I recently sent this letter to my MPP. I encourage you to do the same if you are a healthcare provider, have been involved in a motor vehicle accident, have purchased insurance, or are tired of getting it “stuck to you” by insurance companies! Please feel free to copy this letter and use it however you wish.
Thanks for taking the time to read my rant!
Dear Mr. Jim Wilson,
I am writing this letter to express my displeasure with the ongoing changes in the world of motor vehicle insurance, specifically from the perspective of an owner of a small physiotherapy clinic in Alliston, Ontario. In recent years I have witnessed many changes in accident related claims, changes that I feel have had negative effects on both the claimants, and the health care providers. Now I do not profess to be an expert on these regulations, so what follows is my interpretation of the rules, and my opinion of the effects that these rules have had on both the injured, and the rehabilitation providers. The three areas I intend to cover are: the minor injury guideline (MIG) and accident benefits; the use of personal insurance coverage; and the recent announcement of licensing rehabilitation clinics.
In September of 2010 the Financial Services Commission of Ontario (FSCO) implemented changes for all of those injured in car accidents. Many changes took place including the formation of the MIG, the reduction of medical rehab benefits from $100 000 to $50 000, and changes to the catastrophic designation. These changes have undoubtedly saved the already lucrative insurance industry enormous sums of money, but at what cost? As a clinic owner I have seen people designated as having a “minor injury”, despite having many pre-existing conditions, or more severe injuries than originally thought. The result is people either running out of med/rehab benefits before the condition has resolved, or having to stretch their economic limits to be able to pay for the required treatment. Many more severely injured individuals are using the $50 000 allotment very quickly, and once again find themselves searching for answers on how to finance their treatment (bear in mind that $50 000 can go quickly when multiple health professionals are involved, as well as adaptive equipment required, etc). What I find most comical about all of these changes, is that when they were being announced they were actually framed as though they had the best interest of the consumer at heart. One news report I saw compared it to a value meal at your favourite fast food restaurant and said “why pay for things that you don’t want”? It was presented as though many peoples insurance premiums would drop as a result of this change. In my informal research, I have yet to meet someone who has had a reduction in premiums as a result of these changes. So, did these changes provide the consumer with choice? Or did the insurance companies improve their profit margin, while leaving many people with unresolved issues and financial burden?
My second issue with FSCO is the mandate that all claimants must use their personal insurance prior to accessing their motor vehicle accident (MVA) insurance. This creates a multitude of problems for both the claimant and the clinic. First, many individuals in this situation are not working due to their injuries, and therefore unable to pay for treatment as they go. As a result the clinic has to run a “tab” for the individual, then bill the private insurance company, wait for the client to be paid, then rely on the claimant to pass along payment. The result is a lot of man power dedicated to this process, a delay between service and payment, and in some cases the risk of not receiving payment at all. There is a lot of documentation required, and often the MVA insurance company continues to hold up this process. Secondly, if these clients were to suffer a subsequent injury (say a broken ankle as a result of a slip and fall on the ice) they have already exhausted their private health insurance for the year, so now they have to pay out of pocket for the rehabilitation of their ankle. It appears unfair that these people should have to pay out of pocket or do without as a result having to use their personal insurance for something that they purchased MVA insurance for in the first place.
Finally, I just received notice that FSCO has decided that all clinics that direct bill MVA insurance companies are now going to have to be licensed providers (in order to”regulate” us), and that we as providers will have to pay for this licensing. It is unclear at this time how much this licensing will cost, but the result could be yet another barrier for people to receive care. Many small clinics may be unable to afford the licensing, resulting in these smaller clinics not providing care to MVA sufferers. These small clinics, in my humble opinion, often provide a higher level of care than their franchised counterparts. A lot of smaller clinics provide a high level of care, spending more time with clients, and therefore bill less per hour. It appears as though this licensing process is going to further increase the money the insurance companies make, and perhaps reduce the quality of care the injured will receive. If the licensing is required, should it not be funded by the billion dollar insurance companies? As a physiotherapist, I am a regulated health professional, and already pay my professional college to ensure that I abide by certain regulations and a code of ethics, making this licensing requirement redundant.
In summary, we have been forced to pay the same amount (and I would argue more in many cases) for inferior coverage, resulting in many people having to cease rehabilitation treatment prior to maximum medical recovery. In addition, clients are forced to use their personal coverage prior to their MVA insurance meaning inconvenience and risk for the clinic, and if they are to be injured in an unrelated incident, they likely will have to pay out of pocket. Finally, FSCO has now decided to provide another barrier to clinics trying to provide optimal care. By making clinics license (of course at the clinics expense) they are providing yet another barrier for clients seeking care in order to “regulate” already regulated health professionals. So, I ask you, shouldn’t the insurance companies themselves be reaching into their deep pockets to pay these fees if they don’t trust our professional college’s ability to regulate? Shouldn’t people be able to use their private insurance for what it was intended for and not for MVA related injuries? And shouldn’t people receive the care they require instead of nearly every injury being classified as a MIG?
I welcome your thoughts on these issues and would love to see these changes petitioned!
Ryan Shea PT, HBKin, CAFCI, CGIMS, FCAMPT
Registered Physiotherapist
Owner of South Simcoe Physiotherapy