Some Unusual Comprehensive Claims

In Ontario comprehensive coverage is optional and pays for the cost of repairing or replacing your vehicle up to the actual cash value if it is damaged by other unexpected situations such as falling or flying objects, vandalism, fire, theft or attempted theft, a natural disaster, or a riot or civil disturbance.  Just about everything that isn't the result of a collision.

I thought I would share some photos of unusual comprehensive claims - no hailstones or falling trees here.  No one was injured in these incidents.

  

Are We Still Trying To Figure Out What Is a Minor Injury?

The other day Mike Bullard was talking about a recent accident he had on his motorcycle on his radio show.  I’ve provided a video of that segment of his show below.  What isn’t covered in the taped segment is Bullard’s description of his interaction with his insurer.  That can be heard on the podcast of the show (November 16, 2012). 

Fortunately as you can hear from his story he did not sustain serious injuries. What you can hear on the podcast is a description of how the adjuster assigned to his file provided him with paper work to begin treatment under the MIG.  Bullard refused indicating he didn’t think his injuries were minor and he was waiting for his doctor to report back on his MRI.  As a result of his refusal to accept treatment under the MIG, he received a letter from the adjuster indicating that his physiotherapy treatment was being denied.. His doctor did finally report that, in fact, his knee is in pretty bad shape and he has a torn ACL and two tears in the meniscus.   

I raise this story because from time to time I hear similar ones.  I don’t know how frequently it occurs but it does happen.  This was an insured that had returned to work two days after his accident and had refused other services. 

The MIG was developed predominantly to deal with whiplash injuries in addition to minor strains and sprains.  Torn knee ligaments probably do not fall under minor injury definition but I’m not in a position to make a determination.  Sometimes adjusters are too quick to classify an injury without fully considering all the medical evidence.

When a health care provider exaggerates a diagnosis he or she undermines the integrity of the auto insurance system. Similarly an adjuster that inappropriately directs claims into the MIG undermines the system.  Both situations increase demand for dispute resolution services and delay access to appropriate rehabilitation services.  It is more than 2 years since the SABS minor injury definition was introduced and although disputes that have yet to be resolved regarding the definition, there should be a better understanding of what falls under the definition. 

FSCO's Mediation Backlog Is Getting Smaller

There appears to be some good news coming out from FSCO regarding the backlog of mediation cases.  Based on data released by the Commission, the number of disputes waiting to be assigned to a mediator has been falling throughout the year.

At the end of 2011, 29,305 cases were waiting to be assigned to a mediator.  However, the backlog was continuing to increase in the early part of 2012.  A blog post by an insurance stakeholder in May of this year indicated that the backlog was 35,000 cases at the time.  As of September 30, 2012 FSCO reports that the backlog had dropped to 23,745 cases.  That is a 19.0% drop in nine month or as much as a 32.2% drop in just five months based on the unconfirmed figures.

In addition, ADR Chambers was selected by FSCO through a Request for Proposal to provide dispute resolution services specifically to target the mediation backlog.  FSCO began assigning mediation files to ADR Chambers on September 19, 2012.  Up to 2,000 mediation files per month are expected to be assigned to ADR Chambers. This is over and above the files that will continue to be handled by FSCO’s mediators.  Therefore, the mediation backlog may very well be below 20,000 cases at this time.

So how has FSCO tackled the backlog?  Well beside the ADR Chambers contract, the DRS eCalendar has had a significant impact on mediation process at FSCO. 

The DRS eCalendar was first launched in July 2011 and made mandatory on February 1, 2012.  The system allows claimant representatives and insurers to book and manage their files online.  Not only has it freed up mediators’ time from doing scheduling but has allowed the parties to quickly fill up vacant time in the mediators’ calendars resulting in a significant improvement in productivity.  Mediators have been handling many more cases per week – FSCO reports an increase of 63 per cent closed files for the period of February 1, 2012 to August 31, 2012 compared to the corresponding period in 2011.

In addition, the number of applications has begun to drop off.  FSCO stats show that back in 2007 FSCO averaged about 1,200 mediation applications per month.  The application rate steadily rose over the next four years peaking at 3,000 per month in 2011.  Over the first nine months of 2012 the average number of mediation application has been 2,500.  If new applications continue drop off, it will allow FSCO to chip away at the backlog that much quicker.

On February 10, 2012, in Leone and State Farm, a FSCO arbitrator ruled that mediation was deemed to have failed because it did not take place within 60 days of an application being filed and that the parties could not extend the time limit on consent once 60 days had expired.  On July 31, 2012, a decision​ was released by the director’s delegate that upheld the 60-day deemed failure.  This decision has likely had an impact on the backlog by allowing insureds to jump out of the mediation queue. 

FSCO stats show that the monthly average number of cases closed with full settlements and partial settlements increased by 29% and 38% from 2011 to 2012.  However, the monthly average number of cases closed that failed increased by 76% from 2011 to 2012.  So it appears failed mediations may also be having an impact on the backlog.

To head off a possible backlog of arbitration cases, the contract with ADR Chambers includes the ability to assign up to 500 arbitration files per month to the vendors. Again, this is over and above the files that are currently handled by FSCO’s arbitrators.

So when will the backlog disappear?  Well it’s difficult to predict as there are a number of factors chipping away at the numbers.  My guess is that 12 months from now it may be down to 2,000 cases which would be below the number cases waiting to be assigned to a mediator in 2007. 

More Could Be Done To Reduce Premiums

Current environment within the auto insurance sector is best described as uncertain.  The 2010 reforms changed the playing field but no one knows by how much.  Over the past 2 years industry data shows that accident benefit costs have dropped significantly but premiums have not followed suit.  Why not?

The 2010 reforms reduced the level of mandatory benefits that consumers much purchase.  As many people predicted almost all consumers chose the minimum coverages merely to avoid further rate increases.  However, a recent court decision (Zefferino v. Meloche Monnex Insurance) creates uncertainty even with regards to the impact of lower coverages.  The courts have signalled that if consumers were not properly informed of their options then insurers may be on the hook for the optional benefits.

This is not a problem that the government can fix.  Insurers need to be satisfied that they or their agents or brokers are properly informing policyholders about the optional benefits?  They need to be certain that they will be able to defend a claim by a policyholder that they were not properly informed about optional benefits.


To its credit, the government has continued examine auto insurance system and work on longer term reforms following the Five Year Review.  An expert panel was appointed in 2010 to review the SABS definition of catastrophic impairment.  However, the Superintendent's report on the expert panel's work has had minimal stakeholder support.  It appears that there has been no attempt to reach a compromise position to get more buy in from stakeholders and so that we can move forward on this issue.

In 2011, the Auto Insurance Anti-Fraud Task Force was appointed by the government to measure the impact of fraud in Ontario and recommend changes that would reduce the incidence of fraud.  The Task Force has now completed their work and we are awaiting the release of their final report.  In their status report released in their summer the Task Force indicated that some changes are already taken place such as changes to HCAI and better training for police regarding fraud identification.

Some of the more significant measures will require legislative and regulatory amendments.  It's up to the government to move forward on these recommendations if consumers are to see premium relief.  I also can't see why the insurance industry cannot set up an agency similar to the U.S. National Insurance Crime Bureau in Canada and duplicate some of its work.  It does not appear to require any legislation.  Not all the solutions can come from the government.

One of the more significant reforms introduced in 2010 is the SABS definition of minor injuries
along with the $3,500 cap on rehabilitation and assessment costs. This definition and cap should have brought about a significant reduction in premiums in Ontario.  However, a set of circumstance has failed to save consumers any money.  Most stakeholders have expressed some uncertainty as to whether the current interpretation of the SABS definition will withstand challenges within the dispute resolution system.  It is over 2 years since the reforms were implemented yet no disputes have made their way to arbitration at FSCO as a result of the ongoing backlog of cases in the dispute resolution system.

There are no quick fixes to address the chronic high caseloads at FSCO. However, FSCO could have facilitated more certainty in the system and lower premiums had it fast-tracked a number of cases through their system.  Nine million drivers are waiting to see whether the reforms have actually reduced costs in the system.  In addition, had these cases revealed flaws in definition (meaning a different interpretation than intended by the government) those issues could have already been addressed through regulatory amendments.

12-Year-Old Sues Parents For Drunk Driving

Photo by RTE

Faith, now 12, is suing her parents for the physical and psychological injury they caused. Faith and her brother, John, sustained severe injuries when their alcoholic mother passed out while driving the children home from school. Ava, Faith’s 6-year-old sister, and friend Michaela Logan, 9, died when the vehicle crashed into an embankment.

The children’s mother, Mary Carberry, was “in the middle of a pub crawl and decided to pick up the four kids from school.” Mary remembers bits of the accident that killed her youngest daughter. “All I remember is the thump. Then the flashing blue lights,” she testified in court in 2007. “I did not know what I hit. I remember Ava, I remember her face, I just don’t know what happened. I don’t remember arriving in the hospital.”

After the accident, Mary was sentenced to six years in prison, but her time was later reduced to four years.

 Now, Faith, with the help of her grandfather, is seeking justice for her sister. Faith was injured in the accident, undergoing surgery to her spine and spending ten weeks in a spinal cast at Our Lady’s Children’s Hospital. Faith also suffered “severe psychological trauma and upset and she attended a child psychologist for three months after the incident.”

Mary Carberry had already been banned from driving at the time of the accident. After two previous DUIs, Mary had no license and no insured vehicle. Faith’s father – also being targeted in the girl’s lawsuit – claims that he bought Mary a car, but didn’t expect her to drive it. He’d merely purchased the car after Mary allegedly told him that the children were “wet and cold” walking to and from school.

“It pulled at my heart strings. She was seeking for me to provide transport, purchase a car and somebody who was insured and had a full licence would drive it,” Tommy Varden told the court, adding that he never intended for Mary to drive the purchased BMW.

Varden added that Mary was attending Alcoholics Anonymous meetings at the time, and “seemed to be turning a new leaf.”

The father recounts the night of the accidents, saying that he received a phone call from Mary. “She said Ava was dead and she thought Faith was dead too,” he said. Vargan notes that it was only when he arrived at the hospital that he discovered Mary had been driving the car. “I was angry. I am still very angry. No way would I have given the car to her if I thought she was going to use it that way. I trusted her,” he said.

Faith, however, still holds her father responsible. He did, after all, purchase Mary a car. Vargan insists that, although he’d purchased the vehicle, it was only later that he discovered Mary had insured it, forging his signature on a check.

The lawsuit was settled on Wednesday, but the official outcome has yet to be disclosed.

According to Yahoo!News, Faith’s story is not a unique one. In the US, more than two-thirds of children fatally injured in car accidents “were riding with drunk drivers.” Young children, unlike adults, often do not have the awareness or option to opt out of getting into a car with an intoxicated driver, especially if a parent is behind the wheel.

In March, a mom in Iowa was allegedly driving drunk, and her 15-year-old daughter called 911 from the passenger’s seat. In 2009, four young kids died in a crash after their guardian was found to have a “blood alcohol level of .19 percent.

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Facebook Link Helps Break insurance Fraud Case

The value of analytics as a fraud tool has become well accepted.   The concept has been borrowed from social media platforms like Facebook where users can reach out to past friends who share similar characteristics such as attending the same school, summer camp or workplaces.  The case below illustrates that even without sophisticated analytics, social connections can help identify potential fraud cases.

Four Sacramento women are suspected of working together to defraud auto insurers of more than $37,000, according to the California Department of Insurance (CDI).

CDI spokesman Dave Althausen said Susan Lee, 24; Angelique Jones, 20; Angela Medeiros, 40; and, Krystelmaree Marquez, 23 denied knowing each other but investigators obtained Facebook records and determined the foursome did know each other as "friends" on the social media website.

CDI spokesman Dave Althausen  said according to detectives, 23-year-old Krystelmaree Marquez rented a U-Haul truck Dec. 11, 2011 and purchased extra insurance protection. She was driving the truck the next day when she was involved in a collision with a Toyota Yaris drivien by 40-year-old Angela Medeiros with 24-year-old Susan Lee and 20-year-old Angelique Jones as passengers. The women all claimed crash-related injuries. Althausen also said Medeiros denied knowing the other involved parties to insurance company representatives and the other three women said they didn't know Medeiros.

However, Althausen said investigators obtained Facebook account records and determined the foursome did know each other as "friends" on the social media website.

Medeiros, Lee and Jones were arrested on suspicion of three fraud charges including providing false statements in support of an insurance claim and participating in a vehicle collision for the purpose of submitting a false insurance claim. Marquez, who faces the same allegations, hasn't been located.

Althausen said if convicted of all charges, the suspects face two to five years in state prison and/or a $50,000 fine.

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California Proposition 33, Automobile Insurance Persistency Discounts

In California, a ballot proposition is a proposed law that is submitted to the electorate for approval in a direct vote. Propositions have been part of the California political landscape for quite some time.

A ballot proposition may be proposed by the State Legislature or by a petition signed by members of the public under the initiative system.

One of the best known was Proposition 13 in 1978 which decreased property taxes and imposed a 2/3 requirement for budget votes and tax increases. Some Propositions have been passed but found unconstitutional such as Proposition 22 in 2000 which banned same-sex marriages but was struck down by the California Supreme Court.

 On November 6th, there will be eleven propositions on the ballot including Proposition 33 which if passed would change current law to permit insurance companies to set prices based on whether the driver previously carried auto insurance with any insurance company. Insurance companies would be allowed to give proportional discounts to drivers with some prior insurance coverage and increase the cost of insurance to drivers who have not maintained continuous coverage.  It would also treat drivers with a lapse as continuously covered if the lapse is due to military service or loss of employment, or if the lapse is less than 90 days.

Proposition 33 is similar to Proposition 17, which was on the June 8, 2010 ballot. Proposition 17 was narrowly defeated. Unlike Proposition 17, Proposition 33 exempts soldiers and those who have been unemployed for 18 months or less from paying more after a lapse.

There is a provision in Ontario regulations dealing with lapses in insurance coverage.   Ontario Regulation 664 prohibits an insurer from considering a lapse in insurance coverage for purposes of risk classification unless:

• the insured person was convicted of driving without insurance during the lapse in coverage;
• the lapse resulted from the termination of an automobile insurance policy because the insured person failed to pay the premiums due under the policy;
• the lapse resulted from the suspension of the insured person's driver's license as a result of a driving conviction;
• the lapse resulted from the insured person's attempt to misrepresent their driving record due to earlier accidents or convictions, in order to avoid paying higher insurance premiums.

As with all California Propositions, there are organizations lined up in favour and opposed to Proposition 33.  Supporting the measure is the Republican Party, veteran groups and a number Cahmbers of Commerce.  Opposed are the Democratic Party, unions and consumer groups.  The insurance industry is split on the initiative because it may cause some consumers to shop around more.


California law requires all drivers to buy automobile insurance. Approximately 85% of California drivers follow the law and buy insurance. If you follow the law and maintain continuous automobile insurance coverage, you are currently eligible for a discount, but only if you stay with the same insurance company. Current law punishes you for seeking better insurance or trying to get a better deal by taking away your discount for being continuously insured.


Those opposed are concerned that insurers will use the new rules to raise rates on drivers.  There is concerns that people who stop driving, perhaps for economic reasons, and need to begin driving again and will therefore pay higher rates.  The Ontario regulation only allows insurers raise rates due to a lapse of coverage where the lapse was the result of a driving conviction, licence suspension of policy cancellation.

UPDATE:   Proposition 33 was defeated on Tuesday for the second time in three years.  It was the second attempt by billionaire insurance executive George Joseph to let insurers lower rates for drivers who maintain insurance coverage and raise them for drivers who dropped coverage in the past.  Consumer advocates raised about $200,000 to defeat the measure but were dramatically outspent by Joseph, who donated $16 million to the yes campaign.

Dwight Duncan To Retire

Earlier I had written on the impact of Premier Dalton McGuinty's resignation on the auto insurance system.  At the time I had speculated, as had others, that Minister of Finance Dwight Duncan would be running for Liberal leadership.

McGuinty had informed his Cabinet that ministers planning to run for leader would have to resign from Cabinet.  I can tell you from experience that this was a wise decision.  Back in 2002, when Mike Harris stepped down as premier of Ontario he did not ask his ministers to resign if there were running to replace him.  As a result Cabinet dissolved into competing factions and was pretty dysfunctional for a while.  I had an opportunity to observe this first hand when appearing before a Cabinet committee I witnessed a war break out over a minor regulation change being brought to the committee by the minister who was a leadership candidate where the committee chair was also leadership candidate.

My earlier post had suggested that with Minister Duncan resigning to run for leader, there would be little happening on the auto insurance file for some time.  Now that he appears to be staying in Cabinet there will be some opportunities over the next few months to move some auto insurance issues forward.  There will be no legislative changes with the legislature having been prorogued, but they may be opportunities to make some regulatory changes since Cabinet will continue to meet.

This window will be small with a leadership vote over the weekend of January 25th.  Shortly after the new premier will likely be appointing a new Cabinet before calling an election.  Since Minister Duncan has announced he will not be running for re-election, he will certainly be replaced shortly after the Liberal leadership convention.

So during this small window, if the outgoing minister still wants to make changes to the UDAP regulations or the definition of catastrophic impairment, it is possible.  In addition, since he is leaving office he may be may more willing to introduce changes that might be more contentious. 

So this change in events creates a different set of opportunities and possibilities, so stay tuned.  It could get interesting.

Woman Accused Of Committing Insurance Fraud From Inside Ambulance

This is an interesting story from Philadelphis where woman tried to commit insurance fraud — from an ambulance — after her vehicle was involved in an accident.

On the way to the hospital after she was involved in a four-car accident last October, Regina Whitehead did what most people do: She called her insurance company.

Only she didn’t call to report the accident, but to add comprehensive, collision and rental coverage, according to the Pennsylvania Attorney General’s Office.

Recently, Whitehead was charged with insurance fraud and criminal attempt/theft by deception. The 22-year-old Ambler woman was arraigned before Bensalem District Judge Joseph Falcone, who set her free on $25,000 unsecured bail.

Both charges are third-degree felonies punishable by up to seven years in prison.

According to the AG’s office, Whitehead’s 1998 Ford Taurus was involved in the accident Oct. 6, 2011, shortly before 4 p.m. on West Chester Pike in Chester County. At the time, Whitehead was insured through Infinity Insurance, which has an office in Bensalem, according to a probable cause affidavit.

About an hour after the accident -- during an ambulance ride to Chester County Hospital for treatment -- Whitehead allegedly called the insurance company to add extra coverage to her car, according to court documents.

A few hours later on the night of the accident, she called Infinity to report she was involved in an accident and to verify that she had comprehensive collision coverage. She was told during the phone call that if she didn't have the coverage in place at the time of the accident, the insurer wouldn't cover the damage, according to the attorney general.

The next day, Whitehead spoke with an Infinity representative in Bensalem and specifically affirmed that her collision coverage was added “before the accident,” according to the affidavit. Later that same day, though, she withdrew her insurance claim.

The attorney general said Whitehead admitted last month that she added the coverage after being injured in the accident and while in the ambulance and then lied about it. “Whitehead said she did this at the advice of a friend so she would be covered by the insurance company,” according to the attorney general.

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Will The Resignation Of The Premier Impact On The Auto Insurance Sector?

As we look around at the fallout after Ontario Premier Dalton McGuinty resigned after nine years in office, informing caucus on Monday evening that it is time for renewal.

Earlier in the day Mr. McGuinty asked the Lieutenant-Governor to prorogue the legislature amid continuing fallout from a scandal over the politically motivated cancellation of two power plants and an ongoing battle with organized labour over plans to impose new collective agreements that contain wage freezes via legislation.

Proroguing the legislature makes a lot of sense when the government is essentially leaderless although a caretaker leader could have been appointed. Proroguing the legislature is a gift to the next premier because the contempt charges directed at the government end along with all the bills before the legislature. As well during the Liberal leadership the Opposition will not be able to embarrass the government if the legislature is not sitting.  There is a possibility despite that the new Premier will immediately call an election despite the Election Statute Law Amendment Act, 2005 which calls for fixed election dates.  The outcome of an election are impossible to predict at this time but it is possible that another party will form the next government.

So how will this all impact on the auto insurance sector?  After all there are a number of significant policy initiatives that are in the pipeline.

Definition of Catastrophic Impairment

The Superintendent at FSCO submitted his recommendations for changes to the SABS definition of catastrophic impairment to Minister Dwight Duncan in December 2011.  His report was released in the spring of 2012 and was consulted on by the Ministry of Finance over the summer. There has been wide-spread opposition to the Superintendent's report.  Some of the recommendations reflect scientific evidence but others do not.  Even those recommendations that are based on science have an element of arbitrariness in the selection of the catastrophic threshold.

If Minister Duncan decides to run for leadership he will likely be asked to resign from Cabinet.  It is unlikely that his replacement will want to wade into this contentious policy initiatives that provides no political benefits.  The prospects for a regulation change are poor.

Fraud

The Auto Insurance Anti-Fraud Task Force is at the conclusion of their mandate and very close to providing the minister with their final report.  However, it is unclear who that minister will be and how long he or she will be the minister.  So what he or she will do with that report is unclear.  It is highly probable that the next minister will be relatively unfamiliar with auto insurance policy and will need to spend time being brief on the portfolio in addition to other finance issues.

It is likely that the more significant changes to be recommended by the Task Force will require amendments to the Insurance Act.  However, with the legislature prorogued, there won't be any bills introduced for at least 6 months if not more.  Even those changes that only require regulatory changes may also be put on hold.  Regulation changes can be made by Cabinet which will continue to meet during the Liberals' leadership campaign.  However, it will not likely be business as usual until a new premier is selected.  Cabinet will continue to make decisions but new policy initiatives will not likely be acted upon except where there is an urgent need.

There are ant-fraud initiatives that will not require legislation or regulation, for example most of the consumer education and engagement proposals.  These recommendations may not be delayed.

It is also not likely that the Task Force will be ignored if there is a new government.  All the parties have stated that they support initiatives that address auto insurance fraud.  What is unclear is how much of the Task Force's report that will be acted on.

Dispute Resolution Review

The government has made a commitment in the 2012 Budget to review the dispute resolution system operated by FSCO.  The review arose from the mediation backlog that has crippled the auto insurance system.  No announcement has been made by the Ministry of Finance regarding the vehicle for conducting the review or the time line.  There is no reason to delay the review until after a new premier is selected as the review is likely to be overseen by bureaucrats and not politicians.  By the time the review is completed the legislature will have returned and if the government decides to act on the recommendations, a bill could be introduced. 

FSCO Approves Form Changes To Facilitate Better MIG Data

FSCO has introduced an additional change effective November 1, 2012 dealing with the submission of the Auto Insurance Standard Invoice (OCF-21).  As of the effective date HCAI will be rejecting invoices submitted that do not include two new mandatory data fields dealing with MIG treatment. 

The two fields are the date that each MIG treatment Block commenced, and the profession(s) of the health practitioner(s) who provided the treatment, are to be identified.

These changes build on previous revisions to the OCF-21 back on July 1, 2012 when it became mandatory to complete the “Plan Number” field. The Health Claims for Auto Insurance July 2012 Guideline (Superintendent’s Guideline No. 02/12) provides direction on how to complete this field.

These changes are intended to provide FSCO and stakeholders with a better understand medical and rehabilitation costs and trends. As well, there have been gaps identified where additional information is required in order to obtain useful data regarding minor injury claims.

FSCO bulletin found here...

Social Media and Auto Insurance

Social media is a tool that people use to share and learn more about each other. In doing so, you get to know people better and build relationships.

Even if you wanted to, it is impossible to ignore the phenomena of social media.  Social media platforms are now part of mainstream business life.  Insurers now have Facebook pages, Twitter handles and YouTube videos.

Many people think it is about e-commerce.  E-commerce has nothing to do with social media; in fact a great way to fail at social media is to spend your time using it to “sell”. Just because you have a sales-enabled web site does not mean you are social.

Social media sites allow users to create, distribute and receive specialized content and to interact with communities of people.  But the extent to which insurer have adapted to, and embracing social media varies considerably, despite the opportunities available.

Social media first benefits the consumer and that in turn benefits the company. Here’s how that works: The company has the greatest opportunity now, with the advent of the social networks and the number of people now using the social web, to provide value added services via social channels. In addition to providing value added content and resources for clients, the company as a result also creates content that increases audience reach (via search engines, LinkedIn, Twitter, Facebook, Google+). Increased reach can then lead to new business development.

The company is also in a position to learn more from our clients about what they care about – as they share on a personal level, ask questions in the public eye, or dialogue with us. Companies used to have to conduct research, surveys and focus groups to get this kind of valuable information in the past. Now you have very real and immediate access. Social media is a win- win. Customers have a very distinct voice which drive services in to meet their needs, and companies who listen and engage stand to benefit.

Smartphone Apps

The Help I Crashed My Car Blackberry cell phone app allows you to contact your car insurance company, a body shop and up to 3 family members if you’ve been in an accident. This is very useful if you’ve been injured as well because this free Blackberry app links up with your phone’s GPS system to help you find police, hospitals and rental facilities in the area that you’ve had the accident.

We all know that drinking and driving is a very dangerous habit and should never be practiced. Not only does it threaten the safety of everyone on the road, it could increase your auto insurance rates. This is why theR-U-Buzzed iPhone app was released. By entering your weight and what you drank into the application, you will receive a fairly-accurate estimate of your blood-alcohol content and a recommendation of whether or not you should drive.

Geico Auto Insurance offers an iPhone app called the GeicoGlove Box. It offers a lot of great features to Geico customers, including offering account access and claims assistance. Also, you can take advantage of videos, how-tos and roadside assistance.

 

Facebook

For insurers, it is important to engage people who refer others to your company.  One of the best examples is Facebook Commerce, which allows customers to share their purchases (or purchase intent) through their Facebook page.  In other words, advertising it to the broader online community.  A credible social media presence not only builds trust with customers, it keeps brands at front of mind.

Twitter

Some companies have embraced Twitter to keep in touch with customers.  A growing number of consumers have shown a preference to Twitter as opposed to a call centre at the end of an 800 number.  Tweets range from job opportunities to weather advisories.  Here are examples of tweets recently sent out by Geico in the U.S.:

Save $10 on tickets to the GEICO 400 at Chicagoland Speedway with coupon code GEICO2012. http://bit.ly/TvyicG

Check out the http://www.youtube.com  homepage today to see some of our new commercials, including one that isn't on TV.

An important message about Hurricane Isaac: http://www.youtube.com/watch?v=29nbrr-tcxk

GEICO is hiring all across the country! For more watch this http://www.youtube.com/watch?v=4FKa5JnY54g … and see our jobs site at http://www.geico.jobs

YouTube

Some successful campaigns have focused on reducing risk through education and safety tips.  A wide range of online tools have been utilized including blogs, Twitter, Facebook and YouTube.  YouTube very much is adept at communicating to customers.  The IBC has created quite a number of YouTube videos including a series on fraudand tips from an insurance perspective on how you can help make it easier to get your life back together after any natural disaster or weather emergency.

Social media should be seen as a tool that complements the business and marketing strategies. It is important to monitor social media activity to learn what consumers and the public comment about you.  And how will you use the feedback to develop new brands and strategies?

Report Confirms That Collisions In Small Vehicles Cause More Injuries

It should come as no surprise that you are more likely to be injured as a passenger in a small vehicle.  The Insurance Institute for Highway Safety (IIHS) and Highway Loss Data Institute reported has provided accident safety data on a wide range of vehicle models including mini, small and midsize four-door cars. Clearly smaller vehicles had more frequent than average personal injury claims.  Below is a comparison of mini 4-door cars and large SUVs. Not only are personal injury claims higher in the smaller vehicles but so are collision claims.

To see the data on all vehicle models reviewed including years prior to 2009 to to the IIHS website at www.iihs.org.



MINI 4-DOORS 2009-11

Vehicle	Collision	Property damage	Compre- hensive	Personal injury	Medical payment	Bodily injury
Chevrolet Aveo	127	123	105	183	212	175
Ford Fiesta	98	95	104	134	140
Hyundai Accent	127	131	81	173	214	179
Kia Rio	115	121	84	175	203	151
Mazda 2	91		130
Toyota Yaris	112	101	89	201	171	125
Toyota Yaris hatchback	89	91	73	127	146	94

LARGE SUVs 2009-11

Vehicle	Collision	Property damage	Compre- hensive	Personal injury	Medical payment	Bodily injury
Buick Enclave	83	101	91	62	61	90
Buick Enclave 4WD	90	116	101	56	62	98
Chevrolet Tahoe	68	108	97	59	70	93
Chevrolet Tahoe 4WD	66	112	95	58	61	96
Chevrolet Tahoe hybrid	47		112
Chevrolet Tahoe hybrid 4WD	104	170	111
Chevrolet Traverse	67	100	86	79	74	88
Chevrolet Traverse 4WD	75	108	97	77	75	81
Dodge Durango	116		103
Dodge Durango 4WD	66		127
Ford Expedition	78	84	108	57	65
Ford Expedition 4WD	86	102	119	56	60
GMC Acadia	63	96	74	66	62	81
GMC Acadia 4WD	70	108	85	62	51	85
GMC Yukon	67	116	108	64	53	92
GMC Yukon 4WD	83	126	113	57	44	87
GMC Yukon hybrid 4WD	74		83
Nissan Armada	88	109	112	93	91	89
Nissan Armada 4WD	89	102	119	83	79
Toyota Sequoia	87	123	89
Toyota Sequoia 4WD	105	131	226	54
Volkswagen Touareg 4WD	99		116

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Pastore Court of Appeal Decision Reinforces a Broader Interpretation of Catastrophic Impairment

The Court of Appeal for Ontario recently released its decision in Pastore v. Aviva, allowing the appeal and restoring the Director’s Delegate’s order.

In Pastore, the claimant was involved in a car accident back on November 16, 2002.  She suffered a fractured left ankle.  Her injury didn’t heal properly, requiring several surgeries over the next five years, and right knee replacement when the ankle pain led to a change in her gait.  She applied for a catastrophic impairment determination in 2005.  Catastrophic impairment was supported by a DAC assessment but rejected by the insurer.  The issue in dispute was whether the claimant was catastrophically impaired due to a mental or behavioural disorder, under subsection 2(1.1)(g) of the SABS.

The arbitrator accepted that a Class 4 impairment (based on the AMA Guides to the Evaluation of Permanent Impairment, 4th edition) in one area of function was sufficient to meet the definition of “catastrophic impairment”.  This was the only area of function she reviewed in detail.  On this basis, she concluded that Pastore had suffered a catastrophic impairment. On appeal, the Director’s Delegate agreed with the arbitrator that a Class 4 (marked) impairment was required in only one of four areas of functioning to establish a catastrophic impairment.

The Divisional Court disagreed with FSCO and granted the insurer’s application for judicial review. The Court found that the Director’s Delegate had failed to properly appreciate the effect of incorporating the Guides into the SABS - that the Guides must be treated as part of the legislative scheme.  Justice Matlow disagreed in part.  He found there was nothing in the Guides which required more than a single finding and there was no requirement to evaluate each of the four areas of functional limitations before a "marked" impairment can be found to qualify.  He held that the Guides are not “part of the legislation” and are only guidelines.

This is just another in a series of decisions on the impact of psychological impairment on the determination of catastrophic impairment under the SABS.  In Kusnierz v. Economical Mutual Insurance Company, the Ontario Court of Appeal confirmed last year that psychological impairments should be combined with physical impairments to determine whether a person injured in a car accident has sustained a “catastrophic impairment.”
Prior to that the Ontario Superior Court of Justice’s 2004 decision in Desbiens v. Mordini was the leading trial decision regarding catastrophic impairment.  

The Superintendent's Report on the Definition of Catastrophic Impairment in the SABS attempts to mitigate some of the decisions by recommending the elimination of psychological impairments from the SABS definition and replacing them with psychiatric impairments.  As well the Superintendent's report recommends that physical impairments and psychological impairments not be combined. The court decisions reinforce my opinion that a regulatory prohibition on combining psychological and physical impairments will ultimately fail. The courts will find ways around it.  Instead a better solution might be to develop a more rationale model that acknowledges that psychological impairments can push physical impairments over the catastrophic threshold but that is less susceptible to manipulation.  The WSIB has been combining psychological and physical impairments for quite a number of years.

The Superintendent's report was submitted in December of last year but has not been acted upon.  The Minister of Finance conducted a stakeholder consultation over the summer. As well, stakeholder discussed the report during presentations to two Standing Committees of the Legislature during May and July of this year.


 the Pastore Divisional Court decision is here..

the Pastore Court of Appeal decision is here...