Québec's No Fault Insurance System

| 2 Comments

By Giovanna Salvagio

Screen shot 2021-04-23 at 8.53.03 PM.png

Effective, simple, and swift are three words that best describe our system (Gardner 2010)

 


A flattering description of the Sociéte de L'Assurance Automobile du Québec (SAAQ, 2002), the government agency that regulates Québec's no fault insurance system. Québec drivers insure their vehicles against theft and vandalism; however, the SAAQ compensates for personal injury and or lost wages.  All Québecois drivers contribute towards Québec's no fault insurance. We also have an option to purchase private car insurance in Montreal.

 

A portion of the contribution derives from drivers licence fees and a much larger portion comes from vehicular registration. Drivers do not have any choice in the matter, and willingly contribute. Unfortunately, drivers in Québec have a false sense of security that in the event of an accident, citizens won't have the burden of dealing with loss of wages. Indeed, the SAAQ compensates car accident victims; however, if the accident victim suffered injuries that prevent the victim from resuming his/her activities indefinitely, then the SAAQ arbitrarily cesses compensation.

 

 

Furthermore, if a driver has the misfortune of getting injured in more than one accident then the SAAQ goes to great lengths to delay or even deny compensations. Unless one has had the misfortunes of having had an accident, the biases and callous treatment that accident victims receive remains unknown. Unlawful describes the manner with which SAAQ whimsically decides whether to compensate or not. In most circumstances the accident victims accept their fate and bear their pain. Other times, faced with no other alternative, victims sue in the hopes of receiving a fair judgement. Although, Québec's no fault insurance exists to protect its citizens, current administrative decision force citizens to sue in order to receive fair compensation.

 

While the SAAQ would have you believe that reckless drivers or drivers that cause criminal accidents should be penalized, such authorization would fuel an already dysfunctional system. Citizens must learn about the countless injustices faced at the hands of the SAAQ.

 

Many nations look to model Québec's no fault auto insurance system (Sugarman, 1998). The Society de l'Assurance automobile (SAAQ) much like the American Department of Motor Vehicles (DMV), legislates vehicle registration and issuing drivers licences. However, this agency regulates much more than vehicle registration. The agency stands for road safety and protection. As a matter of fact, anyone that access the website at www.saaq.gouv.qc.ca can learn that the SAAQ promotes prevention, enforcement and compensation. The agency actively informs and advertises various public service announcements (PSA) related to safe driving.

 

During peak times (for example holidays) the SAAQ increases the volume of PSA`s. The agency stresses managing road safety by offering SAAQ representatives to speak to teenagers before they apply for their drivers licences. The drivers' exam contains several situations of road safety and students understand the importance of road safety. However, for the citizens or drivers that fail to understand that road safety rules protect them, the SAAQ imposes sanctions or fines. The agency imposes fines as a way of enforcing road safety. Examples of reasons for motorists receiving fines: not wearing their seat belts, failing to drive with winter tires between December 15 and April 15, talking on the phone while driving or impaired driving. On the other hand, drivers injured in car accidents can expect compensation. The SAAQ covers both treatment and compensation of lost wages. Although the Régie de l'Assurance Maladie du Québec (RAMQ) covers health care and the Commission de la Santé Securité compensates loss of wages of work related accidents. The SAAQ ensures that drivers injured in car accidents receive both treatment and compensation (Desrosier, 2010). The Québecois assume that victims receive prompt compensation. In fact, even motorists that do not reside in Québec receive care if injured in a road accident in Québec.

 

 '' Individuals who are not Québec residents but are injured in an automobile accident while in Québec may also recover in Québec's Automobile Insurance Act, but only to the extent that they are ''not responsible for the accident'' RSQ 1995 chA-25, Automobile insurance Act $9 (Myers vs. Langlois, 1998).

 

The SAAQ will arbitrarily deny causal relationship between injuries and accidents. In 1998, the Québec ombudsman reported that even though a victim submitted x-rays and other doctor notes confirming his injuries the SAAQ denied him compensation (Ombudsman, 2002).  Even though the man provided all the appropriate forms, the SAAQ determined that although injured, the accident did not cause the mans' state (Ombudsman, 2002). Frequently victims face this very paradox. The agency recognized that the victim had an injury; however, the SAAQ employs a cleverly designed tactic that victims frequently face. Even though the SAAQ recognizes that the victims suffer from injuries, the SAAQ argues profusely against linking the injuries to the accident.

 

Québec provides citizens with a health plan and the ramification to victims rarely surface because frequently victims accept the SAAQ`s decision. The victims can receive fair treatment (I use this word very liberally) only by suing the SAAQ. Victims injured frequently face living in pain. Moreover, incapable of regaining full recovery often victims opt to change jobs because of the unbearable pain that resuming prior duties bring. In the long run, however, injuries persist and the victims must look to private care or public health care system for treatment, unfortunately the issue of loss of wages seems to vanish.

 

Sara Gooderham warns of the SAAQ chronic denial of accident claims (Gooderham, 1998). Gooderham, a financial adviser, writes extensively on this topic. Gooderman's input comes free from any bias as the report aims at educating citizens to invest and build wealth because financial security is not necessarily guaranteed. Although, the underlined assumption points towards compensation, an unfavourable decision can cause an accident victim tremendous financial strain due to lost wages. Other factors contribute to this strain, such including medical bills.

 

Even though Québec has a public health plan some services such as physio therapy, MRI`s, and certain types of prescription medication remain services that the system excludes. Only welfare recipients can obtain services and medication at minimal coat. All other citizens either contribute towards a health plan at work that includes these treatments or must pay for treatment themselves. The financial strain also includes the patients' possible need for assistance. Some accident victims need first hand assistance or hold primary caregiver roles. Injuries that affect an accident victims' physical ability also affect the person or people he/she cares for. 

 

To alleviate the burden, victims need assistance, which they must pay for themselves. Gooderham reminds citizens of this possibility and stresses the importance of saving for this. Forget about saving for the proverbial vacation of a lifetime. Wise consumers must ensure that an accident doesn't financially drain them. In fact, Gooderham reports that 12% of accident victims contest the SAAQ`s decision (Gooderham, 2002). This number suggests that the SAAQ arbitrarily refuses to recognize accident victims as accident victims. Although 12% contest the decision, the percentage of victims that accept an unfavourable decision remains unknown. Many victims accept the unfair decision and painfully go about their lives as best they can (Gooderham, 2002).

 

Based on the ombudsman study the SAAQ can decide to stop reimbursing victims. Left to their own devices victims may opt to sue the SAAQ. However, this requires patience and a lot of money that victims fear may be in vain (Ombudsman, 2002).  The accident victim carries the burden of proving that his/her injury from the accident, on the other side, the SAAQ can arbitrarily claim otherwise. For a civilian going against ''big brother'' (a government agency) can seem daunting, overwhelming, even impossible and therefore reluctantly accept the decision. Others, with courage to forge ahead and contest a decision do so because they sustained a noticeable disability such as a loss of a limb or an eye. In other words, only victims with extremely solid cases attempt to fight the SAAQ (Gardner, 2003).

 

The SAAQ has complete power over the fate of accident victims. Even though the SAAQ`s ministerial mandate supposedly ensures that all accident victims receive compensation and lost wages, the SAAQ frequently renders decisions that cause accident victims wondering about the logic behind the decision. An example that clearly supports this claim: Jeanette Holman Price. In a ``potentially precedent- setting decision'' Price, too falls into the category of accident victim. Price, whose daughter was killed by a snow removal truck sued the SAAQ for not recognizing her as an accident victim (Van Vlaaridigen, 2010). Although, Price received a lump sum payment, it paled in comparison to that of the drivers' compensation. The driver of the snow removal truck received compensation for lost wages, as well as, therapy to help get over the emotional trauma. However, Prices son received no such payment, even though he suffers many injuries as a result of the accident (Van Vlaaridigen, 2010). Price too, decided to sue because the SAAQ refused to recognize her as an accident victim. Moreover, Price suffered from post traumatic stress disorder and a judge recognized her as a victim (Van Vlaardingen, 2010). Twice the SAAQ lost. However, the SAAQ still refuses to respect the judgement. Even if the SAAQ decides to respect the judgement, Price should expect reimbursement for lost wages and fees that the accident caused her. The sheer logic is questionable, Price arrived onto the accident scene as police men drew lines around her lifeless daughters' body and as she lived the horror her son entered an ambulance on a stretcher (Van Vlaaridigen, 2002). Yet, the SAAQ adamantly defended the position that negated Price as a victim. In addition, the SAAQ refused to compensate her or respect the judgement.

 

It is not uncommon for the SAAQ to want to hold onto an idea with tremendous conviction, doing so at the victims' expense. A review of SAAQ practices revealed that the SAAQ can arbitrarily revoke a decision and withhold compensation to victims. Suing the SAAQ in provincial court becomes the victims' only option. Only those victims that cling to the hope of a moral victory endure the agonizingly long process. Moral victory because winning a case against the SAAQ in no certain terms guarantees payment. The SAAQ delays payment, appeals decision and basically acts like a bully with public funds. T

 

he ombudsman report reveals such blatant refusal to compensate, along with failure to remedy their actions despite receiving judgments and sanctions to correct the situations. Legally without new evidence the SAAQ can't modify a decision (Ombudsman, 2002).  Unfortunately, this unlawful denial of causal relationship between victims' injuries and car accidents continues to hold common practice. Unless victims sustain the misfortune of suffering life threatening injuries, the SAAQ, denies prolonged disability. To look at their tactics one would suspect that the SAAQ focuses on denying the victims claims or at the very least prolongs delays for compensation. Another example features a woman, an accident victim in 1994. By 2002, the woman submitted a report claiming that injuries sustained in the accident worsened and that she could no longer resume her previous duties (Ombudsman, 2002). In 2003 the SAAQ called on the expert advice of an orthopaedic surgeon. After evaluating the victim the doctor concluded that the woman's condition would not diminish nor would it improve (Ombudsman, 2002). In other words the woman would never fully heal, but, the condition would not worsen. Upon receiving this report the SAAQ decided to stop reimbursing her treatments, treatments that alleviated her pain (Ombudsman, 2002). The woman filled a complaint with the ombudsman and won.

 

Moreover, the SAAQ alleges that the citizen's failure to produce supporting document influences the decision making process (Ombudsman, 2002, SAAQ,). Clear evidence of this in the following example: a man applying for an upgrade in drivers licence received notice of a denied request as well as a revoked drivers' licence (Ombudsman, 2002). The man had a birth defect causing blindness in one eye. Fortunately, this did not impair the man's visibility because his other eye effectively compensated for this loss. In fact, the man earned his living as a truck driver (Ombudsman, 2002). Upon learning of the man's blindness the SAAQ capriciously decided to revoke the man's licence. This decision penalized the citizen as it impeded him from earning a living. The man made many attempts to ensure the SAAQ reconsider their decision. At each attempt, the SAAQ notified the man that in order to support his claim, the man should submit doctor reports and various document in a timely fashion. Even though the man respected the protocol, the SAAQ repeatedly informed the man that he had failed to submit the necessary paper work (Ombudsman, 2002). The man chose to sue the SAAQ and an investigation revealed that the man submitted the necessary paper work, however, administrative delays and errors prevented the SAAQ`s revision board from revisiting the man's case. ''The SAAQ administrative errors forced the man to take the SAAQ to court'' (Ombudsman, 2002 p 15). The ombudsman instructed the SAAQ review board to review the man's case because a court case could prove unnecessarily lengthy and more costly. The SAAQ agreed and overturned the decision to revoke the man's licence. However, if the SAAQ had respected their mandate and acted in the citizen's best interest the ombudsman's intervention could have been spared. The citizen only received compensation as a result of soliciting help from the Québec's ombudsman. Once again, another example that illustrates the careless administrative practices.

 

Denying payouts to drivers found guilty of a criminal accident, why should criminals receive compensation?  Lobbyists for the SAAQ denying payouts to drivers found guilty of a criminal accident over power the media hype around SAAQ practices (Cardwell, 2010). By focussing on citizen's emotions the SAAQ hopes to deny drivers responsible for criminal accidents compensation. A criminal accident (as defined by the SAAQ) refers to an accident resulting from breaking a law. Drunk driving constitutes a criminal offence or criminal accident. Drivers involved in such accidents generally receive compensation however, victims' families find this practice unacceptable (Van Vlaaridigen, 2002). The families view the comparison as victims of such accidents struggle to receive compensation, while the ones responsible receive restitution. If amendments to the automobile Insurance take effect it would include the following three proposed amendments: ``no driver who is criminally responsible for injury or killing someone would ever be immune from civil action." The Sociéte de l'Assurance automobile du Québec would no longer be compelled to compensate such drivers if they were injured in an accident.

 

The Sociéte would henceforth be entitled to demand that these drivers refund any amount it has had to pay out as compensation to other victims of the accident (if any) '' (Gardner, 2011 p1).

Such a system would grant some citizens the right to sue and deprive others of the same right. Furthermore only councils stand to benefit from such a system since ''43% of vehicular offenders have no source of income and 41% earn less than $ 30 000 per year'' (Gardner, 2011, p2). Finally, no driver is completely shielded from a momentary lack of judgement brought on by driving impaired perhaps because of medication or a seemingly harmless glass of wine or maybe even answering that far too important phone call. Allowing this amendment leads to setting up investigative systems. With investigative systems in place the climate of suspicion of all claimants could dominate.

 

Current practices reflect this climate, however unlawfully. Providing legislature to enforce such practices grossly harms drivers. Citizens must beware and inform themselves of the negative consequences of such an amendment. Gardner attributes the major cause of success of Québec system to lack of legislature especially since the number of ''automobile accidents linked to impaired driving has dropped steadily for the past fifteen years or so'' (Gardner, 2011 p 4).

 

SAAQ administrative practices encourage bias behaviour. Tom's story. In October 2010, Tom was involved in a road accident. The driver of the other vehicle failed to stop at the intersection and crashed his car into Tom's 4x4. The driver of the other vehicle caused the accident and the SAAQ`s investigation confirmed his negligence. Tom's car needed several thousands dollars of repairs which Tom's auto insurance covered. In addition, Tom's insurance paid for a rental car because the repairs would have taken a few weeks to complete. Upon impact, Tom consulted a health profession that confirmed  that Tom had sustained significant injury and require time off work, various treatment options such as physio therapy and medication. Tom adhered to the doctors recommendation and bought the medication, both muscle relaxants and pain killers, however failed to schedule an appointment from physio therapy that could alleviate pain because the SAAQ refused to accept the doctors orders.  Tom received notice from the SAAQ, that unless authorized by the SAAQ, Tom could not receive treatment. Tom patiently waited for the authorization for treatment, but, endured excruciating pain in the meantime.

 

After a month of waiting patiently, Tom called the SAAQ to inquire about treatment options. Someone at the call center replied that Tom's file required review. Tom pleaded for authorization for treatment only, stressing that the wage "review" could wait. Fervently, the agent replied Tom must refrain from receiving treatment until authorized. During this time Tom received no compensation for lost wages, or medical bills and his need for treatment persisted. After another month Tom once again contacted the SAAQ. A call center agent informed him that his file remained pended. Tom explained that it has been two months since his accident and that he had yet to receive compensation for lost wages, however, physio could at least get him on the road to rehabilitation. He pleaded to no avail.

 

This went on and on. Same scenario for the third and fourth month. By mid February 2011 it had been four and a half months since Tom sustained injuries that desperately needed treatment.  The SAAQ still refused to compensate for lost wages and medication. Tom's responsibility to his creditors forced him to return to work, the SAAQ`s failure to compensate depleted Toms resources.

 

Even though the doctor advised against it Tom resumed some duties. He could no longer wait for the SAAQ; it had been four and a half month without pay or treatment. Try as he might the SAAQ ignored his request and Tom endured the pain and forged ahead. At the beginning of March an investigator from the SAAQ contacted Tom requesting a meeting at Tim Horton's, no less. Since when do government officials conduct business at Tim Horton's? Don't our tax dollars pay for fancy offices? Unfortunately, the day that the investigators suggested Tom had a follow up doctors' appointment that conflicted. Tom politely declined and offered the agent several other dates to choose from. The agent informed Tom that he would contact Tom to reschedule a meeting. Several weeks later the agent contacted Tom. Although, Tom had yet to receive compensation, treatment or assistance from the SAAQ the agent wished to meet once more at Tim Horton's.

 

Tom informed the agent that time was scarce and would gladly answer any questions by telephone because a face to face meeting would require time. The agent informed Tom that that this was standard procedure. An obvious lie. No, in fact this is NOT standard procedure. Once the doctor completes a medical certificate the citizen must receive compensation (Ombudsman, 2002). The agent blatantly mislead the citizen. Luckily, Tom knew his rights and shared them with the agent. In addition offered that this practice only occurs when the SAAQ suspects the validity of an accident. Tom added "you have thoroughly investigated the damage of the car, I know, I've sent you the receipts. You have my account of the accident that has been corroborated by the other driver. You have interrogated the other driver. You have the doctor certificates, request for treatment and prescriptions and still you refuse to pay. What are you looking for?"

 

To that the agent informed Tom that failure to meet at Tim Horton's would result in his decision to close his file. Sounds like blackmail. The following day Tom received a call from another agent insisting they meet the following day. Tom had a scheduled business trip out of town and explained that that day conflicted, however, offered an alternative date. The agent threatened to close the file and tactlessly added that she could not careless because she still had a salary while Tom had none for two months.  Tom reminded her that in reality it had been five and a half months and that during that time he exercised nothing but patience. For months Tom made countless phone calls without anyone's reply and now that he had gone back to work the agents behave with such urgency. Arrogantly the agent made a strange parallel. She said: "when the police wants to interrogate you, you must abide'' to this absurd parallel Tom replied: "If he police wants to interrogate a citizen it must be because they are suspect in a crime, at which point the citizen has the right to have an attorney present, is this the case with the SAAQ, am I entitled to have my attorney present?". The agent hung up.

 

Without a closing. Without calling back to apologize for doing so. Without remorse for having behaved in an obviously callous and unprofessional way. Six and a half months later and Tom's file remains pending and Tom still needs treatment. It's important to clarify that Tom is an immigrant and the use of a lawyer ensures that the language barrier does not procure him any prejudice. In addition, Tom contributes to the social system with every vehicle registration. Tom has six registered vehicles with the SAAQ. Moreover, ALL accident victims regardless of contribution are ensured compensation under the no fault insurance. Clearly, the SAAQ administrators abuse their power.

 

Finally, it's a safe assumption to make the generalization that no citizen deliberately looks for or expects to get into an accident. Although, most hope to never have a car accident, they understand the possibility of it happening. Therefore, realizing the unpredictability of road accidents can put the severity of this dysfunctional system into perspective. Current practices offer a climate of frustration. Even though no fault insurance claims to protect citizens, the current practices penalize the citizens that contribute to this very system.

 

Rather than have external forces monitor their practices, the SAAQ should ensure that the citizens rights to compensation remain upheld. Administrative errors and delays should be dealt with in a forceful manner. A governmental agency owes its citizens the duty of acting in the public's best interest, employees that promote unfair or biased behaviour, or that abuse of their power to arbitrarily negate a victim's compensation should lose that power and their cushy governmental positions in the process. Only then could the SAAQ meet their mandate.

 

 

Bibliography

 

Cardwell, M. (2010). Getting Away With Murder. Canadian Lawyer.

Retrieved at:http://www.canadianlawyermag.com/Getting-away-with-murder.html

Desrosiers, M. (2010). SAAQ et CSST Facturation des Actes et Autres Services. Le

 Médecin du Québec. 45 (9), 142-143. print.

Gardner, D. (2003). Ill-advised Reforms to the Automobile Insurance Act. Association de

 Service de Réhabilitations Sociale du Québec. Translated by: Gaston St. Jean.

Retrieved at: http://www.asrsq.ca/fr/salle/porteouverte/0303/salle_por_030302.php

Gooderham, S. (1998). Relying on the Public Insurance Plan Could be Risky Business.

 Stratégies Fiscales et Financières pour Faire Croitre Votre Avoir. (Translated)

                   Retrieved at:http://www.sarafinance.com/fr/articles/199810/

MAAD: Retrieved at: http://www.madd.ca/english/research/insurance_canada.pdf

Myers vs. Langlois  (1998). (97-399); 168VT. 432;721 A.2d 129 (filed 23- oct. 1998) Supreme Court

                  Retrieved at: http://info.libraries.vermont.gov/supct/168/97-399op.txt

Ontario Transport Website:

http://www.mto.gov.on.ca/english/dandv/driver/demerit.shtml

http://amplicate.com/hate/saaq

Sociéte de l'Assurance Automobile WEBSITE: Retrieved at:

                   http://www.saaq.gouv.qc.ca/en/index.php

The Sociéte de L'assurance automobile du Québec. 2002. Québec, QC.

Retrieved at: http://www.protecteurducitoyen.qc.ca/fileadmin/medias/pdf/rapports_annuels/2002-03/en/section_3_2_06.pdf

Sugarman, S. O. (1998). Québec Comprehensive Auto No-Fault Scheme and the Failure

                   Of Any of the United States to Follow. Le Cahier de Droit. Université de Laval.

Retrieved at: http://www.docstoc.com/docs/20212553/Quebec-Revised

Van Vlaaridigen, C. (2010). Mother of Snow Removal accident victim wins in court.

 CTVMontreal.ca

Retieved at:

http://montreal.ctv.ca/servlet/an/local/CTVNews/20101015/mtl_saaq_101015/20101015/?hub=MontrealHome

Interview: Tom- accident victim- anonymity respected

2 Comments

This is the most enlightening article I have ever read. I am in the quagmire of the SAAQ. Thank you for opening my eyes to the reality of a no fault insurance.

8 years of waiting....waiting to obtain justice. SAAQ can take all the time it wants to make a decision..and the TAQ will not force them to act within a reasonable delay. Im my case I waited for a TAQ audition for 3 years. 3 more years have passed since that day, because a decision hadn't been made then, TAQ had to return the file to SAAQ to ''remind them'' that they had to make a decision. Do they need to be reminded of that? During all that time, the victim (me) is denied the justice she deserves....with the help of TAQ, SAAQ can make you waste time and money.
It is also hard to find a lawyer who will defend your case fiercely. They will also make you waste time if you are not on top of them or, will try to make you believe that SAAQ fights fairly: ''You have the same possibilities as SAAQ you just have to find an expert, like SAAQ does (Jannick Perreault...supposdely a victim's lawyer...I suggest you go see another lawyer and avoid her. Any real victim's lawyer knows that SAAQ pays one fourth of what you pay for an expertise..and they are not suffering the your pain or being treated as if they were malingering..

Leave a comment









Visit our community forum!