Car injury claims increasingly denied
Patients forced to wait up to a year for appeals to be heard
Mike Crawley, CBC News
Posted: Dec 30, 2011 8:30 AM ET
Last Updated: Dec 30, 2011 9:04 PM ET
Related
Related Links
External Links
(Note:CBC does not endorse and is not responsible for the content of external links.)
A Hamilton speech therapist says car insurance companies are increasingly rejecting her recommended treatments for people who’ve been hurt in accidents.
Deidre Sperry helps her clients recover from brain injuries. Those who have been hurt in car accidents represent 95 per cent of her client base.
Car insurance companies rejected five of Sperry's recommended treatment plans this year. She said that is more rejections than in her previous 11 years of practice combined.
"I have to be far more adversarial,” she told CBC News. “The treatment plans I'm asking for are only being partially approved when they are approved. There's more denials and I can't do the work in the way that I used to be able to do my work."
Sperry had one client who was hit by a driver who ran a red light.
She expected the man’s insurance company to pay for his entire rehab, but that did not happen.
“The treatment plans that were submitted for his physiotherapy, his occupational therapy and his speech therapy have all been declined,” she said. “He's a good guy. A wife, two kids in college, paying his taxes.”
“It seems they're trying to deny more and wear people down so they aren't going to fight back,” she said.
Rehab patients feeling like they're 'under the gun'
Now, she said, patients already struggling to get through rehab and return to work are made to feel like they are somehow trying to cheat the system.
"They feel like their integrity is being questioned,” she said. “It sets them up to being under the gun and they've already got a host of problems to live with."
Those who decide to fight back are facing a tougher battle than ever before.
All disputed insurance claims must first go to mediation but the average wait time for a hearing has swollen to nearly a year.
Adam Wagman, who represents the Ontario Trial Lawyers Association said the current backlog is "in the tens of thousands".
"If I were to apply for mediation today, my client might be able to have that mediation heard 10 or 11 months from now," he said. "By that point in time the physiotherapy treatment that's been recommended and rejected is almost useless."
Ontario's auditor general is calling on the province's insurance mediator to come up with a plan for reducing the wait time.
Share Tools
Latest Toronto News Headlines
- Rob Ford fired chief of staff for telling mayor to 'get help'
- CBC News has learned the details of what precipitated the firing of Mark Towhey as Toronto Mayor Rob Ford's chief of staff — and it was advice from Towhey that Ford needs to 'get help.' more »
- Giorgio Mammoliti faces questions over $5,000-a-table event
- Toronto councillor Giorgio Mammoliti is facing new allegations after CBC News learned he was involved in a $5,000-a-table fundraiser in Woodbridge last night. more »
- Human trafficking arrests made in Windsor

- Police in Windsor, Ont., have laid human trafficking charges for the first time. more »
- Texting during movie lands complainant in trouble
- A Toronto woman found herself in trouble with the police after repeatedly asking a man in a cinema to turn off his cellphone more »
Must Watch
Top News Headlines
- Greg Weston: Senate scandal may be Harper's worst hour
- The widening Senate scandal that the prime minister flippantly tried to dismiss as a 'distraction' just days ago has instead become arguably Stephen Harper's worst hour. more »
- Washington bridge collapse not Alberta trucker's fault, wife says
- The wife of the trucker implicated in Thursday's collapse of a bridge in Washington State that serves tens of thousands of commuters daily says her husband is not responsible for the incident. more »
- Canada ranks 3rd last in paid vacations
- Canada ranks third last among economically advanced countries in the amount of paid vacation time it guarantees its workers, a new U.S. study indicates. more »
- Hurricane numbers in 2013 season 'well above' average
- Canadian forecasters are warning warmer-than-average ocean waters and the lack of an El Nino warming of the central Pacific Ocean will contribute to an "active" hurricane season this year. more »
- Rob Ford fired chief of staff for telling mayor to 'get help'
- Rob Ford allies to publicly call on mayor to address drug-use allegations
- Alleged Ford crack video seller not responding to calls
- Toronto Mayor Rob Ford fires chief of staff
- Texting during movie lands complainant in trouble
- Giorgio Mammoliti faces questions over $5,000-a-table event
- 15 teens on school hiking trip found after night in wilderness
- Jimmy Kimmel, Jon Stewart crack jokes about Rob Ford
- Police recover purse of woman who died on subway
Toronto traffic with Joan Chang