The lawyers at Aaron Waxman & Associates are experienced with Disability, Personal Injury and Employment claims.
Being involved in a car accident is a traumatic experience.
One of the key points to recovering from a car accident is rehabilitation which includes access to various therapies including massage, physiotherapy, social work and counselling. But, a car accident also affects you in terms of your housekeeping and home maintenance duties as well as your ability to take care of yourself. And of course, a car accident can affect your ability to work.
This is why you have Accident Benefits Insurance. Ideally, if your insurer is paying your benefits, you are receiving medical and rehabilitation benefits, a housekeeping benefit, attendant care benefit and an income replacement benefit.
But what happens when your insurer is denying your benefits?
More and more accident victims are finding that their treatments are being denied by their insurers. If you think about the helpful effects of physiotherapy, counselling, massage and then suddenly having your treatment denied and knowing you can’t proceed with treatment. It has a detrimental effect on accident victims.
In terms of housekeeping and attendant care, accident victims are paying service providers for these services. What happens when the payments stop coming in?
What happens when income replacement cheques stop?
Think of the long-term effects these denials have on accident victims.
Then consider the situation at FSCO (Financial Services Commission of Ontario) with respect to mediation backlogs.
When benefits are denied, accident victims can appeal the denial by filing an Application for Mediation with FSCO. It used to be a 60 day wait before accident victims would find out when their appeals for denied claims would be heard. Now, it can take up to a year before the claimant receives an acknowledgement letter and is able to schedule the mediation time itself.
The backlog of cases is out of hand. FSCO is now looking outside for help, and is asking for proposals seeking assistance from private “alternative dispute resolution” firms.
A recent article in the Toronto Star outlines the situation at FSCO and the effect it has been having on accident victims.
It is noteworthy that the article makes reference to Auditor General Jim McCarter’s annual report for 2011, “FSCO’s mediation service is backlogged to the point that resolution of disputes between claimants and insurers is taking 10 to 12 months, rather than the legislated 60 days.”
Remember, during this waiting period, accident victims, our clients are going without their benefits. This is causing undue financial hardship. But beyond that, this stalls their medical recovery. Starting and stopping treatment is not the way to achieve maximum medical recovery. Especially in chronic pain cases.
Quite simply, FSCO has seen an unprecedented increase in mediation applications over the past couple of years, probably more so since the September 1, 2010 automobile insurance changes and the introduction of the Minor Injury Guideline.
Aaron Waxman and Associates is a Personal Injury Law Firm that handles car accident claims and personal injury claims.
* This blog is for informational purposes only and is not meant to substitute legal advice. Please read our disclaimer for further information.
* All of our lawyers are licensed by The Law Society of Upper Canada
* Office in Toronto and able to represent people in the province of Ontario