Does private insurance fit with Canada’s health system?

The excerpted article was written by DIANA DUONG | The Province

Is paying out-of-pocket for medical care the answer to long wait times?

In Canada, private medical insurance does not exist. Our health care system does not allow paying with private health insurance for any hospital services that are “medically necessary.” It’s illegal for patients to pay out of pocket to skip a long waitlist for a surgery and physicians cannot accept payment from patients who want to see them sooner.

To be clear, we’re not talking about the private insurance that covers dental care, vision, or prescription drugs. Private medical insurance in Canada would aim to provide an alternative option to waitlists and providing faster and better options for currently covered elective procedures. In England, 10.5 percent of the population have private medical insurance while 44 percent of the population in Australia have purchased complementary coverage on top of their public system.

Canada’s model is designed to protect affordability. Healthcare is provided on the basis of need, rather than the ability to pay, states the Canada Health Care System website. A major concern is that if private insurance were introduced, high-income people will receive faster and better care than lower-income people. But with a growing aging population, not enough facilities to manage the elderly, and painfully lengthy waitlists, many wonder if it’s time to consider how private medical insurance could fit into our system.

Healthcare is provided on the basis of need, rather than the ability to pay

Conservative policy think tank Fraser Institute released a new study this week criticizing these objections. It compares the healthcare systems in several developed nations with universal health care coverage. But when Healthing spoke with study author Steven Globerman, he says this study doesn’t offer a prescription or proposal of how exactly Canada could introduce private insurance to our current model.

“It’s hard to say ‘here’s a specific model,’ because it varies from country to country,” he says. “Each country has its own differences and its own idiosyncrasies. If Canada is going to move along the path towards allowing private insurance, Canada needs to go slowly and carefully and adopt the changes and see which seem to work and which don’t. What works in Switzerland might not work in Canada.”

Indeed, if done wrong, it may have unintended consequences. A report from the Grattan Institute states that private hospitals in Australia are “less efficient than public hospitals.” The report found that “a handful of greedy doctors charging more than twice the Medicare Benefit Schedule fee account for the vast majority of out-of-pocket costs private patients pay.”

It also found that private hospital patients stay 9 per cent longer than public hospital patients with similar conditions, which it estimates costs about $1 billion each year.

When asked if services provided by private institutions should be subjected to the same rules and regulations as public institutions — and importantly, the same price or cheaper in order to protect affordability, Globerman said, “it doesn’t necessarily have to be the case.”

“You can have private insurance cost more than the tax dollar value of public insurance if people are willing to pay for it. That’s going to be determined by the marketplace,” he says. “If the government thinks that’s a monopoly price and it’s too high, then they can invoke some kind of regulation that might lower price.”

Globerman suggests adding private insurance can help get faster service, but it may result in a two-tier system.

“In a narrow sense, there would probably be a two-tier system,” he says. “Some people might get faster care or a wider selection of providers but everyone will have shorter wait times, including people who are strictly on the public insurance system and they’ll better off.”

But without a clear model ahead or a health system similar to Canada’s, it’s hard to definitively say that all parts of the population will be better off.

Car crash injury claims aren’t increasing, insurance can handle costs

Car crash injury claims aren’t increasing, insurance can handle costs

LAUREN BOOTHBY

Edmonton Journal

An Alberta group advocating for fair auto insurance is out with a new report challenging the reasoning behind scrapping a rate cap that will now see some drivers paying nearly 30 per cent more for auto insurance this year.

Insurers have blamed climbing injury payouts for creating a “crisis” in the insurance industry, with companies claiming they were paying out more than they were bringing in through premiums. But an analysis by an actuary hired by Fair Alberta Injury Regulations found injury payouts have stabilized in the last few years and even started to dip in 2019.

“They’re not skyrocketing. They’re not significantly increasing from one year to the next. That’s been the case for (three) years now,” consulting actuary Craig Allen told Postmedia.

He acknowledges injury claims did climb between 2011 and 2016, but they have levelled out since then.

“I agree there has been a period of growth, but my interpretation is that period of growth has ended,” Allen said.

He also found that the previous rate cap was high enough to cover injury claims in the last few years, because the Automobile Insurance Rate Board’s (AIRB) allowed rate hikes accounted for claims increasing at a faster pace than what resulted.

“Allowable rate levels since late 2017 … provide more than adequate amounts for the estimated bodily injury claims costs that have subsequently emerged. For insurers that have kept up to date with their rate changes, further rate increases for bodily injury coverage appear to be unnecessary at present and for a period into the future,” Allen wrote in the report.

He said insurance companies and the AIRB overestimated the severity of injury claims, and so that left room to cover any higher costs the company faced.

Fair Alberta is skeptical of claims the industry is overburdened by claims costs, and the reason behind the provincial government’s decision to scrap the rate cap

“We don’t understand where the premier got the idea that personal injury claims are escalating out of control — that is not what this data shows,” he told Postmedia.

“There is not a crisis going on with bodily injury claims costs, and there is no need to take money away, or compensation away, from injured, innocent people to compensate for an industry that is saying that there is a problem.”

The group also says it expects insurers are claiming hardship ahead of lobbying for changes to consumer protection laws around injury compensation.

The Insurance Bureau of Canada (IBC) takes issue with the report’s claims bodily injury claims have stabilized.

“Data from the independent rate regulator’s actuary clearly shows a steep increase in bodily injury claims since 2012. It’s clear that the auto insurance system no longer works for Alberta’s three million drivers: it’s expensive and offers little choice. We hope that all groups, regardless of what stake they have in the situation, will come together and work with the government-appointed expert committee on auto insurance to work on fixes that are in the best interest of drivers,” Celeste Power, IBC’s vice president said in an email statement.

When reached for comment, the AIRB only pointed to a panel reviewing insurance in the province, and did not comment further on the report.

“The government is reviewing the current automobile insurance system to ensure automobile insurance is sustainable and available for all Albertans. The AIRB looks forward to the expert advisory committee’s report and recommendations,” reads a statement from the AIRB.

Jerrica Goodwin, spokesperson for the provincial treasury board and finance, said in an email statement the AIRB is in the best position to comment on its methodology.

“Our government is addressing the issues in the automobile insurance industry that the previous government wasn’t willing to. We have appointed an advisory committee to review the system and are committed to an automobile insurance system that is fair, affordable and accessible for Albertans,” she wrote.

The reality is “insurers are not going to write business that is unprofitable. It’s not their function,” Muir-Wood said.

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DAS and Wawanesa partner to protect commercial customers with Legal Expense Insurance

Toronto, ON – DAS Legal Protection Inc. (“DAS”) is proud to announce a new partnership with The Wawanesa Mutual Insurance Company (“Wawanesa”), which protects its commercial policyholders when they encounter unexpected legal events.

“At DAS, we focus on providing Canadian small businesses with the help and assistance they need to ensure their legal risks are well managed. Our new partnership with Wawanesa, Canada’s largest P&C mutual insurer with a rich history and reputation, well advances this goal,” said Rissa Revin, CEO at DAS.

This partnership with DAS will make Legal Expense Insurance available to Wawanesa’s suite of Commercial Property & Casualty products.

“Bringing our two companies together strengthens our commitment to helping our customers get the right protection for their businesses. Wawanesa’s recognition of Legal Expense Insurance as a key differentiator provides their customers with another product innovation to extend the coverage provided by their commercial insurance,” said Alex Manning, Vice President of Sales and Marketing at DAS.

The comprehensive coverage is launching in Q1 2020 for new Wawanesa commercial policyholders, and Q2 2020 for existing Wawanesa commercial policyholders.

“We are delighted to partner with DAS and offer our commercial customers this important new protection,” said Tracy Riley, Wawanesa Vice President of Business Transformation. “Among its many benefits, Legal Expense Insurance can save customers money on their legal costs and give them a place to turn when they have legal questions. For our valued broker partners, this product offering provides yet another reason to recommend Wawanesa.”

Legal Expense Insurance is an essential piece of any business’ commercial insurance portfolio, offering policyholders financial protection against legal expenses and empowering them with general legal assistance for any legal matter. Covered insured events include contract disputes, employment disputes, tax audits, and many other common legal events a business owner can experience.

Legal expense insurance itself is rooted in a longstanding 100-year old history. It can be traced back to Le Mans, France in 1917, when the first company named D.A.S. (“Defense Automobile et Sportive”) offering legal expense insurance coverage opened its doors.

Interested in the history? Watch this video to hear the story behind it all.

About DAS Legal Protection Inc.

DAS Legal Protection Inc. (DAS) is the Canadian market leader and Managing General Agent (MGA) specializing exclusively in Legal Expense Insurance. Working with brokers and corporate partners, we create access to justice solutions so that Canadian individuals, families, and business owners can protect themselves from legal expenses, be empowered to pursue or defend their legal rights, and have unlimited access to legal resources. DAS Legal Expense Insurance policies are underwritten by Temple Insurance Company, and both companies are members of Munich Re (Group). To learn more, please visit www.das.ca.

About Wawanesa

The Wawanesa Mutual Insurance Company, founded in 1896, is the largest Canadian Property and Casualty Mutual insurer with $3 billion in annual revenue and assets of more than $9 billion. Wawanesa Mutual, with executive offices in Winnipeg, is the parent company of Wawanesa General, which offers property and casualty insurance in California and Oregon; Wawanesa Life, which provides life insurance products and services throughout Canada; and Western Financial Group, which distributes personal and business insurance across Western Canada. With over 5,000 employees, Wawanesa proudly serves over two million policyholders in Canada and the United States. Wawanesa actively gives back to organizations that strengthen communities where it operates, donating well above internationally recognized benchmarks for excellence in corporate philanthropy. Learn more at https://www.wawanesa.com/canada/.

His coverage officially lapsed on April 1. He was diagnosed with cancer on May 23.

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IMS Brings Carrot UBI Platform to North American Insurers

Waterloo, Ontario, Canada and Boston, MA, Jan. 21, 2020 (GLOBE NEWSWIRE) — IMS, a subsidiary of Trak Global Group (TGG), one of the world’s top three providers of connected car data solutions to insurers, mobility operators and governments, is pleased to announce the availability in North America of the (usage-based insurance) UBI platform on which the award-winning Carrot Insurance (Carrot) program is built.

Using this platform, IMS will enable U.S. and Canadian insurers to rapidly scale next-generation UBI programs that go beyond the common approach of offering motorists discounts in exchange for sharing limited driving data. Partners will also have full access to eight years of in-market experience, insights, and validated learnings in driver scoring (informed by real-world claims data), engagement, and reward, as well as the effective use of telematics data within claims.

The highly configurable, modular platform is compatible with telematics data across all device types, from plug-in hardware to mobile apps and embedded telemetry within vehicles. In addition to underpinning Carrot, the platform has been adopted by numerous insurers, such as RSA, Zurich, and Aviva, and auto manufacturers, including Volkswagen and Fiat.

IMS is led in North America by insurance telematics pioneer, Nino Tarantino, who joined the company from Octo Telematics North America shortly after it was acquired by UK-based TGG in December 2018.

“The auto insurance market in North America is very competitive, and UBI has provided an opportunity for insurers to differentiate, while enabling improved risk selection,” said Nino Tarantino, CEO of IMS (Americas). “Insurers must now begin to focus on using telematics data to effect positive behavior change, drive down accident frequency, improve loss ratios and generate ROI from their programs. By giving our partners access to the full breadth of our insights harvested from Carrot and providing them the same tools that helped deliver an accident frequency reduction of over 40% in other geographical markets, we believe it is possible for our insurer partners to see double-digit improvements to their combined operating ratios. No other solution provider in the market has access to the leverage that IMS’s Carrot experience provides.”

In addition to the engagement and reward system at the heart of the platform, which has traditionally delivered increased customer interaction and driver safety – with more than half of policyholders checking driving feedback daily – North American insurers can also benefit from IMS’s expertise using telematics data to improve the claims process. The tools and expertise embodied within IMS’s Claims as a Service (CaaS) offering have already seen global composite insurers, like Zurich, achieve as much as a 10-point improvement in combined operating ratio (COR) through more efficient claims resolution.

“UBI provides insurers with more detailed information about their customers than ever before and will allow for rating systems to accurately reflect customers’ driving ability over time while providing a positive customer experience through increased engagement and reward programs,” said Greg Donaldson, senior analyst at Aite Group. “The race for effective UBI offerings in North America has started and insurers ignoring this trend stand to fall behind as the competition forges ahead. Insurers will need to find experienced partners to help them develop and integrate the right plan to ensure success.”

For U.S. and Canadian-based insurers seeking additional detail, please contact IMS at:  https://www.intellimec.com/contact-us

 

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