Healthcare treatments can help us feel our best again, whether that is physio, a massage or health support.
These therapies can be especially helpful after a car accident. It is important to know that accident benefits, which include healthcare treatments, are mandatory car insurance requirements in most Canadian provinces.
Check your benefits again
Just like you would review your bills and payments for retail and leisure expenses, it’s also important to do your due diligence when insurance covers your injury treatment after an accident.
In health-care settings, you might not always be aware of the details being submitted to your insurance company. Beware of ill-intentioned health-care providers that submit details that don’t match your situation in order to collect extra money from your accident benefits coverage.
This is improper and it drives up insurance premiums for everyone. So, here are a few tips to help protect yourself while getting the care you need.
Things to watch out for
- Check that the treatment provider is qualified to diagnose or provide the treatment required. If you’re not sure, your insurance company can help clarify.
- Ask to review your medical reports with the health-care provider to ensure the information is accurate before they submit to your insurance company.
- Talk to your health-care provider about other options if your current treatment plan for your injuries isn’t helping you get better. It can be a warning sign if they won’t take your concerns seriously or won’t explain your treatment plan or expenses when asked.
- Once you’ve received treatment, your insurance company will periodically send you a letter that confirms what payments have been made. If anything does not add up, contact your insurance provider.
Why you should review this information
The Financial Services Regulatory Authority of Ontario (FSRA), an agency of the provincial government, which works to protect the rights of consumers in Ontario by promoting high standards of business conduct, financial safety, fairness and transparency within the financial services it regulates.
Accident benefits misuse in the news
In November 2023, FSRA imposed a compliance order and administrative penalty of $15,000 against a registered psychologist who made misleading statements to insurance providers to obtain payment for services not rendered. He also submitted a treatment plan to an insurance company that indicated a claimant was employed prior to an accident when the claimant was retired.1
And recently, FSRA took action against a health and wellness clinic for unethical practices such as submitting fictitious invoices while the clinic was closed during the COVID19 lockdown. In this case, FSRA revoked the service provider licence and imposed an administrative penalty of $200,000 against the clinic and imposed administrative penalties against two of its health care practitioners.2
We’re here to assist you
If you see suspicious expenses on your billing statement or have questions related to your account, please contact us. Our team can confirm any concerns directly with you.
