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Writing Sample- Changes to the Insurance Act jeopardize recovery of brain injury survivors

Writing Sample- Changes to the Insurance Act jeopardize recovery of brain injury survivors

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Published by Sybil Edmonds
This article was researched and written by Sybil Edmonds. It appeared in the Winter 2010 edition of the BIST Beacon, as well as on the website of Thomson Rogers, one of the top personal injury law firms in Canada.
This article was researched and written by Sybil Edmonds. It appeared in the Winter 2010 edition of the BIST Beacon, as well as on the website of Thomson Rogers, one of the top personal injury law firms in Canada.

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Published by: Sybil Edmonds on Jul 27, 2011
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January 27, 2010 Sybil Edmonds1
Changes to the Insurance Act jeopardize recovery of brain injury survivors
The Minister of Finance in Ontario has recommended changes to the InsuranceAct of Ontario, which will negatively affect people living with acquired brain injuries(ABI), according to care providers familiar with the changes.In March 2009, the Financial Services Commission of Ontario (FSCO) gave itsrecommendations to the provincial government for changes to auto insurance policies,which happens every five years. Some of the most notable changes include: reducing themedical and rehabilitation limit from $100,000 to $50,000; including medicalassessments within the $50,000, which was previously a separate expense category; andreducing attendant care benefits by 50%, to $36,000. These changes had been under review since March, and were re-confirmed by the Minister of Finance in late October 2009.Ontario is known for having the most beneficial auto insurance policies inCanada. According to Colleen Boyce, the Executive Director of the NeurologicRehabilitation Institute of Ontario (NRIO), insurance companies felt that they were beingtaken advantage of for years, and were blaming rehabilitation companies for spending toomuch money.As a result, FSCO's initial recommendations drastically reduced the amount of money available to survivors of non-catastrophic brain-injuries. Care providers andfamily members of ABI survivors were most concerned with the reduction of fundsavailable for medical expenses and rehabilitation, which was initially cut down from$100,000 to $25,000.
 
January 27, 2010 Sybil Edmonds2Providers involved in the care of ABI survivors found the changes shocking. ³Wewere caught with our pants down,´ says Boyce. ³Where were we?´In response to the recommendations, 63 professional health care associations,such as physiotherapy and occupation therapy providers, joined together in protest. TheAlliance of Community Medical and Rehabilitation Providers was formed with the goalof convincing the Minister of Finance to review, and potentially change, therecommendations.The difficult part of the lobbying process for the Alliance lay in the fact that aconsultation period had already taken place several months before. ³As rehabilitationcompanies, we were not proactive in being part of the consultation process,´ says Boyce.They had assumed that the recommendations to the government would be in the bestinterest of rehabilitation companies, but that turned out not to be the case, according toBoyce.All members of the Alliance contributed money so that public relations companiesand lobbyists could be hired to fight on behalf of the rehabilitation companies. A major concern for both the government and the Alliance was that holding back insurance moneyfrom an ABI survivor at the beginning of the rehabilitation process meant increased needfor other government services in the future, such as additional medical care and disability benefits. The message the Alliance tried to send to the government was, ³if there is no private money, ABI survivors have to fall back on the public sector,´ says Boyce.The Alliance's efforts were successful in getting the Minister of Finance toreconsider the changes, and the publication of the recommended changes was delayedfrom June until the end of October 2009. The biggest change that came as a result of the
 
January 27, 2010 Sybil Edmonds3Alliance's lobbying was that the maximum medical and rehabilitation payout was raisedfrom $25,000 to $50,000 for those suffering from non-catastrophic brain injuries.However, even the current maximum of $100,000 is not enough for non-catastrophic ABI patients, says Boyce.Cheryl Jardine, an occupational therapist with the NRIO, agrees with Boyce'sconcerns. ³There is a clear clinical pathway for non-brain injured people, but braininjuries are more difficult to measure,´ she says. People with severe brain injuries, butwho have either just missed the cutoff or who have not yet been designated catastrophic,are the most affected by the proposed changes to the Insurance Act.It can take two to three years to be designated catastrophic, which would allowthe patient access to $1,000,000 for medical and rehabilitation costs. Adjusting treatment plans for non-catastrophic, yet severely injured people who have access to only $50,000,will be very difficult. Jardine says that intensive rehabilitation is most effective soon after an accident. ³They need care, and they burn through the money quickly. If they don't getthe [catastrophic] designation, the money has been used up,´ says Jardine. If the money iscut off, rehabilitation gains will be compromised, Jardine says.A major problem with the reduction in the amount of money available is thenumber of areas ABI survivors need the money for. With the government's plan to reduce benefit payouts by from $100,000 to $50,000, that money will still need to cover the costsof therapy- such as occupational therapy, physiotherapy, psychology, and speech therapy-as well as private tutors to get back to school, gym memberships, and homemodifications, such as installing railings, ramps, bath chairs, and safety equipment.

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