HCAI Data: Assessments Continue to Be a Significant Proportion of Medical and Rehabilitation Expenses

The IBC has now published the standard HCAI reports for the first half of 2014. The document provides over 75 pages of aggregate data collected by HCAI going back to 2011. HCAI was made mandatory on February 1, 2011. 

 The standard reports are published on an “accident half year” basis. In accident half year statistics, the experience of all claims with accident dates in the same accident half year is grouped together. The accident half years are defined as calendar half years, with January to June being the first half and July to December being the second half for each of the stated years.

Assessment costs continue to be a significant portion of medical and rehabilitation expenses following the 2010 reforms.  Those reforms introduced a $2,000 per assessment cap on both insurer examinations and assessments conducted by healthcare providers.  As well, provider assessments now fall under the overall medical and rehabilitation cap.

Based on data from the General Insurance Statistical Agency (GISA), the total cost of all assessments in 2010 was approximately $ 1 billion.  In 2010, assessments represented approximately 40% of all medical and rehabilitation expenses.

The chart below sets out insurer exams and provider assessments per accident half year as a percentage of all medical and rehabilitation expenses using available HCAI data. Note that the cost of assessment is not really falling as suggested by the chart.  The data is not fully developed and since assessments continue to be a significant cost in older claims, the numbers will continue to grow over time.  What is significant is that assessments continue to be close to 40% of all medical and rehabilitation expenses once the data is fully developed.  

What has changed is the cost of medical and rehabilitation under the SABS with the reduction in the standard medical and rehabilitation cap and the introduction of the minor injury treatment cap.