Ontario's Quagmire
Canadian Underwriter, Jan 2009 by Ford, Donna
Opinion/Analysis
Ontario’s auto insurers have struggled over the past decade with insurance fraud schemes that are a byproduct of an overly complex accident benefits or “no-fault” system.
Ontario’s mandatory, five-year auto insurance review is due to wind up shortly. One issue will be the credibility of the accident benefits (AB) or “no-fault” side of the system – a system that has been hijacked and looted by some assessment companies, legal representatives, health practitioners and rehab clinics.
The Ontario Motorist Protection Plan (OMPP) provided limited, no-fault benefits when it was implemented in 1990. Prior to that, the province’s auto accident compensation was provided mainly on the basis of tort. Various governments have tinkered with first-party benefits since the system was gready expanded in 1994. Each amendment has added successive layers of complexity; now, the 27-page Statutory Accident Benefits Schedule (SABS) of 1996 has expanded to 81 pages in length. Almost no one outside the industry understands it.
I practiced personal injury law during the pure tort system of the 1970s. I returned to the insurance industry to investigate suspicious accident benefits (AB)/bodily injury (BI) claims from 1996 to 2006
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