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Minor injury definition must be crafted right if implemented, consultant tells insurance inquiry

Viivi Riis, an Ontario physiotherapist with expertise as an injury claims consultant, presented a report before the Public Utilities Board Wednesday as part of its review of the automobile insurance system in Newfoundland and Labrador.
Viivi Riis, an Ontario physiotherapist with expertise as an injury claims consultant, presented a report before the Public Utilities Board Wednesday as part of its review of the automobile insurance system in Newfoundland and Labrador. - Glen Whiffen

If the Newfoundland and Labrador government were to agree with the Insurance Bureau of Canada (IBC) and impose a form of compensation cap for residents of the province who sustain minor injuries in an automobile accident, the definition of “minor injuries” must be carefully composed, an Ontario-based physiotherapist says.

Viivi Riis, the owner of Health Service Management, was retained as a consultant by the IBC to present a report to the Public Utility Board (PUB) as part of the PUB’s review of the automobile insurance system in Newfoundland and Labrador.

Riis told public hearings Wednesday that a minor injury definition must include a mechanism to enable compensation for injury effects that are in excess of a cap.

She said that possibility is provided for in IBC’s proposal.

IBC has proposed that Newfoundland and Labrador impose a $5,000 cap, plus other reforms it says will provide accident victims faster access to health care and a quicker recovery.

“The definition needs to be accurate enough so it doesn’t capture people who have significant injuries. For example, there needs to be no question that if you had a fracture, a dislocation or nerve damage, you should not be captured by the definition,” Riis said.

“And so, I think, that’s where care has to be taken in crafting the language around that definition so it doesn’t capture people who obviously have more significant injuries.”

Riis said the PUB is faced with the task of bringing together the needs of injured persons for effective health care and appropriate compensation, and the need of drivers to have affordable auto insurance.

She said she has worked with the public, governments, insurers and health providers in a variety of jurisdictions that have implemented a minor-injury compensation cap and medical/rehabilitation treatment protocols. Riis, who has been a physiotherapist since 1979, has also in the past been engaged in the introduction of minor injury definitions and/or evidence-based protocols in Alberta, Nova Scotia, New Brunswick and Ontario.

She said IBC’s proposal is aimed at limiting the pain and suffering amounts paid for victims with injuries that do not lead to prolonged disability or loss of function.

“In other words, compensation for pain and suffering would continue, but at a level that is commensurate with the impact of the injury on the injured person’s ability to function,” Riis says in her report.

“For those whose minor injury goes on to evolve to a serious impairment with disability, the proposed definition preserves the right to seek pain and suffering compensation in excess of the cap. Evidence-based diagnostic and treatment protocols have been shown to improve health outcomes and lower overall claim costs. It is my experience that, if implemented well, reforms as recommended can improve the working relationship between insurers and health professionals which in turn will improve the experience and health outcomes of injured persons in need of treatment.”

Lawyers representing victims of automobile accidents disagree with the IBC’s proposal and say accident victims will lose their right to sue for fair compensation if a compensation cap is imposed.

The lawyers argue compensation caps imposed in other provinces have not improved the insurance system, or reduced insurance rates, but have negatively affected automobile accident victims.

The PUB has been tasked to look into the reasons behind increasing claims costs for private passenger vehicles and taxi operators, and options to reduce these costs.

The board was asked by the provincial government to examine the impact on rates and implications for claimants of introducing a monetary cap on claims for minor injuries or of continuing with the current deductible of $2,500, or increasing the deductible.

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