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    Making room for the river

    November 19, 2015 by

    After the water receded, things settled down and Alberta politicians began the task of looking at how to prevent a repeat of the 2013 floods, one of the policy tools to emerge was use of voluntary buyouts for those located…

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    insBlogs Auto

    Random Thoughts: Emotions

    November 16, 2015 by

    Hard to get back to “normal” blogging after seeing the news from Paris over the weekend, so just short today. Thanks to Jean Jullien (@jean_jullien on Twitter) for putting out the image on the left to the public domain. My thoughts go out to the Continue reading

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    insBlogs Auto Legal Legislation / Regulation

    ONCA: No Laches in Loss Transfer

    November 12, 2015 by

    The Ontario Court of Appeal has released a long-awaited decision on whether the equitable doctrine of laches applies to loss transfer matters. The Court held that there is no laches in loss transfer. The doctrine of laches issue arises when…

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    Redefining Boundaries: The Global C-Suite Study

    November 9, 2015 by

    My colleagues in the IBM Institute for Business Value have been hard at work over the past few months, analyzing the responses of more than 5,200 interviews with C-Suite executives in 21 industries and more than 70 countries globally on the threats and opportunities facing Continue reading

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    insBlogs Auto Legal

    Birthday Party Fall from Fire Truck not an “accident”

    November 6, 2015 by

    A FSCO arbitrator has ruled that a child who fell off a fire truck at a birthday party was not involved in an automobile “accident”. In Carr v. TD, the five-year-old claimant was attending a birthday party for a classmate…

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    FSCO Mandate Review Undecided on Auto Rate Regulation

    November 5, 2015 by

    The preliminary report by Panel reviewing the mandate of the Financial Services Commission of Ontario (FSCO) and the Deposit Insurance Corporation of Ontario (DICO) has been made public by the Ministry of Finance.  Panel members are George Cooke, …

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    insBlogs Technology

    Digital Wallets and the Mobile Consumer

    October 29, 2015 by

    According to a 2015 Forrester Research survey, 16% of Canadians are interested in or are already using digital wallets, with many using them for financial information like bank account or credit card information. This trend has such momentum that American…

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    Rough road may await Ontario auto insurers

    October 19, 2015 by

    It is fair to say that the profitability of many Canadian insurers is largely influenced by their Ontario automobile results. With this in mind, the industry may be in for a rough ride. Ontario automobile, so often the Canadian property…

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    Ontario Rate Approvals Fall in the Third Quarter

    October 16, 2015 by

    FSCO approved 45 private passenger automobile insurance rate filings during the third quarter of 2015.  A total of 40 insurers submitted the filings.  These 40 insurers represent 77.45 percent of the market based on premium volume.  Appr…

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    insBlogs Business Strategy Technology

    New Work: Stairway to Heaven or Race to the Bottom?

    October 15, 2015 by

    Back in June, I confessed that, as a technology professional, I had been ‘economical’ with the truth about the impact new technology would have on employees. Some analysts suggest we are finding a path to a better future, but others…

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    insBlogs Catastrophe

    Random Thoughts: Blood Moons

    September 28, 2015 by

    Today’s thoughts are even more random [1] than usual. I didn’t see much of the actual eclipse, unfortunately – here in Europe, full eclipse was around 4:30 a.m. or so, so when I got up at 6 you could only see a bit of Earth Continue reading

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    insBlogs Association Professional Development

    The CIP: Celebrating Achievement

    September 23, 2015 by

    Fall Convocation is one of my favourite times of the year. Soon I will be attending the graduation ceremonies of local Insurance Institutes across the country, congratulating many of the 1,000 people each year who receive their Chartered Insurance Professional…

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    Fad or Future: An Introduction to Blockchain Technology

    September 21, 2015 by

    Since 2009, Bitcoin has been a reliable source of headlines and controversy – and it’s easy to see why. The digital currency (or cryptocurrency) is both entirely unregulated and incredibly powerful, making it possible for businesses and individuals around the…

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  • insBlogs Auto Collision Repair

    FSCO Prepared to Introduce New Minor Injury Protocols

    September 18, 2015 by
    Why is FSCO releasing new treatment protocols?

    In the Superintendent’s report on the Five Year Review released in 2009, a recommendation was made to develop a treatment protocol for minor injuries that reflects current scientific and medical literature.  This recommendation was accepted by the government and confirmed in the 2012 Ontario Budget, which acknowledged that newer scientific and evidence-based approaches can be applied to the treatment of minor injuries resulting from automobile accidents.

    How were the new treatment protocols developed?

    In 2012, Dr. Pierre Côté, Associate Professor, Faculty of Health Sciences, University of Ontario Institute of Technology, was awarded a consulting contract to develop the Minor Injury Treatment Protocol (MITP) after an open competitive Request For Proposal process.

    The Ontario Protocol for Traffic Injury Management Collaboration includes a multidisciplinary team of expert clinicians (from medical, dental, physiotherapy, chiropractic, psychological, occupational therapy and nursing disciplines), academics and scientists (epidemiologists, clinical epidemiologists and health economists), a patient liaison, a consumer advocate, a retired judge and automobile insurance industry experts.  I played a small role on the project team.

    Over the 2-year course of the project, the project team drew upon three sources of information concerning traffic injury rehabilitation.

    1.    The team critically reviewed the contents and evidentiary basis of published clinical practice guidelines for the management of traffic injuries.

    2.    They carried out an exhaustive search followed by a rigorous methodological evaluation of the current scientific literature concerning the management of traffic injuries published in peer-reviewed journals in the English language. They screened 234,995 abstracts and conducted in depth reviews of 597 scientific papers. This effort was summarized in 43 new systematic reviews of the literature.

    3.    They also conducted a new study in which they gathered and carefully considered the narratives of Ontarians who have sustained injuries in traffic collisions and received health care.

    The Final Report of the Minor Injury Treatment Protocol Project, titled “Enabling Recovery from Common Traffic Injuries: A Focus on the InjuredPerson” (Final Report) was delivered to FSCO at the end of December 2014

    What does the Final Report recommend?

    The Final Report recommends a new classification of traffic injuries. The natural history of the initial injury is the basis for classification. A Type I injury is likely to recover within days to a few months of the collision; but during the period of recovery the patient may benefit from education, advice, reassurance and time-limited evidence-based clinical care. Type I injuries are the focus of this report. A Type II injury is not likely to undergo spontaneous recovery, and the injured person may require medical, surgical and/or psychiatric/psychological care. Type III injuries are a subset of Type II injuries, that involve permanent catastrophic impairment or disability. The care for Type II and Type III injuries is not covered in this report.

    Persons with Type I injuries should be educated and reassured from the outset that their own inherent healing capacities are likely to lead to a substantial recovery. They should also be informed that only a discrete set of treatments show evidence of any benefit; and that the same evidence shows that benefit is largely on the basis of pain alleviation. Healthcare professionals need to listen to the patient’s concerns and emphasize measures to assist them to cope, recognize and avoid complications.

    The MITP includes clinical prediction rules to screen for patients who may be at higher risk for developing chronic pain and disability. In addition, it focuses on treatment outcomes, and provides health care providers with numerous milestones to measure progress.

    Interventions for Type I injuries should only be provided in accordance with published evidence for effectiveness, including parameters of dosage, duration, and frequency; and within the most appropriate phase. The emphasis during the early phase (0-3 months) should be on education, advice, reassurance, activity and encouragement. Health care professionals should be reassured and encouraged to consider watchful waiting and clinical monitoring as evidence-based therapeutic options during the acute phase. For injured persons requiring therapy, time-limited and evidence-based intervention(s) should be implemented on a shared decision-making basis, an approach that equally applies to patients in the persistent phase (4-6 months).

    Sixteen care pathways have been developed to cover the clinical management of:

    ·         Neck pain and associated disorders

    ·         Soft tissue disorders of the upper extremities

    ·         Temporomandibular disorders

    ·         Mild traumatic brain injuries

    ·         Low back pain

    What’s next?

    FSCO had been conducting a consultation process with stakeholders.  Before any final guidelines can be implemented, the government will need to make changes to the Statutory Accident Benefits Schedule. 

    The complexity of the proposed changes will require a substantial educational initiative.  Clinicians and insurance company claims staff will need to be educated and trained on the recommended care pathways.  In some cases there may be resistance.  In addition, it is advisable that a public education campaign be undertaken to educate the general public on the proper management of soft tissue injuries.  It is not clear who would fund such a significant education campaign.  

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