A - Marshall Flashcards

1
Q

MARSHALL

For ON auto insurance, benefits are fair but are not delivered fairly.

4 CAUSES of unfair delivery of auto insurance benefits in Ontario.

A
  1. COST CONTROL AT THE EXPENSE OF CARE
    • Insurers emphasize cost control instead of care
    • But then victims do not recover and final costs are higher not lower
  2. LAWYERS
    • Lawyers’ contingency fees are a percent of the settlement
    • So lawyers seek higher settlements, not better care for victims
  3. ENTITLEMENTS
    • Victims seek to maximize entitlements versus addressing own care needs
  4. VOLUME
    • Providers are paid on volume of treatment not results
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2
Q

MARSHALL

5 actions items in Ontario’s five-part ACTION PLAN for addressing the unfair delivery of benefits.

A
  1. STRUCTURAL FLAWS
    • Fix structural flaws by appointing an arms-length regulator with powers to enact policies and procedures
  2. CAT INJURIES
    • Change compensation system for cat injuries because lawyers are taking too big of a chunk
  3. CARE NOT CASH APPROACH
    • Focus on timely, appropriate medical care, not cash payouts
  4. LAWYERS
    • Make contingency fees transparent (and simplify benefits so there is less need to hire lawyers)
  5. SMART REGULATION
    • Allow insurers more regulatory freedom to compete on price and service
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3
Q

MARSHALL

What is the opportunity gap in Ontario Auto Insurance?

What is the value gap in ON Auto Insurance?

A
  • Opportunity for ON Auto Premium much higher than canadian avg. Could be much lower without impacting quality
  • The VALUE of medical care could be better if there were more focus on active medical management
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