt’s all about the bottom lineIt’s all about the bottom line

The lower the loss ratio, the better for the insurer ($$$)

For example, if the claims paid plus reserves is $60 in a year and the premiums collected $80, the loss ratio is 60/80, or 75%.

A loss ratio of 75% means an insurer is making a profit. A loss ratio of 90% may represent a loss to the insurer.


Accident Benefit loss ratioAccident Benefit loss ratioVaries among insurers - Varies among insurers - 20082008

Co-operators - 72%Pilot Insurance - 180%.

Average for all Canadian P/C insurers – 125%

Bodily injury loss ratio - 69%


Statistics according to IBCStatistics according to IBCNo-fault injury claims in Ontario

cost much more than similar claims in other provinces.

Alberta - $3,000 per claimNew Brunswick - $11,700 per claimOntario - $38,000 per claim


Statistics according to IBCStatistics according to IBC

in Alberta, 40% of sprain and strain claims are still open after 6 months. In Ontario, that figure doubles to 80%.

This is part of the IBC attack on treatment providers


Here’s the scary part Here’s the scary part – according to FSCO– according to FSCO

Rate increases have not kept pace with rising loss costs and the insurance sector reports significant rate inadequacy in the system.


FSCO’s “bottom line”FSCO’s “bottom line”Declining profitability, significantly

lower earnings and loss cost increases will accelerate in 2009 in the absence of structural changes to stabilize costs.

Read between the lines – premiums will need to increase if costs are not controlled.


Lest we forgetLest we forgetInsurers have done very wellInsurers have done very well2003 to 2007 were record years

for insurersReturn on Equity:2003 – 11.9%2004 – 19.0%2005 – 16.5%2006 – 20.1%2007 – 16.1%2008 – 7.5%


Problems with the insurance Problems with the insurance debate in Ontariodebate in Ontario

No one knows what the true numbers are

Numbers are not shared by the IBCHCAI has not been successfulAnecdotal evidence

◦Assessment mills◦Multiple assessments to overwhelm adjuster◦Increasing requests for in-home

assessments


Policy vs. PoliticsPolicy vs. PoliticsIt’s all about the politics

Nothing strikes fear in the Ontario provincial government more than the risk of increasing premiums.


IBC and Premium IBC and Premium increasesincreasesRecent news stories – IBC has

talked about the need to raise premiums

Cause:◦Investment losses◦Rising costs in Med and Rehab

treatment


The IBC plays on The IBC plays on fears of higher premiumsfears of higher premiums

On average, drivers in Ontario pay higher premiums than drivers in all other provinces where auto insurance is sold competitively by private companies – 25% more than in the “private” jurisdiction with the next highest premiums, Alberta. (IBC submission July 2008)


FSCO ReportFSCO Report39 RecommendationsThere are a few controversial

recommendationsGeneral theme –

reducing Cost and Complexity

The changes will have the most significant impact on non-CAT seriously injured


Health care providersHealth care providersWhat has changed from your

perspective?

What should you be aware of and new strategies to apply?

How do you continue to be an effective advocate on behalf of your patient?


Not quite the sameNot quite the sameThe catastrophically injured will

still have access to a higher level of benefits

BUT there will be G A P S in the system


Current Catastrophic Current Catastrophic definitionsdefinitionsThere is no change AT THIS TIMEThe “straight forward”

definitions:◦GCS – 9 or less◦Paraplegia or quadriplpegia◦Amputation or impairment causing

total and permanent loss of use of both arms or an arm and a leg

◦Total loss of vision in both eyes.


The problem areas:The problem areas:The whole person impairment

rating of 55% or higher

The combining of physical and psychological impairments

Marked impairment


Why is it a problem?Why is it a problem?The injured person has to wait for

assessment:

(a)Until health practitioner says persons condition has stabilized; or

(b)Two years elapsed since the accident

To determine whether Catastrophically impaired


One big reason it’s a One big reason it’s a problemproblem

The most controversial change recommended by FSCO . . .


Recommendation #22Recommendation #22

Reducing the med rehab capReducing the med rehab cap

Reduce the cap for medical and rehabilitation benefits for non-catastrophic claims to $25,000.

Introduce a $100,000 optional medical and rehabilitation benefit along with the existing $1 million optional benefit.


Why did FSCO recommend Why did FSCO recommend this?this?FSCO ReportFSCO ReportProvide consumers with more choice

and would allow them to customize coverage according to their needs.

The insurance industry has proposed that a reduced cap of $25,000 would adequately meet the needs of many consumers.

Consumers that feel they need a higher level of coverage could be provided the option of purchasing $100,000


““Consumers will appreciate Consumers will appreciate it”it”FSCO ReportFSCO ReportConsidering the rate inadequacy

that currently exists in Ontario, consumers will appreciate opportunities to reduce coverage that they may not need and avoid possible premium increases. ◦As an alternative, the cap could be

reduced to $50,000 but this would reduce the opportunity for consumers to realize savings.


Coverage under Tort claimCoverage under Tort claimFSCO ReportFSCO ReportSome auto accident claimants

would be eligible for compensation beyond the $25,000 by suing an at-fault driver.

Those eligible would have to have injuries that exceed the existing “serious and permanent impairment” threshold in the Insurance Act


Reducing the med rehab Reducing the med rehab capcapControversial recommendationAlliance of Community Medical &

Rehabilitation Providers have actively lobbied primarily on this recommendation

No one aware until they are a victim – too late

Potential for an increase in cap to $50,000


Reducing the med rehab Reducing the med rehab capcapAccident victims suffering from

catastrophic injury will not be affected as long as they are deemed Catastrophically impaired immediately

Will have access to enhanced medical and rehabilitation benefits and attendant care benefits.


Future considerations:Future considerations:A third level of coverageA third level of coverage

Some consideration should be given to a more generous level of benefits for group of very seriously injured claimants with serious orthopaedic or brain injury who will not immediately meet the catastrophic test.


Even the IBC made a Even the IBC made a recommendationrecommendation (July 2008)(July 2008)

A. For non-Catastrophic (CAT) claimants, establish the maximum limit for payments for medical/rehabilitation and provider-initiated assessments at $25,000, but retain the $100,000 limit for injured persons admitted to a public hospital for at least two consecutive days in the immediate aftermath of the injury;


So what does this all So what does this all meanmeanSome seriously injured people will

fall into the $25,000 to $1million GAP

They will use up the AB funds well before 2 year mark

They may include:◦Patient with a GCS of 10 or higher◦Patient with significant orthopaedic

injuries but not complete loss as per CAT defn


What do these victims doWhat do these victims doThey are facing the prospect of

trying to get by with $25,000 for 2 years

Future needs will have to be assessed immediately so that strategies can be considered

Contact a personal injury lawyer to develop and implement strategies


What should you be What should you be looking for?looking for?Copy of the patient’s insurance

policy, or some confirmation, to determine if optional medical coverage was obtained ($100,000 or more)

Determine what other medical benefit plans are available – employer; dependant◦Some lose employment and medical

benefitsPresented by Claire Wilkinson and Rob Deutschmann 2009 33

Why a personal injury Why a personal injury lawyer?lawyer?Victims, not at fault, can claim in

tort for future medical costs from the at fault party◦Defining regulation makes access

more restricted

Often considered later in the process due to the availability of accident benefits but will become important early in process


Strategies for medical Strategies for medical benefitsbenefitsSeek an advance for medical

treatment costs from the at fault insurer

Tort insurer incentive:◦the sooner the victim receives

treatment, ◦the quicker the recovery◦the lower the future damages


Strategies for medical Strategies for medical benefitsbenefitsGuarantee payment to third party

provider from tort settlement◦Cash flow problems for treatment

providers

Persuade AB insurers to pay for additional treatment if it can bring injured person back to work sooner ◦Insurer can minimize Income

Replacement Benefits exposurePresented by Claire Wilkinson and Rob Deutschmann 2009 36

Advances spent on other Advances spent on other prioritiesprioritiesThere are some who say we cannot

give the victim these medical fundsMedical funds not applied to future

medical needs but to household debt

Personal injury lawyer could administer the funds

Onus on injured person to use funds for treatment – would reflect poorly at trial


Third party lendersThird party lendersFinancial assistance in the form

of “bridge loans” to plaintiffs facing financial pressures in advance of the resolution of their legal claims.

Flexibility regarding termsCarefully review repayment

options, payment priorities and interest rates


Other Optional benefits:Other Optional benefits:Housekeeping and CaregiverHousekeeping and CaregiverRecommendation #29Make housekeeping and home

maintenance expenses and caregiver benefits optional. Reimbursement for housekeeping and home maintenance expenses and for replacement caregivers needs to reflect actual economic losses.


Optional coverage issuesOptional coverage issuesFSCO view is that as long as the

option is available consumers have access and are protected

Optional coverage will not guarantee all have access if the communication / information process is insufficient

The role of the Insurance Broker becomes more important


Housekeeping and Housekeeping and CaregiverCaregiverFSCO relying on information

provided by the IBC◦“increasing at a significant rate …

contributing to rising claim costs”◦Insurer reports high proportion of

payments … although no numbers were provided

◦Anecdotal evidence – receive claims from multiple family members


Housekeeping and Housekeeping and CaregiverCaregiverFSCO is “concerned about

growing cost of the benefit”5 other provinces do not provide

caregiver benefitSolution – optional coverage


Optional coverageOptional coverageOne approach to address rising

costs and utilization is to provide consumers with more choice by converting a number of mandatory benefits to optional benefits.


Optional coverageOptional coverageThis would provide consumers

with the ability to customize coverage according to their needs.

When do we know what we need.


Insurance brokers roleInsurance brokers roleInsurance brokers have to step up

and educate their clients/customers on the options

Mandatory disclosure – sign off sheet

Form – outlines the following:◦all optional coverages outlined◦Rationale for purchasing coverage◦Premium associated◦Client to initial off


Broker liabilityBroker liabilityWell established in law that the

broker owes a duty to client to advise and review



CAT definitionCAT definitionFurther consultation with experts in

the field is needed to amend the definition of “catastrophic impairment.”

FSCO - The goal for this review should be to ensure that the most seriously injured accident victims are treated fairly.


FSCO concernsFSCO concernsConfusion based on evolving

decisions on CAT definitionParticularly combining physical

and psychological ◦Despite Desbiens and subsequent

decisions FSCO unsure whether appropriate to combine

Expanded definitions have exposed system to “potential abuse”


FSCO concernsFSCO concernsFSCO is searching for a “clear

and fair” definition of catastrophic impairment


IBC has already started the IBC has already started the processprocessThe Insurance Bureau of Canada

(IBC) approached the Ontario Neurotrauma Foundation to form an expert panel to review the current science and evidence with which to measure and define brain impairment.

Evidence Based Classification of Brain Impairment: Application to Catastrophic Impairment Classification


Attempting to build a better Attempting to build a better predictor “mousetrap”predictor “mousetrap”


Attempting to build a better Attempting to build a better predictor “mousetrap”predictor “mousetrap”• Discussion of Evidence Based Framework for Identifying Catastrophic Brain Impairment

• The experts reviewed a large number of assessments that could potentially be used to classify catastrophic brain impairment.

• Measures identified that do have evidence to support their use in classifying catastrophic brain injury.


Attempting to build a better Attempting to build a better predictor “mousetrap”predictor “mousetrap” The final set of assessments that were felt to

have sufficient evidence for use were:

1. Glasgow Coma Scale (GCS)

2. Age

3. Computed Tomography (CT) Scan in those with GCS < than 9

4. Somatosensory Evoked Potentials (SEPs)

5. Duration of Post Traumatic Amnesia (possibly measured by the Galveston Orientation and Amnesia Test (GOAT))

6. Disability Rating Scale (DRS)



Category Score Timing

Automatically Considered Severe Catastrophic Lowest GCS<5 6- 24 Hours Post Onset

Automatically Catastrophic Lowest GCS <9 and CT scan shows obliteration

of the cerebral ventricles by brain swelling 6- 24 Hours Post Onset

Automatically Catastrophic Lowest GCS <9 and age greater than 60 years of

age 6- 24 Hours Post Onset

Automatically Catastrophic Lowest GCS <9 and SEPS show unilateral or

bilateral absence of potentials First 2 weeks

Provisionally/Probably Catastrophic Lowest GCS =6-9 6- 24 Hours Post Onset

Potentially Catastrophic Lowest GCS 9-14 6- 24 Hours Post Onset

Catastrophic/Severe Impairment GOAT Score<75 At 30 Days and 60 Days

Disability Rating Scale >5 6 Months Up to 2 Years

Which way is FSCO trending Which way is FSCO trending on CAT assessments?on CAT assessments?Could reduce the number of

people deemed catastrophicSome involved with the

Neurotrauma team working on the report argue otherwise◦More people will be covered◦More certainty and fewer disputes

More complication


Where should they go with Where should they go with the CAT determination?the CAT determination?If you want to help the most

seriously injured then:Simplify the assessment model –

DON’T make it more complicated◦More CAT variations adds

complicationExpand the number of seriously

injured that qualify as CAT and focus on NEED



Catastrophic AssessorsCatastrophic Assessors

Restrict the ability to conduct catastrophic impairment assessments to practitioners with appropriate training and experience.


Cost of Catastrophic Cost of Catastrophic assessmentsassessmentsOne insurer provided FSCO with

examples of insurer examinations to determine catastrophic impairment that ranged in cost from $15,000 to $43,000

The Toronto Transit Commission reports assessments often cost between $20,000 and $30,000 and involve a multidisciplinary team of experts


Cost of AssessmentsCost of AssessmentsFSCO questions why so much is

being spent on catastrophic impairment assessments

FSCO – “insurers insist on lengthy medical-legal reports in response to requests for catastrophic impairment determinations that have little merit. This type of security comes at a very high price. “

59Presented by Claire Wilkinson and Rob Deutschmann 2009

Cost of AssessmentsCost of AssessmentsFSCO ReportFSCO ReportThe WSIB conducts an analogous

assessment The assessment is also based on

the AMA Guides, but based on the 3rd edition

In the WSIB system, assessors are predominantly physicians who are trained on the use of the Guides.


The problem with inadequate The problem with inadequate assessmentsassessments

Inaccurate ratings, More FSCO disputes

◦Mediations and arbitrationsAdditional assessments

all adding more costs and uncertainty to the system.


Who will do CAT Who will do CAT assessments?assessments?FSCO ReportFSCO ReportWSIB assessors – who are

predominantly specially trained physicians – are paid a substantially lower flat fee which covers time spent with the injured worker, reviewing documentation, and preparing a report.


Capping Assessment costsCapping Assessment costsRecommendation #12:The fee for completing forms

including any assessment required to complete the form should be capped at $200. The cost of all other assessments should be capped at $2,000


Capping Assessment costsCapping Assessment costsRecommendation #18:The costs of insurer examinations

should be capped at $2,000.00

FSCO - providing “balance” in reducing assessments under s.24 and IMEs under s.42◦Would be interesting to know the

costs attributed under each section


FSCO’s view of FSCO’s view of assessmentsassessmentsAssessment costs are getting out of

control and have to be reined in.

FSCO does not want to regulate the provision of third party medical examinations.

FSCO would participate in a process involving health care associations to develop standards


What is the basis for this What is the basis for this view?view?FSCO does not have it’s own

figuresReliance on IBC informationUse of anecdotal evidence:

◦“Assessment mills”◦Multiple assessment requests to

overwhelm adjusters◦Assessments requested without

consent of insured◦Illegal payments for referrals


The cap on assessments and The cap on assessments and IMEsIMEs$2,000 cap on assessments will

not cover the cost◦CAT assessments◦Psychological / neuropsychological

Would the $2,000.00 cap apply per assessment ◦Multi disciplinary assessments


Strategy moving forwardStrategy moving forwardIssue - current AB assessors will

reduce or discontinue CAT assessments

A third party source will have to fund assessment costs◦Third party lenders◦Personal injury lawyers

Clarify the per assessment concept Presented by Claire Wilkinson and Rob Deutschmann 2009 68


In-home AssessmentsIn-home AssessmentsAvailability of in-home

assessments should be limited to seriously injured claimants

Evaluate their need for attendant care services and home modifications.


In-home AssessmentsIn-home AssessmentsFSCO ReportFSCO ReportExisting industry data does not

separate out assessments conducted in the claimant’s home.

There is sufficient anecdotal information to support the suggestion that they have become a growing source of costs.


In-home AssessmentsIn-home AssessmentsFSCO ReportFSCO ReportThe WSIB conducts similar

assessments but they are limited to their most seriously injured clients.

FSCO – “there is nothing unique about auto accident victims when it comes to assessment needs”.


In-home AssessmentsIn-home AssessmentsFSCO ReportFSCO ReportExpensive and limited health

care resources are being tied up by health care providers travelling to clients.

Therefore, most assessments should be conducted in a clinical setting.


In-home AssessmentsIn-home AssessmentsIssues to considerIssues to considerRecommendation based on IBC

reportsUses WSIB analogyWho is “seriously injured”Not a defined term under the SABsHow do you replicate home setting

in clinical settingWill add uncertainty to the processDelay access to assessment and

treatmentPresented by Claire Wilkinson and Rob Deutschmann 2009 73

Future Concern:Future Concern:FSCO reliance on WSIB FSCO reliance on WSIB modelmodelNumerous references to WSIB

throughout the FSCO report#35 – training adjusters

◦FSCO looked at how WSIB structured claim adjudication

#30 – Harmonizing auto and workplace insurance systems

#26 – Fees◦Reduction in 2003 intended to bring

fees in line with WSIB feesPresented by Claire Wilkinson and Rob Deutschmann 2009 74


Payment for past Attendant Payment for past Attendant Care Care The attendant care benefit

should continue to compensate claimants for incurred expenses.

Looking at payments for past attendant care


Past Attendant CarePast Attendant CareMcMichael caseGenerally where 24/7 care requiredInsured did not have to show that

expenses were actually incurred but that they were reasonable and necessary

Insurers could receive windfall by denying and delaying benefit


Past Attendant CarePast Attendant CareFSCO trying to balance interests

by recommending payment if insurer is shown to be unreasonably denying

Uncertainty when interpreting “unreasonable” conduct

Insurer’s tinkering to fill a “loophole”



Future Care reportsFuture Care reportsThe cost of future care cost

reports should not be an expense recoverable under the SABS

Continuing with the theme of reducing assessment costs


Future Care reportsFuture Care reportsInsurers dispute payment of

reports as they do not deal with an “incurred expense”

Insurers would like to see CCAC standards applied to recommendations

FSCO does not consider these reports covered by the SABs


Future Care reportsFuture Care reportsOptionsOptionsAccepted that they are necessary

for CAT casesIssue is whether the insured is

seriously injured to require any significant future care needs

Will become a negotiated item with AB adjuster wishing to settle file

Can be covered where insured has a tort claim


Role of the family doctorRole of the family doctorRecommendations #15 and #21

have been focused on the role of the family doctor in auto insurance claims

Attempting to control cost of assessments

Attempting to better coordinate rehabilation



Assessments Assessments Consider having assessment

requests completed only after a referral is made by the health professional primarily responsible for the claimant’s rehabilitation (in most cases a family physician).

Assessment requests would continue to be submitted by providers following a referral


Involvement of family doctorInvolvement of family doctorFSCO ReportFSCO ReportCurrent problem:Any regulated health professional or

social worker is able to submit a request for an assessment and the insurer must respond.

Insurer cannot deny the request until an insurer examination has been conducted.

Insurer must incur costs in response to even the most questionable assessment requests


Involvement of family doctorInvolvement of family doctorFSCO ReportFSCO ReportWhy is the Ontario auto insurance

system so different than other systems?

FSCO has concluded that one area where Ontario differs is in how treatment is managed.

The Ontario system appears to lead to multiple and duplicative assessments and fragmented treatment


Involvement of family doctorInvolvement of family doctorFSCO reportFSCO reportIn approximately half of

Canadian jurisdictions, physicians direct assessments and treatment. In Saskatchewan claimants are asked to designate a primary practitioner who can be a physician, chiropractor or physiotherapist


Involvement of the family Involvement of the family doctordoctorFSCO reportFSCO reportIn Ontario there are 24 professions

that are authorized to conduct an assessment

expansion in the number of regulated health professions may create even more cost pressures on the auto insurance system when implemented such that they begin to conduct assessments


Involvement of the family Involvement of the family doctordoctorFSCO conclusionFSCO conclusionA single professional responsible

for rehabilitation can fully and accurately respond to questions from the claimant and adjuster concerning the appropriateness of the proposed assessments and treatment


Involvement of the family Involvement of the family doctordoctorFSCO conclusionFSCO conclusionThe increased involvement of

physicians is not expected to impact on the doctor shortage in Ontario.

Claimants with more serious injuries already see their family doctors following an accident.

The proposed changes will not significantly increase the number of doctor visits and will benefit claimants by keeping their family doctors better informed on their progress



Access to treatmentAccess to treatmentConsider having treatment plans

completed only after a referral is made by a health professional primarily responsible for the claimant’s rehabilitation (in most cases a family physician)

Treatment plans would continue to be submitted by providers following a referral.


Physicians initiate treatment Physicians initiate treatment requestrequestFSCO reportFSCO reportConcern about the expansion of

the definition of regulated health professions

Expanding health practitioner status will increase complexity and diffuse accountability

7 of 10 provinces – physicians only may certify need for treatment


Physicians initiate treatment Physicians initiate treatment requestrequestFSCO ReportFSCO ReportNo single health professional

actually overseeing a patient’s rehabilitation◦Left to the AB adjuster.

Directing patient to appropriate treatment providers

The insured would see the health professional before subsequent treatment plans

PAFs would continue Presented by Claire Wilkinson and Rob Deutschmann 2009 91

Physicians initiate treatment Physicians initiate treatment requestrequestFSCO ReportFSCO ReportEliminate the potential for conflict

in existing delivery model - health professional not connected to treatment facility

Family physicians directing their patients to appropriate health care providers and services

Ontarians without family doctors will use walk-in clinics / ambulatory care


Potential issues with #15 Potential issues with #15 and #21and #21Delays to see a family doctor

Delay in treatmentShortage of family doctors in Ontario

Increase use of walk in clinics / emergency

Flexibility needed for those without a family doctor

PAF may have to be expandedRecommendation #23

Not supported by the OMA


Use of family doctorUse of family doctorThe forms and reporting process will

have to be simplifiedReporting to physicians – inundated

with paperwork and reportsTreatment providers will have to

educate physicians on the SABs process

Treatment providers will have to interact more with family physicians



Tort (law suit)changesTort (law suit)changes• Reducing the deductibles (from

$30,000) to $20,000 and (from $15,000) to $10,000• 2003 increase was excessive

• Eliminating the deductibles for fatality claims, • Ex. Grandparent dies leaving a

spouse, 3 children and 10 grandchildren

• Total deductible - $245,000Presented by Claire Wilkinson and Rob Deutschmann 2009 95


Tort (law suit)changesTort (law suit)changes• Revoking the definition of serious

and permanent impairment• Provide clarity

• A closed claim study would assist in determining the impact of further tort changes being considered. • Only jurisdiction with both a

deductible and thresholdPresented by Claire Wilkinson and Rob Deutschmann 2009 96


Better trained adjustersBetter trained adjustersInsurance claims departments

need to better focus on the needs of claimants with serious injuries.

The IBC, Insurance Institute of Ontario and the Ontario Insurance Adjusters Association should work together to train adjusters on the needs of claimants with serious injuries to reduce exposure to potential allegations of unfair and deceptive acts or practices.


39 Recommendations39 RecommendationsWhat will happen next?What will happen next?Announcement has been pushed

back to the end of August

Minister not bound by the FSCO recommendations.

Expect most of the package to be adopted with some modifications – focus on the med rehab cap


Future ReviewsFuture Reviewss.289, Insurance Acts.289, Insurance ActAt least once every two years, the

Minister shall table a report in respect of the adequacy of statutory accident benefits and setting out changes made to the SABs since the last report and changes that are proposed to the SABs at the time of the report

Last report was end of 2008Presented by Claire Wilkinson and Rob Deutschmann 2009 99

Future reviewFuture reviewThis is in addition to the 5 year

reviewReview the July 2008 IBC submission The IBC will continue to propose

significant cuts to Accident Benefits◦ie. Housekeeping – limiting entitlement to

2 weeks for least serious injuries◦Not payable to family members where no

economic loss incurred


Documents

FSCO 5 Year Review Strategies for Health care providers Presentation by Claire Wilkinson Rob Deutschmann (July 15, 2009) Presented by Claire Wilkinson