More Cuts to Accident Benefits – Strategies for Survival Adam Little & Steven Smyth May 3,

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Presentation transcript:

More Cuts to Accident Benefits – Strategies for Survival Adam Little & Steven Smyth May 3,

Summary of Changes: 1.Reduced Limits 2.New Rules 3.Licence Appeals Tribunal 4.MIG Overhaul 5.Tort Changes

When? SABS changes effective June 1, 2016 Applicable at time of policy renewal

1 – Reduced Limits

1. Reduced Limits Effective June 1, 2016:  Non-CAT limits will be reduced to a TOTAL of $65,000 for combined med/rehab and attendant care (down from $86,000 combined total)  CAT limits will be reduced to at TOTAL of $1,000,000 for combined med/rehab and attendant care (down from $2,000,000 combined total)

1. Reduced Limits Strategies:  Careful use of available funds  What therapies will give the most “bang for the buck”?  Avoid any potential overlap between treatment providers

1. Reduced Limits Strategies:  Spread the word: OPTIONAL BENEFITS!

1. Reduced Limits  Non-Earner Benefit to be limited to 2 years only, with a 4 week waiting period (down from lifetime benefit with 6 month waiting period)  Means a maximum total of $18,500 for Non-Earner Benefits!

1. Reduced Limits Strategies:  ???

1. Reduced Limits Strategies:  ???  Spread the word: OPTIONAL BENEFITS!

2 – New Rules

2. New Rules Non-CAT Claims:  $65,000 total limits will apply to both med/rehab and attendant care (no longer $50,000 + $36,000)  Maximum $3,000 per month for AC, for up to 5 years  5 years maximum duration of benefits (down from 10 years), or until age 28 for minors

2. New Rules Strategies:  Focus on the area of most significant need (eg. attendant care where safety is an issue)

2. New Rules Strategies:  Spread the word: OPTIONAL BENEFITS!

2. New Rules  For “other goods and services” aspect of medical and rehabilitation benefits (see s. 15(1)(h) and 16(2)(l)), will only be paid where “insurer agrees are essential”  These “basket” benefits provisions are basically gone

2. New Rules Strategies:  Where available, focus on tort claim for items that do not fall directly within ss of the SABS

2. New Rules Strategies:  Spread the word: OPTIONAL BENEFITS!

3 – Licence Appeal Tribunal

3. Licence Appeal Tribunal  Effective April 1, 2016  Right to sue AB insurer is eliminated  FSCO mediations and arbitrations are eliminated

3. Licence Appeals Tribunal  “Automobile Accident Benefits Service” [AABS] procedure at the Licence Appeals Tribunal  LAT experienced with: -liquor licence issues -new home warranty claims -medical suspension of driver’s licences  How will LAT deal with SABS disputes?

3. Licence Appeals Tribunal  Process designed to move quickly -Case conference within 45 days -Hearings within 60 days of case conference  Expedited resolution process, but at the expense of justice?  No general rule for payment of costs or expenses

3. Licence Appeals Tribunal Strategies:  Push EVERYTHING POSSIBLE to the LAT  Challenge the rules and tear down the boundaries to beat the insurers at their own game  Be selective and conservative (but forceful) with expert reports and witnesses  Make insurers regret their successful lobbying efforts

4 – MIG Overhaul?

4. MIG Overhaul?  Expect replacement of Minor Injury Guideline with Common Traffic Impairment Guideline – implementation not yet announced / confirmed  Based on FSCO’s report Enabling Recovery from Common Traffic Injuries: A Focus on the Injured Person

4. MIG Overhaul?  Concept of “care pathways”  Concerns include significant funding restrictions, arbitrary timelines for recovery, and inclusion of mild TBI’s  No firm details as yet, and no implementation date

5 – Tort Changes

5. Tort Changes  Effective NOW (Since August 1, 2015)

5. Tort Changes Previously:  $30,000 deductible for primary claim (vanishes for claims > $100,000)  $15,000 deductible for FLA claims (vanishes for claims > $50,000)  No deductible for fatal accidents  Pre-judgment interest at 5% per year for pain and suffering damages

5. Tort Changes Now:  $36, deductible for primary claim (vanishes for claims > $123,106.99)  $18, deductible for FLA claims (vanishes for claims > $61,507.99)  No deductible for fatal accidents  Will be revised every January to account for inflation

5. Tort Changes Now:  Pre-judgment interest at pecuniary rate (~1.5%)

Questions?

More Cuts to Accident Benefits – Strategies for Survival Adam Little & Steven Smyth May 3,