Marshall.Benefits

Question 1

Identify the 2 component benefits of Ontario’s mandatory auto insurance system.

Answer 1

1. No fault (accident benefits): provides benefits regardless of fault
2. Tort (bodily injury): allows you to sue the at-fault driver

Question 2

True or False?

Ontario component benefits are fair and are delivered fairly.

Answer 2

These benefits are fair, but are not delivered fairly.

Question 3

Identify the 4 causes of unfair delivery of auto insurance benefits in Ontario.
(Hint = E-CLV)

Answer 3

1. Cost control at the expense of care
   - insurers emphasize cost control instead of care
   - but then victims don’t 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

Question 4

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

Answer 4

1. Structural flaws
2. Catastrophic injuries
3. Lawyers
4. Care not ca$h
5. Smart regulation

Question 5

Explain the action item: STRUCTURAL FLAWS

Answer 5

Fix structural flaws by appointing an arms-length regulator with powers to enact policies & procedures

Question 6

Explain the action item: CATASTROPHIC INJURIES

Answer 6

Change compensation system for catastrophic injuries because lawyers are taking too big a chunk

Question 7

Explain the action item: CARE NOT CASH

Answer 7

Focus on timely, appropriate medical care, not cash payouts

Question 8

Explain the action item: LAWYERS

Answer 8

Make contingency fees transparent (and simplify benefits so there is less need to hire lawyers)

Question 9

Explain the action item: SMART REGULATION

Answer 9

Allow insurers more regulatory freedom to compete on price & service

Question 10

What is the ‘opportunity gap’ in Ontario auto insurance?

Answer 10

There is an OPPORTUNITY for Ontario auto premiums to be much lower without impacting quality

Question 11

What is the ‘value gap’ in Ontario auto insurance?

Answer 11

The VALUE of medical care could be better if there were more focus on active medical management.
or
ON system focuses on cash settlement instead of active medical care to help the injureds back to pre‐accident life