MARSHALL.BENEFITS

Question 1

what are the component benefits of Ontario’s manadatory auto insurance system (2)

Answer 1

• no fault (accident benefits): provides benefits regardless of fault
• tort (bodily injury): allows you to sue the at-fault driver

Question 1

which is true for Ontario auto insurance: [1] benefits are fair [2] benefits are DELIVERED fairly

Answer 1

1] is true - benefits are fair
2] is false - benefits are NOT DELIVERED fairly

Question 2

what are the causes of unfair delivery of auto insurance benefits in Ontario (4)

Answer 2

Cost control at the expense of care
- insurers emphasize cost control instead of care
- but then victims don’t recover and final costs are HIGHER not lower

Lawyers
- lawyers’ contingency fees are a percent of the settlement
- so lawyers seek higher settlements, not better care for victims

Entitlements
- victims seek to maximize entitlements versus addressing own care needs

Volume
- providers are paid on VOLUME of treatment not results

Question 3

Ontario’s five-part ACTION PLAN for addressing the unfair delivery of benefits

Answer 3

Fix structural flaws: by appointing an arms-length regulator with powers to enact policies & procedures

catastrophic injuries: change compensation system for catastrophic injuries because lawyers are taking too big a chunk

lawyers: make contingency fees transparent (and simplify benefits so there is less need to hire lawyers)

care not ca$h: focus on timely, appropriate medical care, not cash payouts

smart regulation: allow insurers more regulatory freedom to compete on price & service

Question 4

what is the ‘opportunity gap’ in Ontario auto insurance

Answer 4

there is an OPPORTUNITY for Ontario auto premiums to be much lower without impacting quality

Question 5

what is the ‘value gap’ in Ontario auto insurance

Answer 5

the VALUE of medical care could be better if there were more focus on active medical management