In Ontario, the Financial Services Regulatory Authority of Ontario (FSRA) says the regulator has received several inquiries from service providers regarding an increase in denials when submitting provider travel time expense claims to insurers.
“FSRA has reviewed Health Claims for Auto Insurance (HCAI) data and has confirmed that insurers across the industry have been denying a greater number of travel time expenses,” they write in a notice emailed July 29.
“Denials alone are not evidence of regulatory non-compliance,” FSRA told the Insurance Portal in response to a request for more specifics. The regulator was not able to share any further data.
“FSRA is reminding insurers of their statutory obligations to pay for reasonable and necessary medical and rehabilitation expenses as outlined in sections 15 and 16 of the Statutory Accident Benefits Schedule (SABS). These may include provider travel time expenses. FSRA continues to monitor this issue and expects insurers to fully comply with regulatory requirements,” the emailed notice continues.
In its reply to the Insurance Portal, FSRA points out that if a health service provider believes an insurer has contravened the Insurance Act, both service providers and clients alike can file a complaint.
“FSRA will thoroughly review each complaint raised by consumers or industry professionals regarding systemic or blanket denials to determine if insurers are meeting their legal obligations,” they write. “Any health service provider who feels their travel time expenses have been unfairly denied is encouraged to speak with their insurer or bring the dispute to the licensing appeals tribunal.”
