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Archive for category: Automobile Safety and Insurance

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Personal Injury and Occupational Therapy: How We Help

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

As one of the largest Occupational Therapy companies in the province, we are noticing a growing trend towards lawyers requesting an occupational therapy assessment and opinion in medical-malpractice, medical-legal, and personal injury lawsuits.  Why is an occupational therapy opinion so important?  Here are the key reasons:

1.  No other profession assess ALL areas of function in the place where people live, work and play – OT is one stop shopping for understanding the physical, cognitive, emotional and behavioral aspects of disability in the environments where people function.

2.  Our reports highlight the story of disability and include information on how injury has translated into lost independence, altered life roles, impacted quality of life and reduced productivity.   This is essential for helping others to truly understand not just the medical issues, but the LIFE issues.

3.  Our assessment and treatment recommendations see the big picture.  We highlight someone’s needs now and into the future, and can indicate how disability and dysfunction will progress as someone ages or changes in time.

4.  Our reports are not fraught with jargon.  Instead, they highlight very practical and real issues that are easily understood and related to by all.  They can help one best understand if and how the injury has truly impacted life and living.

5.  Our assessments are typically more economical than other professionals and our reports often highlight other assessment and treatment needs (both private and public) to help you and your client know where to go to find solutions.

6.  OT’s are also excellent at Future Cost of Care Assessments or Life Care Plans.  These comprehensive reports price someone’s future needs including attendant care, housekeeping, home maintenance, and caregiving, along with device replacement costs and the costs for future therapies.   These aid in the quantification of injury to increase rewards.

The bottom line is that occupational therapy opinions and reports are a crucial aspect of outlining the impact of disability on daily life.  If you are a personal injury lawyer and you are not regularly using occupational therapy assessments and reports in your practice, perhaps consider how this can aid in your ability to help people receive optimal compensation for their loss.

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So I Guess Your Kid Doesn’t Wear A Seat Belt Either?

I get very confused when I see children riding bikes without helmets.  Over the last many years the safety benefits of a helmet for biking, skiing, skateboarding, ice skating (and many other sports) has been well studied.  Research shows that helmets can be extremely effective in preventing head injuries and ¾ of all cycling fatalities are the result of head trauma.  You don’t even have to hit a car or tree to sustain a head injury – the ground or even your handlebars are often enough.

The laws in Ontario are clear:  since October 1, 1995 anyone under the age of 18 is required to ride a helmet on a road or sidewalk (http://www.toronto.ca/cycling/safety/helmet/helmet_law.htm).  Based on an increasing number of adult cycling deaths by head injury, it is likely that this law will soon be extended to adults as it is in other provinces.

So, considering the laws and the well-publicised risks, why are children (including young children) still seen riding bikes without helmets?

As adults, I recognize that we were not raised to wear helmets.  Adopting this practice has been difficult as we find it unnatural, maybe uncomfortable, and probably uncool.  However, most of us likely wear seatbelts when in a vehicle.  Why?  BECAUSE WE WERE RAISED THAT WAY.  Seatbelt laws in Ontario were passed in 1976 and so many of us were raised in the era of this as mandatory.  Many of us probably don’t even have to think about our seatbelt anymore as it is part of our regular “get-in-the-car” routine and we feel naked and exposed without it.  We need to apply the same concept of “normal” to our children regarding helmets.

There are two main reasons why children need to wear helmets:
1.  They are safe and have been shown to save lives and reduce disability.
2.  IT IS THE LAW. 

As a parent, by not requiring that your child wear a helmet on their bike you are not only putting them at risk, but are also teaching them that laws don’t matter.  And I am not talking about the diligent parents whose children leave the house with a helmet on, to later have this on their handlebars or undone on their head.   I am mostly talking about the young kids in my neighbourhood who are out on their bikes without helmets, often under the supervision of their parents, and are thus not being taught that helmets are law, mandatory, and safe.

I am going to hazard a guess that no parent would put their child in a car without a seat-belt.  Heck, child seats are also law and until a certain age these are five point and offer more protection than the adult restraint.  So, for the same reasons you put your child in a seatbelt (protection and law) you need to ensure they are wearing a helmet for biking (skating, skiing, skateboarding).  And lead by example – get a helmet for yourself and model the appropriate behavior.  And be firm: no helmet should equal no bike.  No discussion

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Auto Insurance: How Much Have you Overpaid?

A recent study conducted by the Ontario Trial Lawyers Association shows that between 2001 and 2013 Ontarians have overpaid an estimated $3 to $4 billion in auto insurance premiums.  The recent Ontario budget calls for a reduction to these premiums, but at a huge cost in accident benefits.  Find out more about the study and help by signing the petition to stop the reduction to benefits for accident victims.

CBC:  Ontario drivers overpaid $840M for auto insurance a year, study says

Petition:  Stop Reducing Ontario Accident Benefits

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“Auto” Mobiles: Cars that Drive Themselves

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

It was years ago that I saw a picture of a new prototype Mercedes.  No steering wheel, no gas, brake or clutch – just a joystick that did it all.  My instant thought was of how many of my clients would be able to drive a car like that – it would just take one working upper limb.  No more bulky hand controls, complicated steering apparatus, or wires and cords connecting it all.

More recently I read an article on “cars that drive themselves”.  Amazing.  Imagine that.  Assuming the technology works, these would eliminate accidents, injuries, and the human problems of driving distracted, tired, while texting, eating, putting on mascara, being under the influence, or even getting lost.  It would be like having a driver or a limo every day.  No more tragedies of injury and death at the hands of neglect or mistake.  This has huge potential to help make transportation time both safer and more productive. 

What struck me, however, was that the article I read was written from the perspectives of Ontario insurance companies and body shops. They were expressing concern that “cars that drive themselves” will result in fewer accidents which will lower insurance rates (less insurance profit) and will reduce auto-body repairs.  Sorry, what?  REDUCING accidents is a problem?  I don’t see any health care professionals writing articles or blogs on how devastating it would be to have a reduction in clients who were severely or catastrophically injured in a car accident.  Clearly a health professional would look like a schmuck if they voiced that opinion, as do these deep-pocket and greedy insurers and the body shops they are in bed with.

It just goes to reinforce the problem in Ontario.  Insurance companies cry fraud, losses and keep suffocating benefits without reducing rates.  The government adds restrictions and fees for billing insurance companies and starts to “license” providers.  They blame lawyers, providers, tow-truck drivers, and claimants without looking in house at how they are running their “business”.  Then they show up with an opinion that expresses concern over lost revenue if people stop getting hurt.  Wow.  Disappointing.

I have said it before and will say it again – I would be happy to be out of work if it meant people would stop getting injured in car accidents.  If insurers truly cared about the people they insured they should be all for it.  But then again the incidence of car accidents and resulting injuries have been decreasing for years and our rates have not.  Enough said.

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Warning: Long Weekend Ahead!

Warning:  Long Weekend ahead!  While the Victoria Day long weekend is often a kick-off to summer, it is also known as one of the deadliest weekends in Canada.  Impaired driving and boating numbers are highly elevated during long weekends and MADD Canada estimates that impaired driving kills between 1,250 and 1,500 people every year, and injures more than 63,000 in Canada.  The following PSA is a great reminder of the effects drinking and driving can have on your life and on the life of someone else.  So please, while you enjoy this first long weekend of the season, think smart and be safe.  Don’t drink and drive.

 

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The Government Gets it Wrong – Again!

Sorry people of Ontario, but I feel that the Financial Services Commission of Ontario (FSCO) is an embarrassment.  In short, FSCO is a FIASCO. 

FIASCO is responsible for regulating and governing our provincial auto insurance product.  And what a mess it is.  If you read up on articles about auto insurance, benefits and changes, the comments are hilarious.  Ontarians seem to have a strong dislike for both FIASCO and Insurance Companies.

Working in this field since 2000, I have witnessed many changes.  Some good, most bad.  I have studied this product and written academic papers on the evolution of this since the SABS was introduced in 1996.  Well, more bad news.

Let me describe it this way:  we are all required to purchase car insurance – it is “mandatory” if we want to drive legally.  Insurance companies are “for profit” and compete with each other to sell this product.  The cheap insurance is typically run by crappy companies that have a culture of “deny first” and these will generally treat you poorly at the time of claim.  Like a family member of mine that was ignored by one such company for 2 years after a serious accident to finally receive a cheque to “go away”, you will get what you pay for.

So here is what is happening now.  In 2010 your benefits, or the product you were paying for at the time of renewal was reduced by 97% for “minor injuries” and by 50% for “severe injuries”.  I wrote about this previously and used the analogy that if you were buying a computer (as a comparison) instead of getting the entire computer, you would now just get the monitor for the same price.  Well recently they came out with the next round of executions.  They are suggesting that the benefits for catastrophic injury (the most severely injured that suffer long term and devastating losses) will also be cut in half.  The seriously injured again get hit with another 15% reduction (a total of 65% in 5 years).  No change to minor injury because the only way to honestly reduce that further would be to axe it altogether.  Here is the direct link to the information about what is happening:  http://www.fin.gov.on.ca/en/budget/ontariobudgets/2015/ch1f.html#ch1f_18

But to drive this home I tried to think of another analogy.  I think it would be like you getting and paying your property tax bill (at its usual rates) to then go and pave your driveway to be told “sorry you don’t own that part of your property anymore – we cut that from your property line last year”.  Or, as taxpayers who pay into OHIP one day we go to the hospital in an emergency and are told “sorry, OHIP doesn’t cover emergencies anymore”.  If the stories were comparable, the government would have told you about these changes in some “fine print” but perhaps you would not have noticed.  In fact, they hope you don’t.  After all, if you truly understood what they were doing before they did it, you would join the fight to make a change.

So what can we do?  My peers, colleagues and clients are going to the MPP’s.  They hope that our elected officials can talk some sense into FIASCO.  However, we have done that before with little resolve.  Sorry government officials, you repeatedly let the people of Ontario down when you don’t help us fight for our basic rights on a mandatory product.  As FIASCO says these changes are for “consumer protection” then we can assume that the result will be drastic reductions to our premiums, right?  If you are cutting my coverage by 97% and 65% I expect an equal reduction in my premiums.  My usual $1000 bill for car insurance on my Caravan will now be $30.00, right?  I am sure my refund is in the mail. 

Please join us in the fight against changes to this product by contacting your local elected MPP.  You can find your local MPP here:

http://www.ontla.on.ca/web/members/members_current.do?locale=en&ord=Riding&dir=ASC&list_type=all_mpps

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OT And Personal Injury

When working with clients who have been injured in a car or other accident, most times we work alongside a lawyer who is representing them to ensure they are able to receive the financial compensation necessary to allow them to have the best treatment and care.  The following from personal injury lawyer Roger Foisy discusses how Occupational Therapists assist beyond the recovery, to help clients receive the funds they require to pay for the costs they incur as a result of their loss.

Injury Lawyer Canada:  How an Occupational Therapist Can Help Personal Injury Lawyers Achieve a Favourable Settlement

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This Friday the 13th—Ride Safely!

Tomorrow is Friday the 13th and as a tradition in Southern Ontario, this will mean that thousands of motorcycle riders will head to Port Dover for the day. Statistics from the Ministry of Transportation show that Motorcycle riders in Canada are at least 15 times more likely to be involved in a crash than automobile drivers. And 1 in 10 traffic deaths on the road involves a motorcycle. However, it is anticipated that with safe and undistracted driving these statistics could improve. Here are some safe riding and tips for car drivers to safely share the road.

Information For Riders: www.roadawareness.org

Information For Drivers: Bracebridge Examiner: Frequency of motorcycle collisions a concern for OPP

 

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Best of the blog: Computer vs. Car Insurance… Gigabites or Irb…

Car insurance in Ontario is mandatory. However, how much do you really know about your insurance? Many shop on price, not recognizing that, like many things in life, they may get what they pay for. I wrote the following in June 2013 about why it’s important to really know your coverage. Hopefully you’ll never need it, but if and when you do, you will want it to meet your needs!

Computer vs. Car Insurance… Gigabites or Irb…

It is widely known in my industry that the people of Ontario generally don’t understand their auto insurance coverage – until they need it. For example, when buying a new computer you might look at screen size, megabytes, RAM, GIGs, processor, operating system, anti-virus software and extended warranty. But when buying car insurance do you look at the coverage for housekeeping, NEB, IRB, attendant care, med/rehab, liability, and care giving? No? So, it begs the question: why are you paying for something you don’t understand?

In a brilliant display of smoke and mirrors, your auto insurance company (via the Insurance Bureau of Canada – IBC) pulled some tomfoolery in 2010. They didn’t increase your car insurance premiums, but dropped your coverage significantly. So, in essence at renewal you got half (or less) of the coverage for the same price. That is like spending the same money on your previous computer to now only get the monitor.

So, being an educated consumer, I “bought up” and paid extra for the same coverage I had before the changes. I am one of less than 1% of the population that did so. Now, IBC is saying they are going to drop rates by 15%. Well thank you oh noble insurers. That will give me the same coverage I had before 2010 (because I bought up) for the same price (because of the rate reduction). So, I am back to where I started, but the other 99% of the population are getting 50% of the coverage for 85% of the price. They are still at a significant loss.

In a recent MBA class we talked about risk. Driving a motor vehicle is the # 1 most unsafe activity when compared to 29 other activities people perceive to be risky (including smoking, drinking, extreme sports, risky professions, flying, etc.). So, if driving is our riskiest activity, signifying a high probability of injury, why are consumers so unaware of their coverage? Is it because we don’t think we will get in an accident (the “it won’t happen to me phenomenon”), or because insurance is “mandatory” we just purchase on price?

I find it strange that people take the process of buying a computer more seriously than the process of renewing insurance – especially when driving is the riskiest thing we do daily. In a PC World survey (2012), 63% of people indicated they bought a computer “extended warranty” yet research repeatedly shows that the $16B spent yearly on extended warranties is a waste of money. Compare this to the less than 1% of people that bought an “extended warranty” (i.e. extra coverage) on their car insurance. Buyer Beware! It is time that Ontario drivers start to understand the product that is car insurance so they can ensure they have appropriate coverage for an appropriate price.

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Can the Ontario Government Suck AND Blow?

So your spouse, child, mother, brother, friend is injured in a car accident.  They broke both legs and have been quickly discharged from hospital.  An Occupational Therapist visits the home and prescribes some equipment, sets them up on the main floor, makes sure they have options for bathing, toileting, sleeping, can eat and get out of the house if they needed to, and calculates the amount of care they need in order to safely survive at home in this state.  This is calculated in minutes of care, and converted to a dollar benefit based on pre-determined (government) hourly rates. 

Prior to 2010, this money (attendant care) would be given to the client, and they could use this to pay the providers of their care.  They could choose the provider based on many factors, with most selecting the person that they were least embarrassed with in the washroom and shower.

In September 2010, FSCO decided that this benefit would only be provided when the care provider could prove an “economic loss”.  I get why they wanted to do this.  Too often, attendant care monies were “improving” the financial position of the injured (extra income) and was not always being used for care.  As it is inherent in the insurance act to not “advantage” people, the industry decided they needed to make some changes.

Proving an “economic loss” became a hot topic.  Some insurers wanted to only pay the amount of the loss, and others would pay the amount of attendant care benefit (as calculated by the OT), as long as a loss existed.  This issue was tried in court, and in Henry vs Gore (2013) the decision was that “the extent of the economic loss was irrelevant…as long as there was any economic loss during the period in question the person can qualify for the services they provided…”

Then, just last month this decision was overturned by the Ontario government, the SABS were amended, and now people providing care cannot receive more “than the extent of the economic loss sustained by the attendant…as a direct result of providing the care…”

So, I ask, can the government really suck and blow?  I guess so because there are so many elements of this that both defy logic and are clearly unfair.  Here is my list:

  1. So, if my economic loss is $100 / week (I work part time at Tim Horton’s), I get $100 / week even when the care needed is calculated at more.  So, if the care is calculated at 24 hours / day (as it can be) I get paid .59 cents per hour.  Is that legal?
  2. Then the reverse must also be true.  If I make $10,000 / month (as some people do) then I would get paid $10,000 / month (my economic loss) to provide care, right?  WRONG.  The max is $6000 regardless, and I suspect the insurer would only pay me the amount of the benefit which is often less than the max.  So, they cannot “advantage” me, but they can “disadvantage” me?
  3. So, I guess they will pay the full amount for private care then, right?  WRONG.  The form calculates at rates of $10.25, $13.19 and $19.35 per hour (for recent accidents) but the agencies charge $25 / hour or more.  So, the amount of hours I need is irrelevant as I can’t get the hours anyway in the calculated amount.
  4. If an agency is the only option (as my family will not work for .59 cents per hour), and most have a three hour per shift minimum, but my care is calculated at 2 hours per day, then I have to go without?  Or I guess I will just use the toilet tomorrow instead?
  5. If I was making $30 / hour and worked 40 hours / week, but now need to provide care for 80 hours / week, they will pay me at my “economic loss” hourly rate, right?  Nope.  They will pay the amount of the benefit, again calculated at up to $19.35 / hour.  So, I prove the loss, then take a loss following.
  6. If my family can’t live on .59 cents per hour, and an agency declines to work with me because of my behavior, complicated needs, or because my house is a health hazard, the insurer will change their mind and pay my family, right?  Doubt it.
Then, there are policy limits.  So, regardless of my economic loss, or the care needs of my family member, there will still only be $36K available if they are seriously injured, or $1M if they are catastrophic.

If the government wants to truly suck here, then they should not be able to blow.  Either pay an agency the number of hours needed, at the agency hourly rate, without monthly or policy limits, OR pay an unqualified provider the amount of care needed calculated at the pre-determined rates.  If you cannot advantage people, then you should not be able to disadvantage people either.  Their accident already disadvantaged them enough.