Car insurance can Limit their Liability

Interesting ( Car insurance can Limit their Liability )
** I wonder will Inspectors be able to soon limit their liability ???**

Back to Roseman: Car insurance climbs in Ontario after benefits slashed **Roseman: Car insurance climbs in Ontario after benefits slashed **

October 18, 2011
Ellen Roseman

In just one second, your life can be turned upside down by a motor vehicle accident.
Whether you’re driving, cycling or walking, you’re a heartbeat away from a serious injury and a fight with an insurer to cover your medical treatments.
You probably don’t realize how little you get in statutory accident benefits under your auto insurance policy.
Ontario has a $1 million limit on medical and rehabilitation claims for those with catastrophic injuries. But they make up only one per cent of the 65,000 Ontarians injured in car accidents each year.
Almost 20 per cent of accident victims have severe noncatastrophic injuries. Their benefits are capped at $50,000, down from $100,000 before the reforms came in.
The remaining 80 per cent of accident victims with so-called minor injuries — such as whiplash, strains and sprains — get only $3,500 in medical benefits (down from $100,000 before).
Ontario’s car insurance reforms, forcing you to pay more for less coverage, didn’t become a high-profile issue in the last election. That’s a shame.
In a column on Oct. 5, I said the Ontario government had betrayed the trust of motorists and failed to protect them from inflated insurance costs. This drew widespread support from readers.
Some said I had underplayed the minor injury changes and their major effect on the out-of-pocket costs of accident victims.
“For those put into the minor injury guideline (the MiG), we now have the worst benefits system in North America,” said Stanley Pasternak, an injury and insurance lawyer.
“There is no real lobby for the best interests of injured people. No one really wants to hear from their lawyers. Yet the insurance company lobby is incredibly powerful.
“And since there are hundreds (or thousands) of motorist voters for every injured person voter, the government jumps when the insurance industry utters the words ‘premium increase.’”
With 80 per cent of victims placed in the minor injury guideline program, “the $50,000 in benefits is available to the very few,” said Darren Milne, a chiropractor who acts as a medical legal examiner for the insurance industry.
“You’re right this should be an election issue. The parties have focused on insurance costs by saying the changes will address fraud (which they do not) and therefore will reduce costs (which they have not).
“They should really be focusing more on insurer benefits.”
Liberal Premier Dalton McGuinty, now heading a minority government, may be asked to explain why motorists’ premiums are still climbing after accident benefits were slashed.
Ontario’s auto insurance rates went up by an average 3.05 per cent in the third quarter of this year, the Financial Services Commission of Ontario said in an Oct. 17 release.
Standard accident benefits went up 4.6 per cent during the quarter — the largest increase of any type of coverage, FSCO added.
“This is suspect and needs to be investigated,” says Nick Gurevich, head of the Alliance of Community Medical and Rehabilitation Providers.
Ontario’s $3,500 cap on minor injury benefits is the lowest of all provinces, he points out. Victims get up to only $2,200 at first and have to apply again to get the full $3,500.
About 70 per cent of his group’s clients require more than $2,200 in benefits for minor injuries, Gurevich said. But 40 per cent of them are turned down when they reapply.
I also heard from accident victims, including a couple who spent weeks in the hospital recovering from a motorcycle accident.
After buying optional coverage to boost their accident benefits to $100,000 each, they ran through the money long before the year was over.
“We needed the assistance of physiotherapists, occupational therapists, massage, pool facilities, gym, to name a few,” the wife said.
“The accident changed our lives forever in the blink of an eye. Everyone thinks it will never happen to them, but we are proof that it does.”
Only 1.3 per cent of motorists pay for extra benefits. Now you know how little you get if you’re injured, it’s time to call your insurance provider to ask about boosting your coverage.
Ellen Roseman writes about personal finance and consumer issues. You can reach her at

Car Insurance companies can have limited liability ,why not Home Inspectors too.

Insurance Companies are not our friend

[size=3]By Alan Shanoff ,Toronto Sun First posted: Saturday, January 07, 2012 05:27 PM EST
While the insurance industry has loudly proclaimed the pervasiveness of insurance fraud, it has been quietly leading a battle to deny benefits to the most seriously injured car accident victims.
That battle is being waged over the definition of catastrophic impairment.
Accident victims in this category are entitled to enhanced medical and rehabilitation accident benefits of up to $1 million.
As of September 2010, those seriously but not catastrophically impaired are entitled to reimbursement of medical and rehabilitation benefits to a maximum of only $50,000 (although this can be doubled to $100,000 for an additional premium).
Prior to September 2010, the limit was $100,000.
But none of this money goes into the pockets of accident victims; the money is to be used solely for reasonable and necessary expenses.
Robert Kusnierz was injured in a 2001 car accident resulting in significant injuries. His left leg was amputated below the knee.
Due to cysts and deterioration of the stump, he often uses a walker or wheelchair rather than a prosthesis.
He has had 10 different prostheses. Even with them, he can walk well only on flat surfaces.
He suffers from headaches and pain in his shoulders, neck, back, hips, knees and right ankle.
He lost his job and suffers from “severe” psychological symptoms, likely meeting the diagnostic criteria for a major chronic depressive disorder.
Not surprisingly with such significant injuries, Kusnierz exhausted his $100,000 medical and rehabilitation limit as of late 2005.
That’s because prostheses, wheelchairs, assistance devices, attendant care, housekeeping services, medication expenses, home modifications and other costs all come out of the accident benefit limits.
It’s easy to exhaust them, particularly in cases of serious but not catastrophic impairment.
You’d be hard pressed to find many people to argue Kusnierz’s injuries don’t constitute catastrophic impairment.
Even his insurer, The Economical Mutual Insurance Company, agreed if his physical and psychological injuries were combined, Kusnierz would have satisfied the definition of catastrophic impairment.
Didn’t meet definition
But ignoring years of precedent, his insurer argued combining physical injuries with psychological injuries is not permitted in making a catastrophic impairment designation, and neither the physical injuries nor the psychological injuries alone satisfied the definition of catastrophic impairment.
In late 2010, Justice P.D. Lauwers of the Ontario Superior Court accepted that argument, ruling in favour of the insurer.
Kusnierz launched an appeal to the Ontario Court of Appeal.
The Insurance Bureau of Canada (IBC), the national industry association representing Canada’s home, car and business insurers, intervened in the appeal, trying to uphold the pro-insurance decision.
It’s hard to overestimate the parsimonious nature of such conduct since there are very few cases where physical or psychological impairments would not be considered catastrophic when assessed separately, but would be considered catastrophic when combined.
Happily for Kusnierz, the Court of Appeal’s decision, released in late December, reversed the lower court ruling, concluding that allowing physical and psychological injuries to be combined in making a catastrophic impairment assessment “promotes fairness and the objectives of the statutory scheme.”
But the battle isn’t over.
The Ontario government is sitting on a report by a panel of experts to the Financial Services Commission of Ontario. FSCO is responsible for the regulation of car insurance in Ontario.
This report, prepared by a group comprised of eight members, two of whom have been consultants to the IBC and two of whom have received research grants from the insurance industry, argues against combining physical and psychological impairment.
These experts argue there isn’t “sufficient evidence that combined impairment ratings are more clinically meaningful than using separate criteria.”
Try telling that to Robert Kusnierz.