Ontario Insurance companies are readily willing to pay off claims for damage to vehicles following accidents, but they fight aggressively to avoid paying rehabilitation expenses sometimes flowing from the very same collisions. Accident victims are routinely treated as malingerers, exaggerating injuries in order to obtain access to special treatments not covered by the health care system.
On top of this, in Ontario, benefits for minor injuries are now capped at $3,500 for each victim – the lowest such limit in all of Canada, while the damages offered for car repairs themselves commonly extend far higher than this.
Seventy to eighty per cent of accident victims are stuck within this $3,500 limit, while twenty per cent fall within the $50,000 limit for moderate to major injuries. Prior to September 1, 2010, victims in both these categories were allowed treatments costing up to a $100,000, but the government placed new mandatory limits on payouts supposedly in order to prevent insurance rates from rising.
It is only those victims with “catastrophic impairment” who are allowed benefits of up to $1 million, but the government plans to bring in a new definition of this term that is expected to make it harder to qualify.
These new limits have been implemented in a climate of increased resistance to benefit claims on the part of insurers. Forty-two per cent of treatment plans are now rejected, up from 11 per cent before. Meanwhile the FSCO has failed to meet its 60-day time limit for mediating disputes between victims and insurers, with many waiting upwards of a year.
All of these trends are conspiring to create an atmosphere of extreme hardship for accident victims, and the courts are starting to take notice. Recently, in McQueen v Echelon, a woman was awarded $25,000 for mental distress after her insurer failed to make good faith efforts to deal with her claims, denying her benefits 21 times over a three-year period.
The Ontario legislature is now starting to recognize the problems in the industry. It is hoped that necessary steps will soon be taken by the government to reverse the unfair treatment of the car accident victims by their own insurance companies.
