Marshall.Benefits

Question 1

what are the 2 component benefits on ON’s mandatory auto insurance systems?

Answer 1

• no fault: AB, provides benefits regardless of fault
• tort: BI, allows you to sue the at fault driver

Question 2

which is true for ON auto insurance?
- benefits are fair
- benefits are delivered fairly

Answer 2

benefits are fair, but not delivered fairly

Question 3

what are the 4 causes of unfair delivery of ON auto insurance benefits?

Answer 3

CLEV
- Cost control at expense of care
- Lawyer: lawyer’s contingency fees are a % of settlement so lawyers seek for higher settlements not better care for victims
- Entitlement: victims seek to maximize entitlement vs. addressing their needs
- Volume: providers are paid on volume of treatments, not results

Question 4

identify the action items on ON’s 5 part action plan for addressing the unfair delivery of benefits

Answer 4

SCIL$S “SKILLS”
- Structural flaws: fix structural flaws by appointment an arms length (act independent of each other) regulator with powers to enact policies and procedures
- Cat Injuries: change compensation system for CAT injuries because lawyers are taking a big chunk
- Lawyers: make contingency fees transparent, and simplify benefits so there’s less need to hire lawyers
- care not ca$h: focus on timely, appropriate medical care, not cash payouts
- Smart regulation: allow insurers more regulatory freedom to compete on price and service

Question 5

what is the ‘opportunity gap’ in ON auto insurance?

Answer 5

there is an opportunity for ON auto premiums to be much lower without impacting quality

Question 6

what is the ‘value gap’ in ON auto insurance?

Answer 6

the value of medical care could be better if there were more focus on active medical management