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Thursday, June 29, 2017

 
 
 

 
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Posts Tagged ‘rehabilitation’

Health Provider Survey Reveals Concerning Trends

An interesting article has been posted by the Alliance of Community Medical and Rehabilitation Providers on The Health Professional website.

Based on a survey of health professionals across Ontario it noted the following trends with insurer’s response to applications for medical and rehabilitation benefits:

  • A significant increase in the number of accident victims who are running out of benefits before they are fully recovered
  • Health care service denials have escalated
  • Victims are waiting longer to receive treatment and services
  • Many accident victims are now NOT being assessed
  • Victims are waiting longer to receive treatment and services

The article quotes Dr. Donna Ouchterlony, medical director of the Brain Injury Clinic at St. Michael’s Hospital, as stating that, “Since September, we are seeing more and more patients with serious injuries whose insurers are outright denying treatment, and when funding is approved, it is no longer nearly enough.”

The Alliance makes a number of recommendations:

  • Re-instate the benefits that were in place prior to last September
  • Allow the cap on assessments to be exceeded in certain circumstances
  • Withdraw the right of insurance adjusters to deny medical claims without an independent medical opinion
  • Freeze premiums
  • Require more openness and transparency, with insurers having to release financial and operations data for their auto insurance lines

The full version of the article can be found by clicking here.

Are you in the MIG? Maybe not.

Claims Canada Magazine is reporting that more than 50 percent of all claims in Ontario are currently falling under the Minor Injury Group (MIG). The article acknowledges that insurance companies are “holding their breath” to see how arbitration and judicial decisions will interpret the new regulations as to what is and is not considered a “minor injury”.

Interestingly, the question still remains open as to whether or not individuals who were injured after September 1, 2010 but prior to their policy renewal date can be placed within the MIG category and, more importantly, the $3,500.00 limit for medical and rehabilitation benefits, as this is based on a bulletin from the Financial Services Commission of Ontario (FSCO). A bulletin is not law.

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