COVID-19 Update: How We Are Serving and Protecting Our Clients

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Tone Deaf Insurance Companies Not Helping Curb COVID

The majority of insurance adjusters I have spoken to during the COVID Pandemic are all working remotely from home. I know this because I speak with, or correspond with insurance adjusters every day. It goes with the territory being a personal injury lawyer.

In phone calls, or Zoom calls I can see their children or pets whistling by. Their attention is divided between parenting, insurance adjusting, and surviving. And that’s ok. We’re all walking on egg shells and doing our very best to manage day by day during these difficult times.

The fact that so many insurance adjusters are working remotely from home tells me something. The insurance companies respect the Stay At Home Orders and warnings from the Government and medical officers across the land.

It also sends a message that these insurance companies care about protecting their employees from COVID. Having hundreds of employees work from their offices, cubicles or in a call centre isn’t ideal towards curbing the spread of COVID. Allowing their employees to work for home is a strong signal that they care about the health and well being of their work force.

It’s unfortunate this same degree of care, understanding and compassion which the insurance industry has shown to their employees hasn’t trickled down to its customers.

What do I mean by that?

There are hundreds of thousands of accident victims across Ontario who have accident benefit claims after a serious (or not so serious car accident).

The majority of these accident victims have their own insurance coverage through their own insurer.

The way the law works in Ontario is such that an injured accident victim needs to make an accident benefit claim with his/her own car insurer.

This creates a very confrontational relationship between a customer and his or her own insurance company. The customer will request benefits. Their own insurance company will pay for some benefits; but will enviably deny most benefits; even on a good day.

When benefits get denied the insurance company is required to provide a clear reason for the denial, and set up an insurance examination (IE).

These IEs are not billed through OHIP. The insurance companies pay for these IEs themselves, from the very premiums that you have paid them.linkedin-2-300x300

And during the Pandemic, these IEs have NOT stopped; and continue to run in person. Even when COVID numbers are at their highest, and ICU capacity is being pushed to their limits; the in person IEs continue to run.

Insurance companies are so instant on in person IEs during the Pandemic, that they will even pay for the transportation bill just to get a claimant to attend the IE.

One client of ours resides in a very remote part of the Province. The insurance company not only insisted on an in person IE, but offered to pay for the 4 hour round trip taxi ride to and from the assessment centre.

If the insurance industry is giving a pass to their employees on in person attendance at work; then why aren’t they permitting for the same practice to apply to their own customers when it comes to Insurance Examinations?

These IEs can be done remotely; just as treatment is being done remotely across the province. Treatment providers have found a way to pivot to make things work. It’s unfortunate that the insurance industry not only hasn’t pivoted, but also can play a game of Pandemic COVID roulette with the health and safety of their customers seeking benefits.

What happens if a claimant fails to attend in person? Benefits will likely be terminated for non-compliance. The Claimant can challenge all of this at the License Appeals Tribunal (LAT); which entails a $100 filing fee and a long wait for a resolution (months down the line if you’re lucky). At least by attending, benefits won’t get terminated for being non-compliant; or you may contract COVID from spending time in a taxi with a stranger; and then attending at an assessment centre with some more strangers who will put on their best hygiene theatre performance you have ever seen. Do you really think a bit of plexiglass is going to stop COVID? I wish it were that easy.

Here’s another great example of how Insurers aren’t curbing the stop of COVID. Some insurers (not all mind you) are insisting on original signatures for Releases and Settlement Disclosure Notices. They will NOT accept e-signatures. No DocuSign. No SignNow. No Adobe signature products. They won’t even accept copies with an Affidavit attesting to the veracity of the signature which accompanies the documents for signature. They want originals along with original witness signatures as well. You know what that means don’t you. It means they are forcing people to congregate together in order to execute documents to get those original signatures.

There is a better way; which some (not all) insurers are refusing to accept. It’s really difficult when dealing with a seriously disabled, seriously injured or elderly Plaintiff. It gets even trickier dealing with a Plaintiff who has some serious pre-existing health issues which COVID loves to attack. You are asking these people to get together with other people to get a document executed; thereby putting them at risk. Why?

I am convinced this is being done to delay matters, and to make things more difficult for innocent accident victims.  Do you seriously think any insurance company would treat its employees the same way and make these demands of their very own? Do you think they would make such demands of their executives, CEOs or CFOs? No chance! But put that burden and risk on their own customers and accident victims seeking benefits? Why not!

This only reinforces the power imbalance between insurer and claimant. We tell our clients that the insurance company has something they want (their money and their benefits). In most cases in order to get those benefits; accident victims are required to jump through a few hoops. Who would have known before the Pandemic that these hoops which accident victims need to jump through are hazardous to their health.


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