Saturday 25 January 2014

FSCO Has Released a Revised MIG and OCF-18

FSCO has releasing a revised Minor Injury Guideline (MIG) and Treatment and Assessment Plan (OCF-18) that become effective February 1, 2014.
 
The revised MIG and OCF-18 reflect the recent change made to the SABS in which a pre-existing condition must have been documented by a health practitioner prior to the accident.  The change is reflected in Section 4 of the MIG which deals with impairments that do not fall under the guideline.  As for the OCF-18, changes have been made to the introductory Note box on page 1 and to the second question in Part 4.
 
Revised MIG is here.
Revised OCF-18 is here.
SABS amendment to section 38 (3) (c) (i) is found here.


Saturday 18 January 2014

Ontario Moving Closer to a New Treatment Protocol for Minor Injuries

On a recent snowy morning, a group of auto insurance stakeholders got together at Lakeridge Health in Oshawa for an all-day information session on some of the research findings of the Minor Injury Treatment Protocol Project (MITPP).  This was the first public presentation (although it was by invitation only) of the research team's work.

The MITPP originated in FSCO's Report on the Five Year Review of Automobile Insurance which recommended that examining the feasibility of expanding the PAF Guidelines to provide a more extensive continuum of care and to include the treatment and assessment of other soft tissue injuries (Recommendation #23).  Following an open competitive Request for Proposal process, a two-year contract was awarded to team of researchers led by Dr. Pierre Côté from the University of Ontario Institute of Technology and the Canadian Memorial Chiropractic College in the spring of 2012.

The project team will be delivering a report to the Superintendent later this year that provides:
  • Recommendations regarding a treatment protocol for minor injuries and
  • Recommendations regarding a clinical predictive rules to screen for patients who may be a risk of developing chronic pain.
There have been significant progress made by the project team and to date have completed the following tasks:
  • The project team has developed a methodology for developing a new tasks including a process for identifying relevant studies for consideration.
  • The project team has updated the research carried out by the World Health Organization's Neck Pain Task Force (NPTF) study which was released in February 2008.
  • The project team has also now finished reviewing research on the treatment of neck pain.
There are some significant tasks that still need to be completed before the final report is submitted to the Superintendent.  Those tasks include:
  • The project team will need to complete the review of research on the treatment of other minor injuries, not related to neck pain (for example, headaches, low back pain, injuries to extremities, temporomandibular disorders, minor brain traumatic brain injuries).
  • Make recommendations regarding a treatment protocol for minor injuries.
  • Make recommendations regarding a clinical predictive rules to screen for patients who may be a risk of developing chronic pain.
The project team developed some rigorous standards which were used to decide whether to consider a study for the project.  Their literature search produced over 100,000 papers.  Only published studies that underwent peer review and followed appropriate research protocols were considered.  For example, opinion papers and unpublished documents were not included.  A team of graduate students reviewed the papers to determine if they met the standards.   Many studies were inadmissible because of small sample sizes or possible bias.  In the end fewer than 200 papers made the cut.

The day was filled by research associates presenting on topics related to the treatment of neck pain.  Unfortunately, I cannot report on any of the findings.  The information is being embargoed until it is published as a series of papers in a scientific journal later this year.  A similar approach was taken by the NPTF which published its finding in a special supplement of Spine Journal on April 28, 2008.

The final report of the MITPP will be considered by the government later this year.  Implementation will not only require the release of a new Minor Injury Guideline by FSCO but will likely require regulation changes and an extensive education campaign directed at health care providers, insurance adjusters and the public.

Insurance News - Saturday, January 18, 2014

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Saturday, January 18, 2014:

Thursday 16 January 2014

Ontario Auto Insurance Rates Beginning to Come Down Slowly

The first full quarter (4th quarter of 2013) of rate approvals following the government's announced rate reduction strategy have now been released by FSCO.  The regulator has been able to squeeze 3.98% in rate reductions from 66.55% of the market.  That's an average of 5.98% per insurer of those that filed in the quarter.  That is better than the 3rd quarter results in which only a 0.65% reduction was achieved.  Combined 98.95% of the market has refiled their rates and as the government reports, approved rates are down 4.66%.

The government is committed to bring down rates by 15% over a two-year period which likely makes no one happy - neither consumers or insurers.  Considering that it can take up to a year until new approved rates appear on renewals (depending when a driver's policy renews), consumers could wait up to 3 years to see the full 15%.

The question that remains is how successful will the government be in bringing down rates to the targeted level?  The regulator squeezed less that 5% out of rates so far and that was the easy part.  Those numbers reflect company projection of future benefit costs, investment returns, overhead costs and a profit margin.  Perhaps with interest rates set to increase there will be some wiggle room to lower rates further.  As well, if the benefit costs continue to remain stable as they have for over 3 years, insurers may adjust their reserves which might allow rates to come down.  The severe winter in Ontario means claims have likely been higher so I doubt there is much room there anymore.  Overhead costs don't change much so all that is left is a smaller profit margin.  Perhaps this is part of the motivation for State Farm to get out of Canada.  After all, they haven't been profitable in Canada in a number of years. 

The insurance industry is holding out for further changes to the auto insurance system which might change the cost structure enough to bring down rates further. The government has announced a few initiative which they hope with achieve that:
  • The province will propose legislative amendments in the spring session based on recommendations of the Dispute Resolution System Review
  • The province is consulting on the development of a province-wide system to oversee the towing industry and reviewing vehicle storage and collision repair practices
  • Work is progressing on enabling health service provider licensing so that only licensed providers can get paid directly by insurers.
 The final 10% is going to be a challenge for the industry and the government.