Automobile Insurance Review

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Brent McGee
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1 c C6-16 Automobile Insurance Review \.,~. '\ Report to the Honourable Andrew Petter Minister of Finance and Corporate Relations, and Minister Responsible for the Insurance Corporation of British Columbia

2 Letter of Transmittal March /997 This report follows from a mandate given to me on December 6, 1996 by the Honourable Andrew Petter, Minister of Finance and Corporate Relations, and Minister Responsible for the Insurance Corporation of British Columbia. The Minister asked me [0 review auto insurance in the context of five principles: fairness, affordability, accident prevention, fraud prevention and service improvement. To assist in the review, I was asked to consult with interested parties and consider the views of outside experts and literature on the subject. I was asked to file a report within approximately three months. This document is the product of that exercise. The Review Team did its utmost, in a relatively short period of time, to understand all aspects of auto insurance in British Columbia. We considered written submissions, oral presentations, telephone calls, literature, analysis and critique. The recommendations contained here are informed by what we heard and read from the many groups and individuals who gave so generously of their time to participate in the process. However, this report does not constitute a consensus among those from whom we heard, as this was not asked of us. These are our considered suggestions on possible improvements [0 auto insurance in British Columbia. They are designed [0 be forwardthinking and constitute what I feel is the best advice we can provide. Naturally, it is Government's responsibility [0 assess this advice and do what it thinks is best. We hope this report will contribute in some modest way to positive enhancements in this important area of public policy. \'. The report was written by the Review Team. Nonetheless, responsibility for its content is entirely mine, and for any deficiencies I take full responsibility. I am extremely grateful to my colleagues for their insight, support and dedication through the entire review process. Doug Allen Head of the Review Team Automobile Insurance Review

The Minister asked me [0 review auto insurance in the context of five principles: fairness, affordability, accident prevention, fraud prevention and service improvement.

3 Even with the most effective accident prevention measures, the unfortunate reality is that there will still be automobile accidents, and we will still need to meet the needs of victims. This will be most successful if our au[o insurance system encourages early intervention, quick recovery and a return to health. Such an approach is better for accident victims, and will reduce claims costs over time. Throughout our consultations, the Review Team heard from health care and rehabilitation providers who called for ICBC to do more to support the recovery of accident victims. There is an inherent conflict in all insurance systems between the injured claimant who is seeking compensation apd the insurer who is controlling payment of that compensation. IS In British Columbia, ICBC adjusters are expected to: ensure the needs for recovery are met and that their policies are not a barrier; and, ensure 'value for money' based on efficient and effective business practices. These are difficult objectives to balance, particularly since many claimants enter the system with no knowledge of the process or the benefits available to them. As a result, the needs of the claimant may not initially be voiced as strongly as they should. When there is conflict over benefits or a protracted settlement period, everyone loses-including our larger society, which suffers from lost productivity and larger costs to our health care system. Many submissions [0 the Review Team acknowledged that the treatment of well understood medical conditions is handled reasonably well by our auto insurance system, likely because the therapies and recovery rates tend to be fairly consistent. However, conditions that are less well understood tend to be problematic. Whiplash Associated Disorders (WAD) are a prominent example of this. In recent years, extensive research has been done into evaluating the results of therapeutic interventions in terms of their relative effectiveness in leading to recovery and restoration of function. This research is now having an impact on everyday medicine, where health care practitioners have realized that many traditional practices are either unproved or have failed [0 demonstrate benefit when subjected [0 the discipline of the clinicaltrial. A major study into Whiplash Associated Disorders was undertaken in Quebec during Among the findings of this study were the following: wide provincial variations in the occurrence and compensation of Whiplash Associated Disorders have more to do with systemic factors, such' as insurance claim structures, than they do with variations in accident rates; VII Issue Recovery From Personal Injury U Be (AaUtion of People with Disabilities Submission.. Sdentific Monograph of the Quebec Task Force on Whiplash-Associated Disorders, Dr.Walter Spitzer et 01,(Spine,April , Vol.20 #8S) Automobile Insurance Review 3

Such an approach is better for accident victims, and will reduce claims costs over time.

4 VII Recovery From Personal Injury activist, rather than protective approaches to recovery tend to speed up the return to normal activities; proactive intervention is important, with access to specialized multi-disciplinary visits early in the recovery process; health care providers should be compensated and encouraged to identify patients at risk of chronicity; and, more consistent standards in data reponing should be implemented to enhance future understanding of these disorders. Currently, 92 per cent of injuries dealt with by ICBC--59,500 per year-are temporary and non-permanent. Of these, 47,600 are classified as soft tissue injuries % Injuries :c Submission Automobile Insurance Review

chronicity; and, more consistent standards in data reponing should be implemented to enhance future understanding of these disorders.

5 VII Recovery From Personal Injury Possible Elements of a Recovery Model \'. \" Automobile Insurance Review 37

$a Recovery Model \'.$

6 VII Recovery From Personal Injury Soft tissue injuries have been the focus of much talk about fraudulent claims. ICBC estimates that 15 per cent of all bodily injury claims are fraudulent. 18 focusing on early recovery and outcome instead of compensation would be in a better position to make this distinction. The Review Team heard from claimants with conditions such as fibromyalgia, chronic pain syndrome and others not yet diagnosed, many of whom told us that they were accused by ICBC of committing fraud or of malingering, for no reason other than the fact that their recovery times were inconsistent. The difference between a fraudulent claim and a claimant with a condition that is difficult to diagnose may only be detected by a system set up to assess these differences. A system The KPMG report concluded that one of the primary factors in the growth of bodily injury claims has been increased future care costs. By focusing on outcomes and promoting quicker recovery, the system will thereby become more cost effective. -~'~ Resolution Our auto insurance system should introduce a new way of dealing with bodily injury claims-one that focuses on the recovery of the injured. r..\. Recommendation V Government should consider requiring ICBC to implement a comprehensive recovery model for the handling of bodily injury claims. \'. K estimated cost breakdown of claims dollars, 1996 Automobile Insurance Review

The Review Team heard from claimants with conditions such as fibromyalgia, chronic pain syndrome and others not yet diagnosed, many of whom told us that they were accused by ICBC of committing fraud

Response to the Auto Insurance Working Group s Report

Response to the Auto Insurance Working Group s Report Department of Justice and Attorney General June 2012 Table of Contents Background... 3 Response to Auto Insurance Working Group s Recommendations: