TORONTO, Jan. 29, 2013 /CNW/ - The Province has failed to listen to the cautions of its own Anti-Fraud Task Force, the pleas of accident victims, and the concerns of rehab providers and has amended several provisions within the regulation in a manner that will further distance legitimately injured claimants from their paid-for and desperately needed benefits. The changes, supposedly intended to prevent fraud by a small group of criminals, will place a new and unreasonable burden on legitimate accident victims which will very likely lead to their much -needed therapy and support being unjustly terminated.
"The Ministry of Finance has missed an opportunity to follow a recommendation of the Anti-Fraud Task Force to properly protect claimants whose treatment is wrongly denied by insurers, and additionally they've added a provision which creates another barrier for legitimate victims to access healthcare services", says Nick Gurevich, President of the Alliance of Community Medical and Rehabilitation Providers.
He explains that auto insurance is mandated by the Province, and the government is responsible to ensure fairness in the system by balancing the business interests of the insurers against cost of premiums and the protection of those consumers who are injured in accidents. Since 2010 the government has approved a series of changes which protected insurers' interests and resulted in record profits at the expense of victims and marginal reduction in premiums.
The most recent amendments to the regulation are based on the work of the Anti-Fraud Task Force, which the Alliance strongly supports. However, the translation of two specific recommendations into regulatory language has failed to achieve the intended goals. While the Anti-Fraud Task Force recognized that victims need to be protected against inappropriate denials of healthcare services by insurers, the new regulatory language fails to achieve victim protection because it does not hold insurers accountable for failing to abide by them.
The Anti-Fraud Task Force also recommended that, as a measure to prevent fraud, healthcare providers should keep a record of victims' treatment attendance, and this is supported by the Alliance. However, the new regulatory amendment shifted responsibility for tracking attendance onto the victims, many of who suffer from mental illness or brain injuries effecting memory. If such clients are not able to confirm attendance, their benefits will be withheld. That insurers may request such confirmation at any time, rather than upon suspicion of fraud, flies in the face of the Anti-Fraud Task Force's intention to not adversely impact the innocent, and further, seems to suggest that every benefits claimant is a suspect.
The Alliance fears that these changes may further escalate the number of disputes, adding to the current backlog which both the government and the Financial Services Commission of Ontario have been trying to reduce.
"We hope that the Ministry of Finance reconsiders these two regulatory amendments and revises them to be in line with those recommended by the Anti-Fraud Task Force" says Gurevich.
The Alliance of Community Medical and Rehabilitation Providers is a non-profit association representing more than 90 service provider organizations employing more than 3500 professionals. It is these physiotherapists, occupational therapists, speech language pathologists, chiropractors, psychologists, nurses, rehabilitation therapists, social workers, personal support workers and case managers who are the primary providers of healthcare and rehabilitative services to Ontarians who are injured in automobile accidents.
SOURCE: Alliance of Community Medical and Rehabilitation Providers
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Media contact: Nick Gurevich
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