FSCO backlog- Class Action Lawsuit

Open letter to FSCO:

Honourable J. Douglas Cunningham, former Associate Chief Justice of the Ontario Superior Court of Justice.

Senior Manager, Insurance Policy Unit
Industrial and Financial Policy Branch
Ministry of Finance
95 Grosvenor Street, 4th Floor
Toronto, Ontario M7A 1Z1

Dear FSCO:

According to the Ontario Automobile Insurance Dispute Resolution System Review Interim report,  beginning in 2007 FSCO began to experience a dramatic increase in Applications for Mediation.

 In 2006 – 07, FSCO received 13,053 new applications and in 2011– 12, received 35,727 applications — a 174 per cent increase.

As a result, FSCO was not able to meet the legislated 60- day time line for mediation and a backlog of files awaiting assignment to a mediator developed.

At the end of December 2011, there was a backlog of approximately 30,700 files,

FSCO was receiving an average of 2,949 new Applications for Mediation every month and claimants were waiting in excess of 11 months for mediation.

The FSCO backlog created forced settlements.

Victims of insurance had no choice but to sign forced settlements because Insurance Companies cut benefits off just before settlement.

When victims were told that mediation could take up to or more than a year to get heard. We had no choice. With no income, no justice, disabled, what can you do, we got screwed.

By purposely creating this backlog, these forced settlements were illegal, immoral, and insurance companies profited greatly by them.

I suggest that all the victims of these forced settlements be compensated.

Why not a class action lawsuit in this regard?

No names have been posted on this blog in accordance to the forced settlement agreement. That’s why you don’t hear from the victims of insurance.

Sincerely,

Administrator,

http://survivingacollision.blogspot.ca/

What happens after the FSCO backlog?

Dear Service Canada:


In 2007, I was  in a crash that took the life of a 19 year old boy
that was speeding,
 and passing on a solid double line,
 on a blind hill,
crashing into me head-on with his car.

The crash sent me rolling 8 times
 and hitting a tree.
With the air bag going off in the side of my head
I was trapped upside down in the twisted wreck
 that was not my fault.

You have had the evidence that you needed in 2008.

You are making it difficult to contact you because your fax number no
longer answers mine.
The fax log will show that yours times out now.

I called the Service Canada office that I was sending the fax to
several times, for days.
It just rings, and rings for days.

No-one answers the phone or fax now.

I called Service Canada several times by way of the number that
Service Canada gave me, and numbers I found online. According to
Service Canada they will not accept my fax. They will not give out a
fax number to me, and suggested that I go to the Service Canada
office.

How would a disabled person, shafted by the FSCO backlog, with no
income, be able to travel an hour and a half round trip? To find out
that their office may, or may not be open?

You have accepted my faxes at prior times.

I just want to verify receipt of a doctor’s report.
Why is this so hard to do?

Previously my application was lost in the mail you say. And have
denied my claim for disability benefits for bogus reasons.

Your previous acknowledgement of receipt for a fax in one of your
denial letters (“we know you can't work now”) established your receipt
of my faxes, and also by your own admission in a phone message that
you left on my answering machine.

Why are you not accepting my disability application, and properly, and
fairly, investigating my claim?

Are you on strike?

Shouldn't you notify people?

Your latest tactic of not accepting a doctor’s report from me, so I
may further produce evidence,
 will not be tolerated.

To hide and not communicate with me is babyish. So I will treat you like a baby.

 Please accept this fax until someone at your office can establish to
me how I may send you
1 doctors report.

Sending.......................

............................................................................................................................................................................................................................................................................................................................................1
of 48000.


Fax sent November 5, 2013


Sending 2 of 48000...........................................................................................................................................................................................……………………………………..

Amputate your leg’

‘Amputate your leg’

Insurer’s expert recommendation to accident victim

Catastrophically impaired car accident victims in Ontario are eligible for medical and rehabilitation benefits up to $1 million.

Victims suffering serious, but non-catastrophic impairment are eligible for medical and rehabilitation benefits up to only $50,000 (the Ontario no-fault limit of $100,000 was cut in half in 2010).

Insurance companies seem prepared to make any argument to limit the number of victims who qualify for catastrophic benefits.

At least that appears to be the case from the recently reported arbitration decision involving a 53-year-old woman, D.B., (the decision doesn’t reveal the victim’s name) and her insurance company, Economical Mutual.

D.B.’s vehicle was hit head on by a truck while driving on Highway 24 to Cambridge.

The collision was so severe paramedics had to use the jaws of life to remove her from her vehicle.

She was initially hospitalized for 10 days.

Along with injuries to her neck, back, shoulders, knee and abdomen, she suffered a fractured right leg below her knee.

After five surgeries, with extensive hospitalization, the fracture had not healed, she could not bear any weight on her right leg, could not move one leg in front of the other and could not stand independently.

Prior to the accident, D.B., led an active life including housekeeping, babysitting her grandchildren and attending exercise classes.

Following the accident, she was unable to walk, suffered pain requiring daily doses of opioids, and felt depressed, not wanting to leave her bed. She withdrew from social functions. Due to her inactivity and eating for comfort, her weight increased by 90 pounds. She gets around with a wheelchair, save when she is in a chairlift, although she can use a walker to take a few steps.

D.B.’s doctors believe she satisfies the criteria for catastrophic impairment benefits.

That her insurer and its doctors disagree isn’t troubling; what’s troubling is why they disagree.

The insurer’s expert concluded D.B. doesn’t suffer from any psychiatric impairment based, in part, on a trick.

He had an assistant knock on the door to his office to see if D.B. would be startled by the knocking.

Hyperarousal is said to be a feature of a stress disorder and D.B.’s failure to jump at the sound of the knocking was used against her.

But as D.B.’s expert, Dr. Dory Becker, stated, door-knocking is not an accepted test for diagnosing a stress disorder. In addition, being sedated on her daily medication, her reactions would be muted and being wheelchair bound, of course D.B. did not jump.

The insurer’s expert also relied on his observation that D.B. was able to smile and laugh. But, as Dr. Becker pointed out, even a depressed person is able to laugh and enjoy some things and laughing at a doctor’s — even an insurance company’s doctor’s — jokes, is the polite thing to do.

The insurer’s expert also took the bizarre view D.B. ought to have her right leg amputated below the knee and that she’d then no longer require a wheelchair.

So he assessed D.B.’s impairments based on the assumption she was an amputee!

D.B.’s doctor pointed out even with an amputation it was doubtful D.B. could get around with a prosthetic and that she’d more than likely remain wheelchair bound.

In the end the arbitrator decided in favour of D.B., ruling she was indeed catastrophically impaired.

In doing so he stated that, “(n)o doctor, insurer, arbitrator or judge can dictate to D.B. that she must have an amputation as a remedial procedure. I am mindful that D.B. has had five remedial surgeries as a result of the accident and has suffered from the non-union of a fracture. No one can assure D.B. that she will increase her mobility if she consents to an amputation.”

Those are wise words, along with these: Don’t laugh at a doctor’s jokes and remember to be startled if you hear someone knocking at your door.

_{Source: By Alan Shanoff   ,Toronto Sun First posted: Saturday, October 26, 2013 06:33 PM EDT http://www.torontosun.com/2013/10/25/amputate-your-leg}  

   

Tell Queen’s Park there’s plenty wrong with car insurance

Disclaimer: The names have been removed in the following letter to comply with legal demands.



May 27, 2012

Via Facsimile 613-996-1626

Via Letter Mail
Clerk of the Committee,
Room 1405, Whitney Block,
Queen’s Park, Toronto, Ontario M7A 1A2.

Re: Public Hearings on Car Insurance Industry Practices


Dear Clerk of the Committee:

I thank you for this opportunity to express my views on car insurance industry practices. I regret not being able to come there in person as the trip would be too painful, and can not afford the gas because my Insurer has unjustly stopped paying accident benefits.

Having been a victim of a fatal crash in 2007, I can tell you first hand my dealings with the current Insurance System.

Brief Personal History

I am a xx year old white male, born in Canada with roots going back to 1670. Before the fatal crash I was a 3rd generation truck driver. My jobs included hauling almost every produce and commodity imaginable. I am a professional driver with a perfect driving record. We proudly display a Canadian flag on our back and front lawn. We have two children. Both my wife and I are law abiding members of the community with no criminal records.

Brief History of Crash

I was coming home from work travelling on a narrow country road I used often. When I was about 60 feet from the crest of a blind hill, suddenly there were two cars travelling towards me, side by side, one car was in my lane. There was no where for me to go !...
The teenage boy was speeding and passing on a blind hill and solid double line. He hit me with his car at 102km/hr; taking off the front wheel, sending me rolling 8 times, and into a tree.
I was trapped upside-down. The airbag went off in the side of my head at a force 2/3's more powerful than that of today s cars. I had used the steering wheel to block my face from the crash. As a consequence my head was placed sideways in the steering wheel at the time of impact, and at the time of air bag detonation. Unfortunately the teenage boy died in the crash as he hit another car and a cement barrier.

Page 1 of 6



Findings and Recommendations – Public Hearings on Car Insurance Industry Practices

Our adjuster Mr. xx of xx Insurance has rejected claims of treating physicians, without obtaining a medical opinion. My Adjusters have denied, delayed my legitimate accident benefits off and on over the last 5 years. They began paying accident benefits after a 5 month delay.
Then suddenly before Mediation they cut off my accident benefits in an effort to make me settle in favour of the insurer.

Mediation has taken 5 years in my case. Our adjuster Mr. xx of xx Insurance tactics of sending me excessive distances to insurer interrogations has created a delay. He also mandated an insurer’s examination with a doctor with an obvious conflict of interest  that he new existed, creating further delay. He also mandated on two separate occasions interrogations and the doors were locked creating again an even further delay.

Insurance Companies owe policy holders  fiduciary duties, including the duty to act in good faith.
Our insurer has created an adversarial relationship, which has created great mental distress.
My Insurer has never given the benefit of the doubt when medical reports conflicted in the face of clear medical evidence.

According to a survey by the Alliance of Community Medical & Rehabilitation Providers 42% of all requests for treatment are now being rejected by insurers. The purpose of motor vehicle liability policies is to protect people from financial and emotional stress and insecurity. The main rationale for no fault car insurance accident benefits is that we want people injured in car accidents, regardless of who is at fault, to have quick access to medical and rehabilitation benefits not covered by OHIP. The practice of insurance companies denying requests for treatment has corrupted that philosophy and creates a slow torture to its victims.

The Ontario Auditor Generals report said about 50% of all claims result in mediation requests. With an estimated 36,000 applications for mediation being launched in the current fiscal year, the backlog isn’t likely to decrease. What is a crash victim facing a denial of benefits supposed to do? Forcing injured people to wait a year for non-binding mediation before they can seek a remedy through the courts encourages insurers to deny claims. Mediation is supposed to be fast and inexpensive.

When you buy insurance, you depend on that, thinking insurance is going to help you out if you ever have life-altering injuries. But in reality you have to fight for everything, every step of the way.” They want their money but when roles are reversed, they’ll do anything not to pay.”

In examining the increasing cost of claims, shouldn’t we be examining the increase in costs attributable to defence or insurer medicals, adjuster’s fees and legal fees paid to insurers defence lawyers?
An examination of the insurance industry needs to take place to uncover excessive payments to medical professionals treating accident victims, and how those payments are being declared by the industry.
I have found examples of fraud in the Ontario automobile insurance industry.

Page 2 of 6



We can’t leave the job of making medical determinations to adjusters or even their financially conflicted experts to writing accurate insurer medical reports, with the doctors writing only a small portion.  I have read how the facts have been twisted by assessment mills. Our insurers retained preferred, wordhirelings have been allowed to write whatever they want in there reports, even if it’s not true.

The Insurance system has allowed my personal information to be accessed at the HCAI anonymously.  Wordhirlings working my case have shared all our personal information loosely threw many unsecured channels. I will be requesting an investigation further into this matter; there is obviously a bug in the software and very lenient rules for sending information. No one should be logged-in anonymously accessing my personal information from the Secure Dox web site. Obviously more testing should have gone on before the site was opened for business only a short time ago. They also send emails threw unsecured channels and put personal information in the subject lines that are not encrypted. I feel that the public would react negatively much like I do, when you find out that your medical files are at risk.

Who is going to stop them? They should be held accountable. They should read their own code of ethics. The state of the insurance industry isn’t an election issue. It should be. I feel the Insurance Industry as it stands today is contributing to the general meltdown of society. Insurance Companies hold too much power over the Medical Community. They make misleading allegations, manipulate, and provide false representation of a matter of fact. They report about Scores, and devise graphs with numbers, create paper trails, and make endless non-scientific claims that have little or no evidence to substantiate them. They include and rely on colleagues reports as to be true, and include their Reports, in theirs, over and over again, creating a repetitious paper trail and inducing others in reliance upon them.

To allow a Doctor to run loose to write bias reports to satisfy the agenda of the Insurance Company is criminal and for their own gain only exploits a crash victim further. It’s time for car insurance companies to open their books. Let’s not take our eye off what matters, insurance is supposed to be there for deserving policyholders. While your committee doesn’t have the power to implement changes, it can make recommendations to exam abusive practices by the insurance industry, and we kindly ask that you do so and bring this urgent problem to the attention of the Legislature.

I face a $30,000 deductible and must also satisfy a stringent threshold to recover any award.
We need to examine insurance industry practices to ensure policyholders are getting fair treatment.
The evidence is clear there is a breach of the duty, good faith and fair dealing. Crash victims should not get further victimized by there own Insurance company. We paid insurance premiums for 30 years!
No accidents, no claims, professional driver, and perfect driving records.


Page 3 of 6



Currently I am xx years old, disabled, no job, and no insurance replacement benefits.
I have constant neck pain 100% of the time and constant pain tuning my head that accompanies clicking, cracking, grinding, in my neck 100% of the time. It hurts just to brush my teeth.
I have a sharp pain that originates in the back of my head/neck and radiates into my upper back that feels like pinched nerve spasms. Another sharp electrical type shock radiates into my left shoulder into my left arm and hand. I have a constant high pitch ringing in my left ear from when the air bag went off in the side of my head. My headaches sometimes last for days. I have back pain, and a nerve in my back that is causing a nerve in my toe making it painful to walk. I grind my teeth all night thinking about the insurance and finances which in turn has given me jaw pain and further sleep disruption. I have been bed ridden on many occasions. I’m sure I will be in a ripe mood by the time I get a meeting with a FSCO arbitrator in about a year.

Thank you for this opportunity to submit my findings. Please don't hesitate to contact me if you should have any questions, comments, or wish to view evidence of my claims.  Looking forward to hearing from an advocate as soon as possible in this regard. Thank you, drive careful, and remember, you only think you have insurance if someone hits you.


Sincerely,
Mr. xx
xx xx Rd xx,
xx Ontario, xx








Cc: Mr. xx Law Office
Cc: Mr. xx Law Office
Cc: CEO – xx Insurance
Cc: Dr. xx – Family Physician


Next mailing:
Cc: xx, MPP – Queenspark
Cc: xx, MPP -Queenspark
Cc: xx, Mediator – xx Mediations
Cc: xx, Clinical Manager – xx Management Inc.
Cc: xx - xx Management Inc.

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Next mailing:

Cc: Mr. xx, Lawyer, Journalist – xx
Cc: Letter to the editor - xx Newspaper
Cc: Letter to the editor - xx Newspaper
Cc: Letter to the editor - xx Newspaper
Cc: Letter to the editor - xx Newspaper
Cc: Letter to the editor - xx Newspaper
Cc: Letter to the editor - xx Newspaper
Cc: xx - xx Psychologists
Cc: xx – xx Psychologists
Cc: Dr. xx – xx Psychologists
Cc: Ms. xx – xx
Cc: xx – xx Rehabilitation
Cc: xx – xx Rehabilitation
Cc: Mr. xx - xx Physiotherapy Clinic
Cc: Mr. xx - xx Physiotherapy Clinic
Cc: Chief Privacy Officer - HCAI Processing
Cc: xx, Broker - xx Insurance Brokers
Cc: Mr. xx – Morrison Insurance Brokers
Cc: xx, Privacy Commissioner – Office of the Privacy Commissioner of Canada
Cc: Dr. xx, Associate Professor, McMaster University
Cc: Mr. xx - xx Consulting
Cc: xx, Investigator – The College of Physicians and Surgeons of Ontario
Cc: Financial Services Commission of Ontario
Cc: xx, Lawyer for the Defence (Insurer) -  xx
Cc: Dr. xx
Cc: Dr. xx
Cc: xx, Vocational Evaluator – xx Inc.
Cc: xx – xx & Associates
Cc: Dr. xx
Cc: Mrs. xx – xx Insurance
Cc: Dr. xx
Cc: xx, Claims Examiner – xx
Cc: xx, Case Manager – The xx Company
Cc: xx, Head xx Insurance Operations – The xx Company
Cc: Mr. xx, Occupational Therapist- xx
Cc: xx, Occupational Therapist- xx
Cc: xx - xx Clinic
Cc: Dr. xx
Cc: xx, Occupational Therapist
Cc: Dr. xx, Orthopaedic Surgeon
 

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Next mailing

Cc: xx – xx Minister of Canada
Cc: Members of Parliament
Cc: General Media sources
Cc: Online Media sources
Cc: Online Forums and Blogs
Cc: Online Social Networks


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