FSCO regularly publishes Bulletins which are meant to guide insurers and claimants on the permissible and impermissible practices surrounding claims for accident benefits. In FSCO Bulletin A-14/14, along with outlining regulatory amendments which were to take effect on December 1, 2014, FSCO also sent a strong message about mileage expenses for treatment providers, which will discriminate against claimants who live anywhere other than large towns and cities and which will also unfairly penalize treatment providers who are prepared to do field work instead of in-clinic work.
By way of history, until Bulletin A-14/14, when a claimant lived in a rural setting and was unable to travel into town for treatment, travel expenses claimed by the treatment provider – whether that be a physiotherapist, occupational therapist, social work, etc. – would be funded in addition to the regular costs of treatment. Insurers commonly paid these travel expenses and generally seemed to accept that it was appropriate to ensure that treatment could be provided to those claimants who were unable to access treatment in urban centres.
FSCO Bulletin A-14/14 intends to stamp out this reasonable practice by saying
“FSCO is aware that some health care providers are submitting mileage expenses to insurers to travel to an injured accident victim’s location when providing services.”
FSCO goes on to say that “insurers are reminded” that proper mileage claims only relate to the travel costs of the claimant, and that all treatment provider expenses are capped by the maximum hourly rates applicable to each treatment provider as per FSCO’s Services Guideline.
The hardline that FSCO has taken on this issue will result in rural claimants finding themselves unable to access needed treatment. The pool of treatment providers willing to absorb the travel costs associated with in-home treatment will surely shrink. Inevitably, the ones to suffer will be those individuals in remote communities, particularly those in the near North of Ontario.
The erosion of accident benefits in the last five years is stunning. This is yet another example of a quiet change that further reduces access to accident benefits. This one is crafty as it will not be as readily apparent to claimants, but will emerge as a true barrier to a large segment of our rural population. There is no quick answer for needy claimants. While some claimants who have a viable lawsuit against another at-fault party may well be able to successfully claim these expenses as “out of pocket” expenses, this option will not be available to everyone. Many accident victims who were injured through the fault of another do not commence legal proceedings. Others have no recourse to legal proceedings at all, such as the motorcyclist who strikes a deer.
Bulletin A-14/14 is a step backwards in terms of access to needed benefits. Sadly, it only means that more injured claimants in need of rehabilitation will have to go without.