Q: How does car insurance coverage in Ontario differ
from that of other provinces?
A. After the September 1, 2010 changes, Ontario's
Accident Benefits coverage - particularly its Medical and
Rehabilitation benefit - remains the most generous in Canada, when
compared to other provinces with similar systems of car insurance.
Ontario's standard $50,000 Medical and Rehabilitation benefit limit
(for injuries that are neither Minor nor Catastrophic) compares
favourably to $50,000 in Alberta and New Brunswick or $25,000 in
Nova Scotia and Prince Edward Island.
Ontario is also the only province with privately delivered
insurance that allows the purchase of additional coverage.
Q: Will the September 1, 2010 changes lower the price I
pay for my car insurance?
A: The government's intent in making these changes is
to stabilize pricing - not necessarily to lower it. Leading up to
these changes, the cost of claims was increasing significantly each
year…ultimately causing insurance companies to pay out far more
than premiums covered. This is why many of you have experienced
significant price increases in the past few years. These changes
were designed to control the factors that have recently driven the
price of insurance upward.
By making these changes to car insurance in Ontario, future
claims costs should be reduced or stabilized. This should lessen or
eliminate the need to continue the large rate increases experienced
by many Ontario drivers over the past few years.
Q: How much will the optional benefits
cost?
A: Each insurance company has been required to file its new
rates for optional benefits for approval by Ontario's insurance
regulator, the Financial Services Commission of Ontario (FSCO).
Pricing will vary from insurer to insurer, as they have unique
underwriting and rating rules. The pricing also will vary for
individual drivers.
Q: What happens when consumers' policies come
up for renewal? How will consumers be notified?
A: Because it is important to ensure that consumers
are provided with an opportunity to make an informed decision when
purchasing or renewing automobile insurance, drivers will be
informed about new options available to them through mandatory
point-of-sale disclosure.
FSCO has worked with key stakeholders to launch consumer
education initiatives, including point-of-sale disclosure of the
new choices consumers will have when purchasing automobile
insurance coverage.
By ensuring people are informed, the government is encouraging
accountability so that people purchase the appropriate coverage for
them and their families.
Q: What defines a "minor injury"?
A: Minor injuries, with respect to an auto accident, are
sprains, strains, dislocations, lacerations, contusions, abrasions
and whiplash injuries without nerve damage or a fracture.
Sprain means an injury to one or more tendons or ligaments, or
both, including a partial but not a complete tear.
Strain means an injury to one or more muscles, including a
partial but not a complete tear.
Q: Why did the government impose a cap of $3,500 for
minor injuries?
A: This cap on medical and rehabilitation expenses for
treatment of minor injuries (whiplash, sprains, strains,
contusions, dislocations, lacerations and abrasions) is an interim
measure pending an expansion of the guidelines for treating minor
injuries.
In Ontario, spending on medical expenses for auto accident
victims is growing at an annual rate of nearly 16 per cent.
However, the number of people injured in auto accidents has
remained steady.
When compared to other provinces, medical expenses are quite
high. Bringing the cost of treating similar injuries in line with
other jurisdictions will alleviate cost pressures in Ontario.
Q: What happens to claimants whose accidents were before
September 1? Are their benefits reduced?
A: They will be entitled to the same benefits that were in
their policy at the time of their accident. That means they will
continue to be able to claim up to $100,000 in medical and
rehabilitation benefits, $72,000 in attendant care benefits,
housekeeping and home maintenance benefits, and caregiver benefits.
They will not be subject to the minor injury cap and the new rules
concerning incurred expenses will not apply.
Q: Will the reforms to assessments apply to accidents
that occur before September 1?
A: Yes. Assessments are used to determine entitlement to
benefits, and the rules governing assessments begin to apply on
September 1 even if your accident was before then. This means the
$2,000 cap on claimant assessments and insurer exams applies
beginning on September 1; there are no rebuttal exams available
beginning on that date; and insurers will now have discretion on
whether to conduct an insurer exam when making an entitlement
decision.
Q: What other changes will apply to older claims on and
after September 1?
A: Among the changes are the following: An Assessment of
Attendant Care Needs form (Form 1) will have to be completed by an
occupational therapist or registered nurse. An Application for
Determination of a Catastrophic Impairment (OCF-19) must be
prepared by a physician, or by a physician or neuropsychologist
where the injury is a brain impairment. An election made after
September 1 by a claimant who qualifies for more than one type of
weekly benefit cannot be changed except in limited circumstances.
Revised claim forms will be used for both old and new claims.
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