Thursday, 6 June 2013

Insurance News - Thursday, June 6, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Thursday, June 6, 2013:

Take a 2-week hiatus for a vacation.  Will be back on June 20th.

Will Telematics Put An End To Age and Gender Discrimination?



Telematics has been one of the most talked about issues within the automobile insurance sector over the past several years.  Recently Desjardins Insurance launched Ajusto, the first widely-available automobile insurance program in Ontario which offers savings to drivers centered on usage-based insurance (UBI) technology. This is the ground-breaking territory in Canada despite the fact that pay-as-you-drive insurance has been available in the United States and Europe for some time.

Automotive telematics refers to the technology that uses hardware and software applications with remote communication devices, like cell phones, GPS, wireless devices and such, to obtain information about vehicles. Automotive telematics has been in use, mostly in high-end vehicles, for quite some time. But today newer technologies are helping unfold many opportunities for all stakeholders, more importantly in emerging economies.

Telematics enables vehicle owners or customers to constantly be in touch with service providers through incorporated software and hardware in their vehicles. In turn, service providers too, can offer a host of new services based on their customers’ preferences. Also, data sent remotely from a vehicle allows stakeholders like auto makers, dealers, fleet managers, and insurance providers to build better customer-relationship strategies.

There have been tomes written on the benefits of telematics and UBI including lowering premiums for good drivers¸ reducing traffic congestion, allowing parents to monitor teenage drivers and combating auto insurance fraud.  What we haven’t heard much about is that UBI will allow insurers to begin to move away from historical rating criteria such as age and gender, both of which have been contentious over the years.

In 1983 Michael Bates alleged that he was discriminated against because Zurich Insurance charged him higher premiums for his automobile insurance than a young, single, female driver with the same driving record or than drivers over age 25. He alleged that the rate classification system discriminated by grouping drivers by age, sex, and marital status and determining their premiums based on these factors.

Moving forward to 1992 the majority of the Supreme Court of Canada found that Zurich  did not discriminate against Michael Bates contrary to the Ontario Human Rights Code by charging him higher premiums for automobile insurance because of his age, sex, and marital status.

The Supreme Court found that charging higher premiums to young, unmarried, male drivers was discriminatory and contravenes the Ontario Human Rights Code. However section 21 of the Code permits discrimination in automobile insurance because of age, sex, marital status, family status or handicap as and the court determined that statistical evidence showed that young, male drivers are involved in proportionately more, and more serious, accidents than other drivers.

However the insurance industry was not totally absolved by the Supreme Court.  The Court encouraged the industry to begin looking more closely at non-discriminatory alternatives in rate setting in the automobile insurance industry. It ruled that the insurance industry could continue to use discriminatory criteria such as age and marital status as a bona fide means of assessing risk, but that the industry could not do so indefinitely.

To a certain extent insurers have used the Bates v. Zurich decision as a green light to base automobile insurance premiums on age, sex marital status and other socio-economic factors where statistical evidence supports higher rates.  It may be a matter of time before another court challenge occurs.  However, the next time it would be difficult to defend the existing practices now that non-discriminatory alternatives actually exist.

The move away rating based on age, sex and marital status has already begun.  It is prohibited to use gender in considering rates for automobile insurance in five provinces, with Alberta only allowing its use for private policies, not through the government-mandated scheme.  Ontario which has the largest share of the privately delivered automobile insurance market in Canada still uses age, sex and marital status in determining premiums.

In the U.S., California has recently joined 11 other states that prohibit gender rating in the individual health insurance market.  Consumer groups in the U.S. have been battling insurance regulators to prohibit or restrict non-driving factors in setting automobile insurance premiums.  Currently, insurers have been able to maintain the status quo while developing UBI programs that provide an alternative.

The European Union, has recently outlawed gender-based insurance premiums.  The European Court of Justice’s ruling, which follows a ten-year legal battle against the proposals by insurers, will put an end to women getting better deals on car insurance.  The ruling has increased pressure on the industry to adopt better discriminating factors, like those available through telematics.

It’s not just rating based on age, sex and marital status that is under the microscope but other socioeconomic factors like credit scoring as well.  Ontario, Alberta and Newfoundland and Labrador have banned the use of credit scoring in auto insurance as a result of pressure from politicians.  Politician supported by insurance brokers have begun to turn their attention to home insurance market where the use of credit information is also used.

The Office of the Privacy Commissioner of Canada recently released a report stating that it did not object to the use of credit information for purposes of assessing insurance risk.  It was noted that section 8 of Ontario’s Consumer Reporting Act confirms that credit information may be disclosed for the purpose of underwriting insurance. 

However, the privacy commissioner noted that there is no obvious link between credit information and insurance premiums and little transparency in the use of credit information.

So while the use of age, sex and marital status as well as other socio-economic factors in rating drivers has been upheld by the courts and tribunals, their continued use attracts criticism and in some cases legislative action.  Although UBI is still not available to many drivers, insurers who are considering moving towards UBI ensures that predictive criteria continued to be available as governments prohibit or restrict traditional criteria. In Canada, automobile insurers are keeping a close watch on developments at Desjardins.

Monday, 3 June 2013

Anti-Fraud Regulations Became Effective on June 1, 2013

Earlier this year the Ontario Government released the regulatory changes that will be made to help combat auto insurance fraud.  The changes were approved on January 21, 2013 and became effective on June 1, 2013. 

Regulation 14/13 amends the Statutory Accident Benefits Schedule (SABS) - 34/10

The amendments to the SABS include:

  • a requirement for insurers to provide all reasons when denying medical and rehabilitation claims; 
  • providing FSCO with authority to stipulate additional information that insurers must provide in bi-monthly benefit statements to claimants; 
  • giving insurers authority to require claimant confirmation of receipt of goods and services that have been billed; and 
  • providing FSCO with authority to stipulate by Guideline the maximum payable by insurers for goods as well as services.
A revised Cost of Goods Guideline was issued by FSCO on May, 29, 2013.  The accompanying Bulletin (A-2/13) also releases a number of revised claim forms. Effective January 1, 2013, the maximum fines under Part XIX of the Act have increased from $100,000 to $250,000 for a first conviction for an offence, and from $250,000 to $500,000 for each subsequent conviction. 


The following forms have been revised to reflect these changes:

Regulation 15/10 amends the Unfair or Deceptive Acts or Practices (UDAP) Regulation - 7/00.

The changes to the UDAP regulation include:

  • an offence to request, require or permit a claimant to sign an incomplete claim form and 
  • clarifying the exemption for lawyers and paralegals to ensure the regulation applies to lawyers and paralegals when not acting in a legal capacity.

Regulation 16/13 amends the Disputes Between Insurers (DBI) Regulation - 283/95.

The amendment to the DBI regulation allows for the insurer that receives the initial application for benefits to request one examination of the claimant under oath to assist in the determination of priority issues.

This amendment provides insurers with a second opportunity to request a claimant undergo an examination under oath.  The new DBI requirement is to assist an insurer to determine which insurer is liable to pay the claimant accident benefits.  The SABS provisions continues to assist an insurer to determine whether the claimant entitled to accident benefits.