Assessing assessment caps: A health care perspective
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As part of the auto insurance reforms, caps are being placed on Ontario drivers. One of the caps limits the amount of money available for assessments to $2,000.
Is $2,000 enough? ILSTV asked Dorianne Sauvé, Co-Chair of the Coalition Representing Health Professionals in Automobile Insurance Reform.
Dorianne Sauvé: If you were looking at the cap component in terms of the assessment, the question here is is that $2,000 per assessment appropriate? I guess the answer to that is … sometimes. The vast majority of assessments will be under $2,000 but there’s a lot of specialized assessments of which the costs are higher. The costs are associated to the amount of time that’s required to do the assessment and the professional time that goes into that.
What is also of concern here is that right now the cap applies to all costs related to that assessment. So if you need an interpreter to interpret for those who don’t have fluency, that cost is supposed to be included in that $2,000. If you have to travel in order for a qualified assessor to go see someone to do an assessment, then those travel costs are now included within that $2,000.
So the question becomes: with these additional costs added into it, we’re not just looking at the professional time as part of that $2,000 cap but travel and interpretation which would leave less time or money for the professional assessment – especially if you’re talking about people in rural areas or those who don’t speak English or French.
Dorianne said that assessments are far-reaching and are key to classifying an injury.
Dorianne Sauvé: The assessment can be in order to determine whether you have a catastrophic injury. You need to have an assessment in order for you to receive the designation of catastrophic. Those assessments can include multiple different professionals. You might have a medical assessment; you might have a neuro-psychological assessment to determine neuro-psychological injuries. You might have an in-home assessment for home modifications. All of these types of assessments would be an assessment that would have to be done in order to access benefits or to look at a catastrophic determination.
The position of the Coalition has always been that the standards of the profession in terms of completing the assessment plus the hourly rate determines the cost of that assessment. Any additional costs relating to travel and interpretation should not be considered part of a cap because that disadvantages those who live in rural settings or who don’t have fluency in language.
No one should be penalized on accessing care simply because they don’t live in a metropolitan centre and I think looking for professionals that are qualified in those specific areas is challenging depending on where you live in Ontario.
