Ontario insurer demands man maimed in hit-and-run pay care worker less than minimum wage

Insurer refusing fair wage for crash victim's care An Ontario man maimed in a hit-and-run says the driver's insurer is refusing to pay a fair wage for workers to care for him.

A Toronto man who was grievously injured in a hit-and-run crash last year says he can’t believe an insurance company is withholding benefits until he finds someone who will care for him for less than minimum wage.

Alan Weymouth says he’s now being taken for a ride by the insurer of that driver, who was charged criminally in the case, thanks to what his lawyer says is a misinterpretation of Ontario rules.

But that misinterpretation is becoming so common it could affect hundreds of people injured in crashes per year and is forcing some home-care providers to scale back their businesses, observers say.

“It’s sad. They shouldn’t be able to get away with treating people like that,” Weymouth said in an interview with CTV News.

“None of this is my fault, and I don’t understand why I’m being denied. My life will never be the same because of this accident, all because of one person and now I’ve got to fight to get everything,” he said.

Weymouth was riding his e-bike on Wilson Avenue in March 2022 when he was hit by a driver of a rental car. His bike was destroyed, and he was sent flying.

“I remember it all. I remember flying through the air, my head smashing in the road, my helmet flying off,” he said.

“It shattered my femur bone. I had seven hours of surgery, blood transfusion, and now I’ve got to learn to walk again,” he said.

Toronto Police confirmed the driver, a youth, was charged criminally, and the car was a rental. The insurer of that car is Economical Insurance.

Weymouth was eventually discharged from hospital, unable to work, and needing constant care. He said he was briefly able to access attendant care, which is someone who does basic jobs around the home that he is no longer able to do, before the service was cut off.

“It’s absolutely not right and in Alan’s case it has hurt him significantly,” said Ben Fotia, Weymouth’s lawyer. “Basically his accidents benefits insurer has been trying [to] pay less than minimum wage for his housekeeping, home maintenance and care services since the accident.”

Fotia said it all comes down to rates. The provincial government guideline for attendant care, which was set in 2018, is $14.90 for routine personal care, $14.00 for basic supervisory functions, and $21.11 for complex health care and hygiene.

In Ontario’s no-fault system, insurers would typically pay these amounts quickly while any disputes would be resolved later in the courts.

In the past, insurers recognized the hourly amounts are low and allowed customers to pool the money from all approved hours to form a monthly total, which could then be paid to the caregiver to cover however many hours that money paid for at their rate, Fotia said.

But since a court decision in 2021, insurers have been more bold in demanding that the hourly rates they pay for match $14.00 or $14.90 — something that’s impossible given Ontario’s minimum wage is $15.50, Fotia said.

That approach, which was rarer last year, is becoming more common and has forced Anchor Rehabilitation Support Services to scale back its business, said its CEO Justin Kline.

“The insurance companies we were working with understood that it wasn’t a realistic rate to pay for PSWs [personal support workers],” he said, but that’s changed recently. The new approach could affect hundreds of people injured in car crashes across Ontario each year.

“There’s going to be a lot of people left without care or left with the option that they may have to pay for that care out of their settlement later down the road,” he said.

When approached by CTV News, Economical said it could not comment on Weymouth’s case, citing a need to protect his privacy.

“Economical is committed to delivering on its promise to be there for Canadians when they need us the most,” spokesperson Mathieu Genest said.

“Accident benefits are highly regulated with defined coverages and in many cases are intended to only partially cover certain costs. Economical pays benefits according to the accident benefits regime,” he said.

In a statement to CTV News, a spokesperson from Ontario’s insurance regulator, FSRA, said it would be “incorrect” to interpret Ontario’s rates as setting an hourly wage.

“An individual can choose to receive care from a provider charging any reasonable hourly rate, but their benefit will be capped at the maximum insurance limit,” the statement said. “Additionally, insurers are not prohibited from paying above the hourly rates provided in the guidelines.”

FSRA encouraged anyone facing this situation to submit a complaint.