The April 2017 Marshall Report commented:
"The majority of injury claimants report that they have “minimal” or “minor” injuries at time of the accident. While symptoms may manifest themselves long after an accident, the fact is that most people are not seriously injured. Some 83 per cent of motor vehicle injuries involve whiplash or other soft tissue injuries such as a sprained back, which, most of the time, can be treated by relatively simple, short-term and inexpensive procedures that are well understood by health care providers.
Soft tissue injuries should not normally develop into permanent impairments if they are treated properly to begin with. The rate of impairment in the auto insurance system is a warning sign that medical care is not being properly handled. Appropriate medical treatment has been shown to reduce or prevent the development of permanent impairments from soft tissue injuries by as much as 80 per cent."
And quoted the Initial Patterns of Clinical Care and Recovery from Whiplash Injuries: A Population-Based Cohort Study, saying:
“We found that increasing the intensity of care beyond two visits to (family doctors), beyond six visits to chiropractors, or adding chiropractic to medical care was associated with slower recovery from whiplash injuries even after controlling for initial injury severity. Clinicians who promote frequent visits may inadvertently encourage patients to cope passively with their pain ... patients who cope passively with their pain may demand more clinical care. Relying on repetitive clinical care likely reinforces some patients’ belief that whiplash is a serious disorder with a long, disabling course. As with low-back pain aggressively treating patients with acute whiplash injuries likely promotes illness behaviours and disability rather than return to normal activities."
All of which is to say that the industry should expect a MIG-style approach to categories of impairments which feature minor injuries, but also have other impairment components that require a more multi-disciplinary approach to treatment with a cap higher than $3,500.
The Marshall Report commented:
"Programs of care are developed for specific types of injuries, the most common and high-volume ones. For example, there will be a program which treats muculoskeletal injuries such as whiplash, others that treat low back injuries, shoulder injuries, mild traumatic brain injuries and so forth. The programs set out clear expectations to providers and insurers: the treatment goals are defined, the duration of the care is defined and the total fee for the treatment is set."
Of course, the interesting challenge will be to create such a system that is simple enough to be applied, flexible enough to accommodate a range of potential impairments, and drafted with the recent [unopposed] constitutational challenges to the MIG in mind.
These changes are intended for a Spring 2018 implementation. Expect a vigorous discourse once the draft legislation is tendered!
See the Press Release here: https://news.ontario.ca/mof/en/2017/12/ontarios-fair-auto-insurance-plan.html