Anthony Grande, physiotherapist and owner of Focus Physiotherapy, prepares napkins in Toronto on March 2nd.Christopher Kasaroff/Globe and Mail
Medical professionals who treat people injured in car accidents say Ontario’s auto insurance rules hurt them and their patients by keeping reimbursements low and unnecessarily draining workplace benefit plans. says.
Auto insurance is mandatory for vehicle owners and is heavily regulated by both the provincial government and the Ontario Financial Services Regulatory Authority (FSRA). The Ontario government has made reforming auto insurance rules a priority in recent years, but health care providers such as physiotherapists, occupational therapists and nurses say progress has been slow.
One of the big problems is that the amount auto insurance companies pay for their services is effectively frozen for 10 years. Fees are set by he FSRA through their Professional Services Guidelines and have not been updated since 2014.
The Ontario Rehabilitation Alliance, which represents 4,000 medical professionals who do at least some work with patients injured in car accidents, surveyed its members last summer and found that three-quarters had no premiums from auto insurance companies. He said it was lower than what he got from other providers.
“The guidelines have been essentially sealed since 2014,” said Laurie Davis, executive director of the Ontario Rehabilitation Alliance.
Expenses increased while income remained flat. Anthony Grande, a licensed physiotherapist and owner of the Toronto chain Focus Physiotherapy, says that since 2000, his rent has tripled, his salary has doubled, and he’s been getting an hour’s rent from his auto insurance company. He said the fees he could receive for a session rose slightly from $84 to $99.75. .
“As a small business, this is hurting us,” he said.
FSRA spokesperson Russ Courtney did not directly answer questions about whether the regulator would consider updating the guidelines, but the fees are minimal and the FSRA has capped the amount professionals can charge. Said it wasn’t set up. “Insurers are not prohibited from paying fees in excess of those stated in the guidelines,” he said in an email.
Davis said individual assessors may agree to pay higher than the guidelines on a case-by-case basis, but generally the nature of insurance companies is to base reimbursements on the minimum amount allowed. rice field. pay.
“It doesn’t stop them from paying more,” she said of the guidelines. I will not.”
Insurance Canada, which is focused on working with the government to bring down auto insurance rates, said the amount being paid to professionals was out of control.
“The rates for medical/rehabilitation services based on auto insurance claims are set by the state regulator, the FSRA,” said spokesperson Brett Weltman.
Another flat amount is the amount reimbursed by the motor insurance industry to the Ministry of Health for costs incurred by government services, such as ambulances, related to motor vehicle accidents. Fixed at $142 million annually since 2006.
The Ontario government said it did not have the authority to change the amount it charges professionals, but indicated it was prepared to change the amount it collects from insurance companies themselves.
Government spokesman Scott Blodgett said in an email, referring to annual levies from auto insurers, that “assessment of the cost of health insurance schemes could be considered part of possible future reforms.” has potential,” he said.
Health care providers are also pushing to change how much insurance plans initially pay for treatment after a car crash. Ontario now mandates that workplace benefit plans pay for treatment first, and only when they are exhausted will the auto insurance company have to pay. Alberta is the only other province with this law.
From an expert’s perspective, paying your car insurance company first eliminates the tedious paperwork of going back and forth between the two insurance companies, says Grande. More importantly, however, it can mean that patients are not making the most of their workplace plans, which can impact the treatment patients and their families receive, as well as and the premiums paid by their employers may increase.
“Punishing someone who has a job when they are in a car accident is not the rest of the world,” Grande said.
The Ontario government has indicated it is considering the issue in its 2022 budget, but has made no changes over the past year.
Ontario Treasury’s Blodgett confirmed that changes to which insurance plans pay first are still under consideration.
“As part of efforts to improve equity, the government will consider whether auto insurance will continue to be the payer of last resort for car accidents,” he said.
Ontario’s next budget is scheduled for March 23rd.
The government has said other reform priorities include giving consumers more choice when choosing insurance plans and making insurance companies more responsible for tracking and reporting fraud.
