Nearly 70% of Ontario drivers do not understand the impending auto insurance reforms or how the reforms will affect their auto insurance coverage, according to a survey commissioned by RSA Canada.
Leger Marketing was commissioned to conduct the RSA Canada Automobile Insurance survey. In the survey 1,524 Canadian adults were polled. Of these respondents, 625 resided in Ontario.
The reforms, which will take effect Sept. 1, 2010, reduce the standard coverage offered to drivers, but with the option to purchase enhanced benefits.
Only two per cent of Ontario drivers surveyed by Leger have a confident grasp on the legislation and its effect on costs.
"These statistics show there is a real opportunity for brokers to educate drivers on the host of improvements the auto reforms will bring," said Irene Bianchi, RSA's vice president of claims and corporate services.
Monday, September 6, 2010
"Formal application" for accident benefits not necessary: Ontario Court of Appeal
If a claimant has not submitted an OCF-1 form (Application for Accident Benefits) to an insurer, it does not automatically disqualify them from being considered to have provided a completed application for accident benefits, Ontario's Court of Appeal ruled.
Four people travelling in a car were injured in a car accident in 2006. Francisco Quintera was the driver at the time of the accident. The car was allegedly insured by TD Insurance Meloche Monnex, but TD maintains it had terminated the policy prior to the accident.
The other car in the collision was insured by ING.
Ten months after the accident, ING received four OCF-23 forms (Pre-approved Framework Treatment Confirmation Form) from a chiropractor, one for each claimant riding in the Quintera car at the time of the accident. The forms included the names and addresses of each of the claimants, along with a brief description of the nature of the injuries each had sustained in the accident.
By July 2007, ING was unable to contact any of the four claimants, and had not received a completed OCF-1 form from any of the claimants so denied benefits and closed the file.
Shortly thereafter, TD received four OCF-1 forms from the claimants' representative, GM Accident Claims & Dispute Resolution Specialists.
Neither insurer adjusted the files or paid benefits. ING and TD disagreed about which had been the first insurer to receive a completed application for accident benefits within the meaning of s. 2 of the Insurance Act.
In arbitration, it was determined that ING's receipt of the forms from the chiropractor constituted the receipt of "completed application for benefits" within the meaning of s. 2.
ING's application to the Superior Court to have the determination set aside was dismissed, and the Court of Appeal also upheld the arbitrator's decision.
The arbitrator stated that a person "need not provide a formal application to an insurance company to be deemed to have provided a completed application for accident benefits," the Court of Appeal decision says.
"A person need only provide sufficient particulars to an insurance company so as to reasonably assist the insurer with the processing of the application and the assessment of the claim."
The OCF-23 forms submitted by the chiropractor, even though they are not OCF-1 forms, met the test, ruled the arbitrator.
"Accordingly, I would dismiss the appeal with costs to the respondent fixed at $8,000, inclusive of disbursements and applicable taxes," wrote the panel of Court of Appeal judges.
Four people travelling in a car were injured in a car accident in 2006. Francisco Quintera was the driver at the time of the accident. The car was allegedly insured by TD Insurance Meloche Monnex, but TD maintains it had terminated the policy prior to the accident.
The other car in the collision was insured by ING.
Ten months after the accident, ING received four OCF-23 forms (Pre-approved Framework Treatment Confirmation Form) from a chiropractor, one for each claimant riding in the Quintera car at the time of the accident. The forms included the names and addresses of each of the claimants, along with a brief description of the nature of the injuries each had sustained in the accident.
By July 2007, ING was unable to contact any of the four claimants, and had not received a completed OCF-1 form from any of the claimants so denied benefits and closed the file.
Shortly thereafter, TD received four OCF-1 forms from the claimants' representative, GM Accident Claims & Dispute Resolution Specialists.
Neither insurer adjusted the files or paid benefits. ING and TD disagreed about which had been the first insurer to receive a completed application for accident benefits within the meaning of s. 2 of the Insurance Act.
In arbitration, it was determined that ING's receipt of the forms from the chiropractor constituted the receipt of "completed application for benefits" within the meaning of s. 2.
ING's application to the Superior Court to have the determination set aside was dismissed, and the Court of Appeal also upheld the arbitrator's decision.
The arbitrator stated that a person "need not provide a formal application to an insurance company to be deemed to have provided a completed application for accident benefits," the Court of Appeal decision says.
"A person need only provide sufficient particulars to an insurance company so as to reasonably assist the insurer with the processing of the application and the assessment of the claim."
The OCF-23 forms submitted by the chiropractor, even though they are not OCF-1 forms, met the test, ruled the arbitrator.
"Accordingly, I would dismiss the appeal with costs to the respondent fixed at $8,000, inclusive of disbursements and applicable taxes," wrote the panel of Court of Appeal judges.
Monday, August 30, 2010
MPI files suit against "chronic" teenage car thieves
Manitoba Public Insurance has filed a lawsuit against a pair of teenage "chronic" car thieves, dubbed ‘Bonnie and Clyde' by some local justice officials and media.
The suit is a $53,000 statement of claim against a 16-year-old girl and an 18-year-old boy, stemming from an alleged spree of car thefts and vandalism, said MPI spokesperson Brian Smiley.
MPI is seeking to recover the money from the teens for damage they allegedly caused to six different trucks and SUVs stolen in Manitoba in 2009, according to the Vancouver Sun.
The duo recently garnered media attention because of the brazen and shocking nature of their alleged crimes. The pair videotaped their actions, which included vehicle thefts, drinking and driving, and performing lewd acts on the stolen vehicles, the Winnipeg Free Press reported.
In August 2010, the 16-year-old pleaded guilty to 21 charges stemming from a 30-day crime spree that spanned across rural Manitoba, Saskatchewan and Alberta, in the summer of 2009, reports the Winnipeg Free Press.
"Some of the crimes included burning a Hummer they stole just outside Winnipeg, nearly mowing down a vehicle owner who tried to interrupt a theft in eastern Saskatchewan and scrawling lyrics to a crude rap song over the interior of another car they left behind to be found by the police," reported the Winnipeg Free Press. This 30-day spree across the Prairies is separate from the spree MPI is seeking to recover damages from, Smiley noted.
The suit is a $53,000 statement of claim against a 16-year-old girl and an 18-year-old boy, stemming from an alleged spree of car thefts and vandalism, said MPI spokesperson Brian Smiley.
MPI is seeking to recover the money from the teens for damage they allegedly caused to six different trucks and SUVs stolen in Manitoba in 2009, according to the Vancouver Sun.
The duo recently garnered media attention because of the brazen and shocking nature of their alleged crimes. The pair videotaped their actions, which included vehicle thefts, drinking and driving, and performing lewd acts on the stolen vehicles, the Winnipeg Free Press reported.
In August 2010, the 16-year-old pleaded guilty to 21 charges stemming from a 30-day crime spree that spanned across rural Manitoba, Saskatchewan and Alberta, in the summer of 2009, reports the Winnipeg Free Press.
"Some of the crimes included burning a Hummer they stole just outside Winnipeg, nearly mowing down a vehicle owner who tried to interrupt a theft in eastern Saskatchewan and scrawling lyrics to a crude rap song over the interior of another car they left behind to be found by the police," reported the Winnipeg Free Press. This 30-day spree across the Prairies is separate from the spree MPI is seeking to recover damages from, Smiley noted.
Tuesday, August 24, 2010
CRTC refuses insurance brokers exemption to unsolicited telemarketing rules
The Canadian Radio and Telecommunications Commission (CRTC) decided its unsolicited telemarketing rules apply equally to insurance agents and brokers and investment and financial advisors.
The commission's Unsolicited Telecommunications Rules include the National Do Not Call List and the Automatic Dialing-Announcing Device (ADAD) Rules.
Previously, the rules did not apply to investment or financial advisors - a point of contention for brokers. The commission re-evaluated this distinction in March, and in its recent decision has ruled that rather than granting an exemption to those in the insurance industry, it would instead apply the rules to those in the financial industry as well.
The commission noted that while parties from both industries have a duty and obligation to communicate with clients in certain circumstances, there "is no obligation to do so exclusively by telephone," it said in its decision.
"Furthermore, the commission notes that there is no evidence on the record of this proceeding that investment or financial advisors and insurance agents or brokers have an obligation to communicate with their clients in a manner that would violate the Telemarketing Rules or the Automatic Dialing-Announcing Device Rules (ADAD) - for example, calling outside calling hours, not identifying themselves during the call, and not accepting do not call requests from their clients."
It went on to note that every other industry is subject to the rules when making unsolicited calls to sell or promote products or services, and as such, "there is no compelling reason, policy or otherwise, for the financial and insurance industries to be subject to a different application of the Telemarketing Rules and the ADAD Rules."
The commission's Unsolicited Telecommunications Rules include the National Do Not Call List and the Automatic Dialing-Announcing Device (ADAD) Rules.
Previously, the rules did not apply to investment or financial advisors - a point of contention for brokers. The commission re-evaluated this distinction in March, and in its recent decision has ruled that rather than granting an exemption to those in the insurance industry, it would instead apply the rules to those in the financial industry as well.
The commission noted that while parties from both industries have a duty and obligation to communicate with clients in certain circumstances, there "is no obligation to do so exclusively by telephone," it said in its decision.
"Furthermore, the commission notes that there is no evidence on the record of this proceeding that investment or financial advisors and insurance agents or brokers have an obligation to communicate with their clients in a manner that would violate the Telemarketing Rules or the Automatic Dialing-Announcing Device Rules (ADAD) - for example, calling outside calling hours, not identifying themselves during the call, and not accepting do not call requests from their clients."
It went on to note that every other industry is subject to the rules when making unsolicited calls to sell or promote products or services, and as such, "there is no compelling reason, policy or otherwise, for the financial and insurance industries to be subject to a different application of the Telemarketing Rules and the ADAD Rules."
Tuesday, August 17, 2010
Auto insurance fraud ring in Manitoba draws organized crime charges
Winnipeg police have laid criminal organization charges as part of its ongoing investigation into an auto insurance fraud ring.
According to the Winnipeg Sun, this is the first time an auto insurance fraud investigation is believed to have resulted in organized crime charges.
In August 2009, a series of arrests were made as a result of a joint investigation between Winnipeg Police Services and Manitoba Public Insurance dubbed ‘Project Rollback.'
"After nearly a year of reviewing evidence, and in consultation with a Crown Attorney, it was determined that additional charges were warranted," a Winnipeg Police Services release says.
Three individuals have received additional charges of:
• participating in a criminal organization; and
• commission of an offence for a criminal organization.
The joint investigation identified an auto fraud scheme that involved odometer rollbacks, sale document manipulation and staged incidents including staged collisions, hit-and-run collisions and false stolen vehicle reports.
As a result of the fraud ring, participants are alleged to have received inflated MPI claim payouts in excess of fair market value and defrauded the insurer of roughly $800,000, according to police.
According to the Winnipeg Sun, this is the first time an auto insurance fraud investigation is believed to have resulted in organized crime charges.
In August 2009, a series of arrests were made as a result of a joint investigation between Winnipeg Police Services and Manitoba Public Insurance dubbed ‘Project Rollback.'
"After nearly a year of reviewing evidence, and in consultation with a Crown Attorney, it was determined that additional charges were warranted," a Winnipeg Police Services release says.
Three individuals have received additional charges of:
• participating in a criminal organization; and
• commission of an offence for a criminal organization.
The joint investigation identified an auto fraud scheme that involved odometer rollbacks, sale document manipulation and staged incidents including staged collisions, hit-and-run collisions and false stolen vehicle reports.
As a result of the fraud ring, participants are alleged to have received inflated MPI claim payouts in excess of fair market value and defrauded the insurer of roughly $800,000, according to police.
Tuesday, August 3, 2010
TorQuest makes "significant" equity investment in SCM Insurance Services
TorQuest Partners, a Canadian-based manager of private equity funds, has made what it calls a "significant equity investment" in SCM Insurance Services (SCM).
The exact amount of the investment was not disclosed.
TorQuest Partners has more than $700 million of equity capital under management. It has made a number of previous investments in the insurance and insurance services industries, including the creation of a limited partnership in early January 2007 that now operates under the name of FirstOnSite Restoration LP.
SCM is an independent, privately owned provider of claims management, risk management and related services in Canada. It has more than 110 offices nationally, with more than 1,400 employees.
"TorQuest's investment in SCM is a strong endorsement of our strategy, people and potential," SCM said in a joint press release. "We see this as an exciting opportunity for growth and, in conjunction with the great team and client base we already have, this partnership will prove to enhance our strategic positioning both nationally and internationally.
"It's also important to note that our management team will continue to hold a sizable equity stake in the company. The leadership and operations of SCM Insurance Services,
ClaimsPro, Forensic Investigations Canada and SCM Risk Management Services will remain unchanged."
SCM also notes the national launch of iClarify, its proprietary insurance-to-value (ITV) solution, will continue on schedule.
The exact amount of the investment was not disclosed.
TorQuest Partners has more than $700 million of equity capital under management. It has made a number of previous investments in the insurance and insurance services industries, including the creation of a limited partnership in early January 2007 that now operates under the name of FirstOnSite Restoration LP.
SCM is an independent, privately owned provider of claims management, risk management and related services in Canada. It has more than 110 offices nationally, with more than 1,400 employees.
"TorQuest's investment in SCM is a strong endorsement of our strategy, people and potential," SCM said in a joint press release. "We see this as an exciting opportunity for growth and, in conjunction with the great team and client base we already have, this partnership will prove to enhance our strategic positioning both nationally and internationally.
"It's also important to note that our management team will continue to hold a sizable equity stake in the company. The leadership and operations of SCM Insurance Services,
ClaimsPro, Forensic Investigations Canada and SCM Risk Management Services will remain unchanged."
SCM also notes the national launch of iClarify, its proprietary insurance-to-value (ITV) solution, will continue on schedule.
Police action, legislation required to combat insurance fraud: RBC Insurance roundtable
Police action and legislative changes are required to effect stronger penalties for insurance fraud, an RBC Insurance media roundtable concluded on July 28.
Insurance fraud cost the Ontario auto insurance industry about $1.3 billion (out of about $9 billion in collected premium), according to background materials prepared for the conference. The materials cited Insurance Bureau of Canada statistics.
"There is no legislation or fraud bureau in place to combat insurance fraud," the RBC Insurance background materials note. "Jail sentences are uncommon for those who are caught committing insurance fraud."
In her presentation notes, Cathy Honor, president of RBC General Insurance Company, suggested regulators could also do more to help combat insurance fraud by requiring the accreditation of medical clinics.
RBC Insurance reviewed seven accident benefits claims from both 2004 and 2009. All claims occurred in the Greater Toronto Area (GTA) and all involved similar diagnoses including soft tissue injuries, whiplash and psychological factors.
While the average cost of repairing the vehicle hovered at just under $4,000 for the claims occurring in both 2004 and 2009, the average medical assessment cost skyrocketed from just below $4,000 for the 2004 claims to well above $10,000 for the 2009 claims.
Insurance fraud cost the Ontario auto insurance industry about $1.3 billion (out of about $9 billion in collected premium), according to background materials prepared for the conference. The materials cited Insurance Bureau of Canada statistics.
"There is no legislation or fraud bureau in place to combat insurance fraud," the RBC Insurance background materials note. "Jail sentences are uncommon for those who are caught committing insurance fraud."
In her presentation notes, Cathy Honor, president of RBC General Insurance Company, suggested regulators could also do more to help combat insurance fraud by requiring the accreditation of medical clinics.
RBC Insurance reviewed seven accident benefits claims from both 2004 and 2009. All claims occurred in the Greater Toronto Area (GTA) and all involved similar diagnoses including soft tissue injuries, whiplash and psychological factors.
While the average cost of repairing the vehicle hovered at just under $4,000 for the claims occurring in both 2004 and 2009, the average medical assessment cost skyrocketed from just below $4,000 for the 2004 claims to well above $10,000 for the 2009 claims.
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