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BKC News Bytes - Central Saskatchewan

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Sunday, 19 April 2020 23:33

No-Fault Insurance - Questions to ask your MLA Featured

No-Fault Insurance - Questions to ask your MLA	No-Fault Insurance - Questions to ask your MLA
motorcycle accidentFirst, No-Fault is not bad insurance.  It can, however, be administered badly. 
It really just cuts out your options for litigation and instead automatically approves you for things you'd normally seek litigation for...aside from any pain and suffering.

No-fault does not mean the fault is not assigned, it means that regardless of fault, you automatically receive a certain level of wage replacement (should you qualify after a 1 week waiting period) and injury insurance, to deal with injuries only, that kicks in immediately.  Your vehicle can be immediately fixed, or written off, with no waiting period. 

So generally all things you'd have been billed for "outside of" what provincial medicare covers, will automatically be picked up by your insurer.

If you need certain things in place to get home from the hospital, or while you recover if you have no hospital stay, you will be responsible for contacting the companies and getting quotes for your insurer...they will approve...and only then can the work be carried out to get you home.  For example a wheelchair rental, a lift rental if you have stairs, etc.

Once you are home your insurer will automatically arrange for a "caseworker for in-home assessments" to visit to see what else you need in your home, if anything.  If you live alone or have no one to assist you, they will determine the level of assistance you need and you'll be given monthly payment, determined by the insurance company, to pay for that care.  Be prepared for the amount you receive from insurance to be nowhere near the cost.  These are rates set by the insurance company, not by fair market value in your area.

Any "at-home devices" like bathtub chairs, special handles for things, basically anything you will need to aid in your recovery at home to help with things around the house...will need to be recommended by the "caseworker" when they visit.  They make arrangements to get you the items and insurance automatically looks after it.

Any physiotherapy needed is generally approved quickly and you are responsible for making your own arrangements from an approved list of companies in your area.  You make the appointments, your insurer handles the rest.

Financial compensation for any injuries, permanent disability from injuries that don't fall under "pain and suffering" or scars will generally occur at a minimum of 12 months after the accident, and only after being fully assessed by an approved Dr or injury assessment company.

It means that with no-fault, you are no longer financially compensated for any "pain and suffering".  You can only sue to access the "liability" insurance this is covered under, in extremely limited circumstances.

In cases of extreme trauma, PSTD, nerve damage, chronic pain or any of the "hidden damages you may suffer from" as a result of an accident,  you may be approved for therapy (to a point), but you will receive no financial compensation long-term.  After a certain point, you are simply "on your own".

Regardless of fault, you can have your vehicle fixed right away by "insurer approved" shops that deal directly with the insurer...not you.

No-Fault also acts like "WCB, or work benefit insurance, or life insurance" in that it is a one-size-fits-all approach.  This can bring problems if you know you'll never qualify for the benefits you're paying for at the "one-size-fits-all" price.  

Questions to ask you MLA and Minister / Government Department responsible for legislating no-fault insurance
1.  How will insurance companies be assigning fault in the case of multiple vehicle accidents?  Will adhere to who the police or RCMP decide is at-fault at the scene, or will they determine fault on their own relying solely on accident forms and notes?  

In Saskatchewan only SGI (our only private vehicle insurer) assigns fault and it is all done via the Traffic Safety Manual.  So if you rear-end someone...regardless of the circumstances...you are automatically at-fault.  

This is a crucial part to understand as it has the ability to affect other things such as the cost of your registration insurance, your personal driving record, and where the total costs of the accident will fall.  

Fault determines what "vehicle class pool" the accident costs are assigned to and that, in turn, determines rates for that class of vehicle.  

2.  One of the issues with No-Fault is with 2 vehicle accidents.  There is, or can be, a tendency of a higher ratio of 50/50 accidents where both parties are deemed equally at fault, meaning 2 deductibles are paid and the costs of the accident are kept in each respective vehicle pool.

How will this be tracked and addressed if it becomes an issue?

3.  If I'm not satisfied with how my claim is being handled, who do I appeal to?  I can't litigate, so where do I go for help?   

It is important that insurance companies are not a part of this process in that...they should never own it or be responsible for administering this.  They, like you, should be arms-length away from it so there is never a conflict of interest.  This should always reside with an independent 3rd party.
4. I'm self-employed and my insurer has determined I only qualify for wage replacement in an amount equal to EI.  How do I dispute this?  
5.  I'm retired and on full pension and will never qualify for wage replacement.  Is there a way for me to "opt-out" of this portion of insurance under no-fault as I should not have to pay for something I'll never qualify for?

6.  I've been seriously injured in the past and I am a "pre-existing condition" from head-to-toe when it comes to further disability payments for certain things like back injuries, knee injuries, shoulder injures, etc.  Is there a way for me to "opt-out" or to have "reduced" injury insurance under no-fault as I don't qualify and therefore should not have pay for something I'll never qualify for?

7.  I'm on permanent disability and therefore do not qualify for wage replacement, nor will I qualify for much of the injury insurance outside of what is already covered under provincial medicare.  Is there a way for me to "opt-out" or to have "reduced" wage replacement and injury insurance under no-fault as I don't fully qualify and therefore should not have pay for something I'll never qualify for?  

5.  Is it possible to keep, under no-fault, the basic wage replacement and injury insurance we currently have via provincial legislation?  Then for all the "extra insurance" that generally comes with no-fault to be handled via extra add-on packages that I can pick and choose from?  This way I know I'm not being forced to pay for coverage I'm paying for elsewhere, or will never qualify for.

6.  Is it possible for basic wage replacement and injury insurance to be tracked via our drivers' licenses instead of vehicle registration?  This way if I have 3 vehicles registered in my name, I'm only paying for wage replacement and injury insurance 1x, instead of 3x.  After all, I can't be injured in an accident with all 3 vehicles at the same time.   

In Alberta, we already must provide our insurer with a list of people we've approved to drive the vehicles registered in our name.  They would then be responsible for having basic wage replacement and injury insurance in place via their drivers' license, and the price they pay would be according to their driving record.  

This would keep vehicle registration itself very reasonable.  

Those with a higher risk for needing to use wage replacement and personal injury insurance would then pay for that risk themselves via their driver's licenses.

7.  Who will track "traffic safety" to ensure that trends causing insurance rates to rise are caught and addressed quickly?
Last modified on Friday, 24 April 2020 23:39

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