Insurance New - Friday, November 29, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Friday, November 29, 2013:

• A great article on the need for provincial regulation of towing in Ontario and the industry's connection to fraud.
• DirectAuto Insurance in the U.S. has rolled out new mobile capabilities, including a pay-by-text feature and an app that evaluates driving habits.
• Renault has developed a low-cost, part-time self-driving car that could go on sale as early as next year - the automated feature will only work at speeds under 19 mph and in areas where no pedestrians or bicycles are allowed. It's a start.
• The first public road test of Nissan's Autonomous Drive technology on a Japanese highway was a success.
• Though motor vehicle deaths have been declining, a recent study found that deaths in pedestrians and cyclists are increasing as a result of distracted driving.
• Electric vehicle charging stations are now available at five GO stations.

Insurance News - Thursday, November 28, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Thursday, November 28, 2013:

• A great article on the need for provincial regulation of towing in Ontario and the industry's connection to fraud.
• Who has the most accidents per km of driving? No it's not teens, it's actually seniors. 
• Insurance telematics have evolved into 4 different models: the silent witness model, the simple measurement model, the behaviour-based model and the context information model. 
• The insurance industry is divided on who will choose telematics - good drivers (to save money over a classic policy) or bad drivers (to improve experience and get back to a classic policy).
• One of the offshoots of Obamacare is that e-billing is spreading to more insurance lines in the U.S.
• Another Google car has been involved in a collision but again Google says the car was being driven manually.

Insurance News - Tuesday, November 26, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Tuesday, November 26, 2013:

• FSCO has revised the OAF 1 – Ontario Application for Automobile Insurance to reflect new data reporting requirements.
• Auto insurance fraud lawsuits continue against Toronto medical assessment centres.
• PEI is considering raising no-fault auto benefit caps including increasing the medical/rehabilitation limit to $50,000, the weekly for income loss limit to $250. They are also considering raising the cap on court awards for pain and suffering for “minor personal injuries” to $7,500.
• The U.S. National Highway Traffic Safety Administration to give green light to self-driving car projects.  Apparently they like what they see in self-driving cars: their potential to operate more safely and fuel-efficiently.
• Meanwhile, U.S. lawmakers are not necessarily on the same page as they expressed a mix of wonderment and concern about driverless cars during congressional hearings.
• Still, 17 states (and Washington D.C.) have considered legislation addressing autonomous vehicles while 4 have already enacted laws.

Insurers Trying To Keep Claimants in the MIG Will Need Medical Reasons Before an IE

Insurers may be in a "Catch 22" situation in efforts to keep claimants within the limits of the Minor Injury Guideline (MIG).  Many insurers have been routinely sending claimants for an insurer examination (IE) to determine if a claimant has a minor injury and should be treated under the MIG. But according to a recent FSCO arbitration, an insurer needs to provide "medical reasons" for denying a benefit and requesting the claimant attend an IE.  The SABS require a benefit denial to trigger an IE needed to determine if the claimant belongs in the MIG but also medical reasons which insurers normally obtain through an IE.

In the decision, Kadian Augustin and Unifund Assurance Company [FSCO A12-000452] the arbitrator considered whether or not Ms. Augustin is allowed to dispute the insurer’s denial of treatment because she failed to attend an IE.  In order to make a determination the arbitrator needed to consider whether or not the IE was compliant with the SABS.

Unifund wanted to send Ms. Augustin to an IE to determine if she was within the MIG after receiving a treatment plan that, if approved, would take her out of the MIG.  Unifund provided the following notice to Ms. Augustin in their Explanation of Benefits: “Based on our review of the medical documentation provided to date, we require an assessment by an independent medical assessor, in order to determine if your impairment is predominantly a minor injury as described in the Minor Injury Guideline. Please see the Notice of Examination for further details.”

The arbitrator found that this explanation did not comply with section 38(8) of the SABS because it did not state that Unifund “believes” the MIG applies, or why.  Nor did it state the “medical reasons and all of the other reasons why the insurer considers any goods or services, or the proposed costs of them, not to be reasonable and necessary.  The arbitrator noted that it provided no reason, medical or otherwise, explaining why it refused to pay the benefit.

Health care providers have been complaining for some time that benefit denials often to not come with proper explanations regarding the reason for a denial.  The government has amended these provisions several times to make it clear that the claimant is entitled to a proper explanation.  Now an arbitrator has ruled on the wording.  The problem is that no one knows what explanation would satisfy an arbitrator.  As well, the arbitrator failed to reconcile that the purpose of the IE is to collect medical information and assist in making entitlement decisions.

The decision can be found here.

Insurance News - Thursday, November 21, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Thursday, November 21, 2013:

• A product that Travelers believes can win back the auto insurance sector from direct writers. 
• Michigan poised to approve self-driving vehicle testing and limiting the liability of auto suppliers and manufacturers of vehicles that are modified for testing. 
• MetroMile in Washington state plans to allow drivers to insure cars by the mile - a new variant of “pay as you drive.”
• CCIR has released its final position paper on e-commerce.
• Here’s how California is to have saved residents $100 billion on auto insurance.
• No surprise, passengers point to their spouses as being “the most annoying drivers” according to a recent survey.

Insurance News - Tuesday, November 19, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Tuesday, November 19, 2013:

• The Consumer Federation of America has concluded that California auto insurance regulation and rate prior approval has been a boon to consumers since Proposition 103 and should be adopted by other states. 
• The Progressive CEO believes telematics will help his company adapt to and underwrite driverless cars sooner.
• Florida no-fault may not be dead yet. A ratings agency indicates Florida PIP reforms designed to reduce loss cost volatility and fraud are credit positive as costs begin to fall. 
• A U.S. regulator has offered to relax safety rules if car manufacturers accelerate new safety systems that prevent drivers who are drunk or have unbuckled seatbelts from operating cars.
• According to the UN World Health Organization and the OECD/International Transport Forum, international road safety data reveal death rates falling in high-income countries, rising in low-income countries. 
• Have you seen questionable fees charged by towing companies? How about a $150 cursing fee?

Insurance News - Thursday, November 14, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Thursday, November 14, 2013:

• For those who don't believe auto insurance is turning into just another commodity, a U.S. insurer is setting up a number of transactional insurance kiosks in malls, car dealerships, gas stations and supermarkets.
• York Regional Police have busted a high-end car theft ring that resulted in 14 arrests.
• Proposed bill would expand New Jersey's distracted driving law to include traffic jams, red lights, stop signs.
• A Kanetix survey shows that drivers of high-end vehicles have fewer tickets, accidents and claims.
• Detroit's Mayor-elect is exploring setting up a municipal auto insurance company to sell policies to its residents to combat the high price of auto insurance in the city.

Insurance News - Tuesday, November 12, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Tuesday, November 12, 2013:

• IBC reports that motorists talking on cellphones or texting are killing more people in Ontario highways than impaired drivers.
• CarSharing Association has released a draft liability insurance guideline for carsharing operators in the U.S.
• Technology is playing a key role in the communication of auto insurance and the growth of direct insurance. 
• Two new initiatives were announced this week, which shows that Canada is becoming fertile ground for telematics.
• Fully autonomous cars could free up ~75 billion driving hours each year or roughly 6-7 hours per week per driver.

Interim Report of the Ontario Automobile Insurance Dispute Resolution System Review

The Interim Report of the Ontario Automobile Insurance Dispute Resolution System Review is now online.  The interim report provides an overview of the history and structure of the Ontario auto insurance DRS, the structure of auto insurance dispute resolution systems across Canada and in other jurisdictions and trends in the current Ontario DRS, including outcomes of recent court and arbitration decisions.  It also makes a few recommendations and sets out a possible framework for a future DRS.

The report recommends that mediation no longer be mandatory in its current form.  It suggests that the government consider introducing a new system that consolidates the strengths of the existing mediation and arbitration processes to facilitate a more efficient model for resolving disputes.

It also recommends that the government consider that FSCO’s DRS adjudicative functions be delivered externally. The final report will address whether the adjudicative functions should be established in an independent public sector tribunal or in the private sector.

The proposed model set out in the report would provide a process that takes no longer than six months from start to finish. Cases would follow a different stream based on the benefits in dispute and the complexity of the issues involved.

The process would begin with a benefit denial.  Every Ontario auto insurance company would have to establish a formal internal review process. A claimant wishing to dispute a benefit denial would first have to meet with their insurer to clarify why they believe the insurer was incorrect and present any new information to support their claim.

If the parties cannot resolve their dispute, the claimant would then be free to file an application with the new ADR body (whether in the private sector or within a tribunal) or perhaps they could access the courts at that stage. Cases using the court option would be subject to the rules and timelines of the court system.

If the claimant chooses ADR, a case manager serving as a gatekeeper to the process would review each application to determine whether the parties are ready to proceed through the system. The case manager would determine whether there are jurisdictional issues to be addressed and whether a proper exchange of documents has taken place. The case manager would have the ability to return the application if there were any outstanding issues.

Once everything is in order, the case would immediately be assigned to an arbitrator, who would arrange a mediation session within 45 days, which would be a hybrid of the current mediation process and pre-arbitration hearing. During this stage, the arbitrator might provide a non-binding opinion on the likely outcome; in other words, the mediation session could potentially be a more evaluative process. Should the mediation fail to produce a settlement, the arbitrator would immediately schedule a hearing for the parties.

The arbitrator would also perform a triage role at this point to determine whether the case should be subject to a paper hearing, an expedited summary in-person hearing or a full in-person hearing. For a paper hearing, the parties would submit their final positions in writing along with all supporting documentation, and the arbitrator making a decision based on a document review.

For an expedited in-person hearing, the parties would submit supporting documentation, including affidavits and expert reports. Although testimony and cross-examination could take place within set time parameters, the use of expert witnesses would not be permitted. Expedited hearings would take no longer than half a day.

More complex cases, such as catastrophic impairment determinations, would be permitted to make use of expert witnesses but still would be limited to a short timeframe.

The paper hearing would take place within 60 days of the mediation, while in-person hearings would take place within 90 days.

There would be rules established, perhaps in regulations, setting out timelines, sanctions for non-compliance and other provisions to ensure the parties follow the principles set out in this report. There should be a prohibition on adjournments in all but the most exceptional cases. The length and content of expert reports would be restricted.  Each case would be decided on the merits of that case alone. Arbitrators would be required to follow the policy intent of the regulations and the Superintendent’s interpretive guidelines.

Arbitrators would have discretion to assign costs to either side when warranted. Fees may differ depending on the type of hearing. Decisions should be issued within 45 days of an in-person hearing. For paper hearings, decisions should be issued within 30 days. The process from application date to the issuing of a decision would be four and a half months for paper arbitrations and six months for in-person arbitrations.

Appeals would be heard by a single judge of the Superior Court.

Auto Insurance Section of the 2013 Ontario Economic Outlook and Fiscal Review

The governments Fall Economic Statement included a section on auto insurance but did not include any new initiatives.   Instead, the government provided an update on current initiatives.

With respect to the government strategy to reduce Ontario auto insurance rates by 15 per cent on average within the next two years, the government gave FSCO the authority to require insurers to re-file new rates for FSCO approval. The government reports that insurers have started to file new rates with FSCO as a result of this new authority. The government also made the Superintendent of FSCO’s guidelines binding to help reduce unexpected costs.

The government expects that the January 2014 report on approved rates from FSCO will provide the first evidence that its strategy to reduce costs and rates is working.

Transforming the auto insurance dispute resolution system is another key element of the government’s cost and rate reduction strategy. The Province appointed former Associate Chief Justice of the Superior Court of Justice, the Honourable J. Douglas Cunningham, to lead a review and make recommendations on how to make this a more efficient and effective system.  Stakeholder consultations on the recommended legislative direction will be held in the coming months in preparation for the final report.

The government also committed to protecting consumers by continuing to ensure that insurer rate filings include rates that reward safe drivers and by helping to ensure that all regions of Ontario benefit fairly from cost savings.

The Ontario government is also continuing to crack down on auto insurance fraud to further benefit consumers. The government has already taken a number of actions to address key recommendations made by the Auto Insurance Anti-Fraud Task Force, such as a framework for licensing health clinics in the auto insurance system, and expanding the regulator’s investigation and enforcement authority.

FSCO has launched an Anti-Fraud Hotline will allow the public to play a greater role in combating fraud. Ontario has also added important information to the Ministry of Transportation’s Driver’s Handbook to help new drivers understand and prevent auto insurance fraud.

The government is also actively working to develop a province-wide system to oversee the towing industry. In the winter of 2014, the government will work closely with the sector, the Association of Municipalities of Ontario, the City of Toronto and other key stakeholders on the development of a proposed model. As part of this work, the government will also look at the issues of vehicle storage and collision repair practices.

In addition, the insurance industry is working to fight fraud. It recently announced the creation of Canadian National Insurance Crime Services (CANATICS), a new not-for-profit organization that will use data analytics to identify suspicious claims. The Task Force supported the use of data analytics to combat auto insurance fraud and recommended the creation of such an organization in its final report.

Insurance News - Thursday, November 7, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Thursday, November 7, 2013:

• Alberta bill if passed will regulate premiums for optional auto insurance coverage.
• Intact and Belairdirect plan to launch telematics-based solution in Quebec with up to 25% auto insurance premium savings based on driving behaviours.
• Stakeholder submissions to the Ontario Automobile Insurance Dispute Resolution System Review are now available online.
• Teenage drivers are getting in fewer accidents in Massachusetts after the state increased young driver training requirements.
• Future Google cars will likely come with other Google product lines - gmail, gchat, Google maps and YouTube - afterall you need something to do while not driving your car.

Insurance News - Wednesday, November 6, 2013

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

• At the IBC Regulatory Affairs Symposium, a Cornell professor suggests there is too much moral hazard in Ontario's auto insurance system.
• Ontario appears to seriously looking at demerit points for distracted drivers.
• Lawmakers try again to clean up auto insurance fraud in Florida by repealing no-fault and replacing it with a tort-based system.
• MIT researcher claims traffic woes could be cut by an advanced cruise control system and without self-driving cars.
• A British town is replacing its buses with 100 driverless pods that run on a track.

Insurance News - Tuesday, November 5, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Tuesday, November 5, 2013:

• Cornell professor suggests that there is too much moral hazard in Ontario's auto insurance system.
• Young drivers in Ontario may soon be able to save money on auto insurance when new telematics programs are introduced.
• New York bans 12 doctors and 6 therapists from billing no-fault insurance program because of fraud.
• New York has also approved auto insurance discounts for drivers who complete an approved defensive driving course. 
• Canadian ownership in the property and casualty insurance sector just dropped with the purchase of Dominion Insurance by Travelers.

Insurance News - Wednesday, October 30, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Wednesday, October 30, 2013:

• Referral fees in personal injury cases have become the norm rather than the exception.
• More and more auto insurance is all about price and the direct writer model wins.
• By 2017, 60% of the world's vehicles will be connected monitoring the safety and security of vehicles and drivers. 
• There is a spike in auto insurance vandalism and theft claims each year on Halloween. 
• New York continues to crackdown on fraud by baning 12 doctors and 6 therapists from billing the state's no-fault insurance program.