Fear that Benefit Cuts Will Swamp OHIP,
Concern about Insurers Denying Treatment
TORONTO, Sept. 22, 2011 /CNW/ - The Ontario government's changes to auto
insurance will have a devastating impact on the public health care system as accident victims
run out of privately-funded benefits and are forced to seek
The McGuinty Liberals brought in changes a year ago that essentially
transferred hundreds of millions of dollars in medical and
rehabilitation costs from the insurance industry to public health care.
The government did this because insurers were claiming that the
province's 'overly generous' system was going to result in even higher
"Politicians don't like higher insurance rates, particularly in an
election year," says Nick Gurevich, President of the Alliance of
Community Medical and Rehabilitation Providers. "So the Liberal
government allowed insurance companies to chop benefits in the hope
that this would stabilize rates. The problem is, it hasn't worked."
Rates have continued to move up, and at the same time, consumers now
have less protection if they're hurt in an auto accident.
Dr. Peter Rumney, Physician Director of the Brain Injury Rehabilitation
Team at Holland Bloorview Kids Rehabilitation Hospital, says that kids
with brain injuries need access to rehabilitation services as quickly
as possible because early intervention can have a dramatic impact on
their recovery. "When a child is injured in an accident, families rely
on insurance coverage to get access to appropriate rehabilitation
services in a timely manner. Inadequate insurance levels put additional
pressure on an already-burdened public rehabilitation system," says Dr.
Some of the injuries will be assessed as catastrophic, in which case
they will then be eligible for significantly higher medial and rehab
benefits. But it often takes two or more years for catastrophic brain
injuries to be identified, during which time patients will now be
limited to a maximum benefit of $50,000 instead of the $100,000 that
was available before the government changes.
"That's far below what they'll need," says Gurevich.
In another disturbing development, rehabilitation providers in Ontario
say insurers are now denying a higher percentage of requests for
assessment and treatment. A survey conducted by the Alliance found that
more than two-thirds of the respondents report the denial rate is now
30% or more, compared to 10% or less a year ago.
Dr. Donna Ouchterlony, medical director of the Brain Injury Clinic at
St. Michael's Hospital notes: "Since September, we are seeing more and
more patients with serious injuries whose insurers are outright denying
treatment, and when funding is approved, it is no longer nearly
The Alliance represents approximately 80 companies and about 3,500
health care providers including physiotherapists, occupational
therapists, speech language pathologists, chiropractors, psychologists,
rehabilitation therapists, social workers, personal support workers and
case managers. It is these individuals who are the primary providers of
healthcare and rehabilitative services to Ontarians who are injured in
For further information, visit www.ontariorehaballiance.com
SOURCE Alliance of Community Medical and Rehabilitation Providers
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