This website is to promote positive change with the No-Fault law and Saskatchewan Government Insurance in Saskatchewan
(I  am using my situation as an example of the problems with SGI, the No-Fault system, and the legal system surrounding the No-Fault system in Saskatchewan.  You may just want to read until you see "****" to get the general idea of the page.  After that spot on the page, it ​is a more detailed explanation.)  I want to be clear -- I like No-Fault insurance, so this is not a 'I hate No-Fault' campaign.  I just want some reform to the No-Fault System. Is it worst or better than Torte? IDK.  Both have their strengths and weaknesses. They are completely different insurance systems.  I'm not debating the value of one system vs the other.  But there definitely needs to be reform with the disagreement process for No-Fault and ensuring claimants are getting his or her benefits. Without a check on the No-Fault system to ensure claimants are getting their benefits in a timely manner, it becomes a lottery system and then just glorified welfare making costs go up.  I got Living Assistance started in year 13, Speech Therapy started in year 2 even though I had a grade 7 level of English at the beginning of my claim, and physiotherapy started years later as well.  As soon as SGI found out what happened in my claim, SGI gave the adjuster who did this an early retirement by about 10 years possibly because she was related to high ranking official in Saskatchewan and probably because SGI wanted to get rid of evidence. (Early retirement and being related to a high ranking official is provable in court.)   

The solutions DO NOT have to be expensive, they just have to be solutions that are fair to both parties. And these solutions, if done right, would NOT cost the taxpayers any money, would broaden the base of the economy, creating and maintaining jobs thereby increasing tax revenue to the province.
​FAIR DOES NOT HAVE TO MEAN EXPENSIVE!

​

While the first page talks about the reasoning behind changing the system and bringing back the lawyers, the  second page titled 'Law Change' addresses the law changes needed in No-Fault insurance to make it fair to BOTH parties. 

On the bottom of the page 'Lawyers, Judges & Inflation' I talk about what the lawyers said to me when I contacted them about my problems with SGI. I talk about inflation as well.

On 'What happened to me' and 'after the appeal' page it talks about my story with SGI and the problems I had with the appeal as well as showing how SGI raised rates when 2 claimants were going to court for not getting benefits. 

Finally, the last page talks about the REAL reasons your insurance costs are rising in Saskatchewan.



​ 


Make the No-Fault Insurance disagreement process and ensuring the claimants are getting all their benefits in a claim an issue in the fall election.

I would like 8 law changes:
1: The cap for the claimant's costs was eliminated if they won a disagreement against SGI at the AIAC and the Queen's Bench Court.
2: A formal meeting before hand to choose which court to proceed to and to see if a resolution could be made prior to going to court (the claimants must be assisted by lawyers at this point). Maybe get rid of mediation as this could replace it. 
3: The application was changed to explain more about the different courts, telling you which laws are not applicable at the AIAC, that SGI will be represented by a lawyer employed by SGI specializing in these cases, as well as telling the claimant to see a lawyer, especially if they have a brain injury. (due to poor problem-solving skills)
4: Lawyers to become involved again at the disagreement level to allow for a broader base of the economy and support jobs in Saskatchewan as well as to make the playing field even in court against SGI.
5: Consequences or repercussions to adjusters for not giving out benefits in a timely matter (instead of rewarding them for poor actions) 
6: A check on the No-Fault system to ensure claimants were being told all the benefits and getting their basic benefits and understanding they can appeal decisions.
7: The ability to transfer an appeal from the AIAC to the Queen's Bench Court.  As well as,
8: A re-assessment of the No-Fault system every 4 years
​
​The disagreement process within the No-Fault Auto Insurance System in Saskatchewan
NEEDS to be re-assessed thoroughly
and
​ LAW CHANGES
need to be made to make the system fairer to claimants.  Currently, the No-Fault system heavily favours SGI and claimants are extremely disadvantaged, especially with the disagreement process.

​
When we moved from TORTE auto insurance to NO-FAULT auto insurance, rights and responsibilities changed.  
With TORTE insurance, the onus was on each claimant to find out all the rights and responsibilities, and people usually got a lawyer and went to court. But with the NO-FAULT insurance, SGI must tell you what your benefits are. Although, sometimes they do not, and this results in claimants not getting benefits in a timely manner, and in some cases it can take over a decade to get needed benefits.

But having a 100% Torte system made for very costly automobile insurance in Saskatchewan and was considered unsustainable in Saskatchewan.  So, in 1995, Saskatchewan went to the No-Fault system.
This was a more sustainable system and covered everyone involved in an auto claim.  The focus of No-Fault insurance was also rehabilitation instead of compensation for future medical costs.    As of 2020 and since the inception of the No-Fault insurance in Saskatchewan in the 1990s, the No-Fault system is currently based on the ‘honor’ system without any checks or balances to ensure claimants are getting all their benefits. There have been many suggestions to the Government of Saskatchewan to allow a check on SGI with the No-Fault system, but nothing has been done by the government yet.

And then there are problems with the disagreement process
within the No-Fault system ...

Initially, when claimants had disagreements with their No-Fault claim with SGI, they would go to the Queen's Bench court to get them rectified.  But there were problems with this; it was costly and a long process for sometimes minor disputes.  In 2002, the Government of Saskatchewan created the Automobile Injury Appeal Commission (AIAC) to give claimants wanting to appeal SGI's decisions another option to the Court of Queen's Bench.
The government, in their infinite wisdom, legislated the maximum the commission could award to the claimants for legal expenses to $2400 if claimants won their appeal or case. 1


In the document, "Cash and Crash" written by Saskatchewan lawyers, Kenneth Noble and Reginald A. Watson, it stated, “… it was anticipated that SGI and members of the public would utilize the Commission much like a Small Claims court.  It was thought that appellants with minor decisions would appeal to the Commission, that lawyers would not be used by appellants, and SGI would use their personal injury representatives to speak on their behalf before the Commission.  It was thought the Commission’s decisions would be rendered much more quickly than that of the Court of Queen’s Bench and there would be few appeals. Such has not been the case.  It is not unusual to have cases before the Commission which involve issues that potentially translate into tens or even hundreds of thousands of dollars … Although SGI initially used non-legal persons to represent their
interests, they now always use members of their legal department ... If an appeal is to be filed, often after reading the letter from the Personal Injury Representative, the individual will file their appeal with the Commission because they are afforded the assistance of the Commission staff and the one page application form which is all that is required. ... No suggestions are made as to the procedure.
No where is the word "lawyer" mentioned. I expect most people will follow the path of least resistance and least expense and file their claim, if they have the will to fight the monopoly, and the machinery of SGI, with the Appeal Commission. At some point, the claimant will learn that SGI has in-house legal counsel who will be defending the appeal. The claimant must either pursue the claim themselves or hire counsel. At some point, the claimants will learn the restriction on cost recovery of appeals taken through the Commission. Once the appeal is filled with the Commission, the claimant can not change their mind and file an appeal or transfer to the Queen's Bench Court.
 
If claimants pursue the claim themselves, they are unlikely to have the ability to recognize the issues, interpret the legislation, hire and instruct experts to rebut the in-house consultants that SGI employs and are invariably favourable to the position of SGI.  Claimants are not equipped to present a case against an in-house lawyer, who specializes in such cases.

Alternately, they can hire a lawyer.  No matter what the result, even in cases where the Commission has determined that circumstances are rare and exceptional, where the conduct of SGI is scandalous, outrageous and reprehensible, where the costs awarded are intended to censure the behavior of SGI, and where the party should have complete indemnification, the maximum the Commission says it can award is $2,500 for all legal fees and expenses. In other words, even if the claimant wins the case, he losses monetarily. Even if he wins, he loses.

The Commission says its hands are tied by the legislation. But the Commission has made no recommendation to the Minister for reform. Why does independence mean the Commission has to turn a blind eye to an unjust result?
The minister has given no indication of any reform.
The Legislation has no provision for Enforcement"2

Please read more in the document "Cash and Crash", written by Saskatchewan lawyers Kenneth Noble and Reginald A. Watson as it details a lot of the inequalities in the No-Fault system between SGI and the claimant.

You may think this is just happening in Saskatchewan, but it is happening in every province in Canada and a lot of States in America. Eventually, what the insurance companies will probably do, is just decline benefits and FORCE people to go to court to receive their basic benefits.  THE SYSTEM IS CRAP!! All claimants are asking is to make the disagreement process fair to both parties instead of making it completely lopsided towards the insurance companies.

If lawyers were allowed be involved at just the disagreement level, this would increase jobs not just to the lawyers (but to all the people employed by the lawyers, including the secretaries, the legal assistants, paralegals, accounting staff, investigators, the cleaning crew and others and through these jobs it would help people through Local Multiplier Effect; read about this below). Instead with the way the government structured the ‘system’, they decrease jobs in the province, decreasing tax revenue from those extra jobs thereby decreasing social programs available to the province.  In addition, through the reduction of employment, they are not broadening the base of the economy and this could become a problem with a recession.  Broadening the base of the economy helps reduce the severity of a recession.

Not only that, but with the lawyers dealing with all the disagreements with the insurance companies, then the claimants can concentrate fully on rehabilitation which was the premise of the No-Fault system.  Instead the claimants are spending countless hours just trying to represent themselves in court just to get basic benefits.
We have gone from one extreme to the other... from when the system was unsustainable and incredibly expensive to now the insurance companies are making hundreds of millions of dollars, reducing jobs and tax revenue to the governments.

You think the insurance companies can’t afford it?  Don’t forget when they transferred from the Torte system to the No-fault system insurance companies started to save a lot of money.  In the last 15 years, SGI has made over to $800 million (I will be including the years and specific amount in a few days). The cost of including lawyers into the disagreement process would probably cost SGI 1 to 2% of their yearly expenses.  Instead, the Government of Saskatchewan has structured the system costing the province taxpayer’s money.  There are NO checks in place, such as discovery to ensure frivolous court cases are going to the commission.
This idea was good in theory, but the practical application was terrible because what ended up happening was the insurance companies are taking advantage of the system.  They are not going to court because they are right but because they can afford to.

Below I explain some of the inequalities of the No-Fault system in layman's terms​

*****************************************************************
 
SGI always insists that getting lawyers involved to get a disagreement resolved will make insurance expensive. This statement is wrong on so many levels.

The lawyers for the claimants would ONLY  be involved at the disagreement level and ONLY be paid by SGI, IF AND ONLY IF the claimants won their case for getting benefits SGI should have given them anyway; not if the claimants lost their case against SGI and SGI's assessment was correct in the first place. Also, with the No-Fault system the lawyers should only be involved at the disagreement level NOT throughout the life of the claim.
The claimants are not suing; that went out with the Torte auto insurance system.  All the claimants are trying to do is get benefits to help them return to work/life. (That is the premise of the No-Fault system -- to try to rehabilitate a claimant, whereas the Torte system was more to compensate them for the future medical issues with their injury.  In reality, the difference between the Torte and the No-Fault system has to do with accounting which I will get into at the end of this page)

With the Torte system, if lawyers were not involved and the claimants would have represented themselves in court, then the claimants would have gotten 100% of the payment. (The lawyers typically took 50% of what the claimant got)  So, it was not the lawyers but the insurance structure/scheme making the insurance expensive. This is the reason why SGI was talking to the government about going to a different insurance system/structure in the 1990's. SGI was saying that having a 100% Torte System was unsustainable in Saskatchewan. (I believe the Torte system would have been more sustainable if there were multiple insurance companies in Saskatchewan, but due to a monopoly, it was not.  But I do not know for sure.)

Why does SGI have their lawyers representing SGI at the Automobile Injury Appeal Commission (AIAC) if SGI thinks lawyers make the system expensive?  Isn't SGI making the No-Fault system more expensive by having their lawyers dispute disagreements at the AIAC instead of the adjusters? The adjusters are always there anyway, so why not let the adjusters represent SGI?  This is the way the AIAC started, which is WHY the reimbursement costs of an appeal started out so low if the claimant won his/her case.  It was thought that SGI adjusters and the claimant would represent each side, and the disagreements would be over small issues. But SGI changed the rules of the game ... SGI got lawyers to represent SGI at the AIAC, and larger and larger medical benefits have been declined by SGI. The claimants must fight SGI just to get basic benefits.

At one appeal against a claimant, SGI had 2 lawyers representing SGI, a neuropsychologist, plus the adjuster was present. How is this a cheaper way to go!?! They probably didn't even car pool and everyone got paid for their mileage and parking from SGI.
And then (at this particular appeal) SGI wanted to settle with the claimant in front of the AIAC.

SGI can not say that lawyers make the system expensive when they, themselves use lawyers to dispute disagreements. That is a complete nonsense.  (And please do not let SGI say that their adjuster's workload is too full, so they need their lawyers to handle these cases.) That is a load of crap.  If this was true, then SGI needs to hire more assistants for the adjusters and get rid of some of the expensive lawyers SGI employs; there would be a cost savings between the lawyer's salary and the assistant's salary.  Currently, SGI is trying to save costs by not handing out pamphlets. (Big eye roll) This was told to me by an adjuster, Bonnie G. in an email about why a pamphlet was not included in a letter they sent out.

If SGI wants to save on more costs, why not get rid of the doctors, nurses, physiotherapists and other professionals who help a claimant during their rehabilitation.  Just let their family members take on those roles with the professionals supervising.  Think of the money SGI will save!!!
You may think that to be ludicrous.  But how much more ludicrous is it for claimants to represent themselves in court against SGI's lawyers. Lawyers have gone to school for about 7 years to learn about the intricacies of the legal system.  And doctors have also gone to school for about 7 years to learn about the intricacies of the human body.  So, what is the difference? There is NONE.

The system is making the insurance expensive by SGI not giving benefits out in a timely matter (one claimant didn't get speech therapy until her second year and was refused living assistance for over 13 years), and SGI lawyers coming to the AIAC unprepared stating they haven't read the case yet (yes that actually happened). Also, by the claimant focusing on the tribunal representing themselves instead of concentrating on therapy and the way the system is not systematically arranged causing delays also increases costs -- it was mentioned many times in one appeal that the tribunal was affecting a claimant's therapy and she was getting worse by representing herself at the commission .  (Read more under the tab "Change")

If SGI's lawyers are not going to read the case before coming in front of the commission members, then why not have the adjusters represent SGI?  Working on an appeal for the AIAC is taxing on the claimants increasing their workload so they can not focus entirely on therapy while decreasing the number of jobs in society and decreasing the tax dollars to the Government of Saskatchewan. Health care costs in the province could also be increasing due to health problems caused by the stress of the claimant representing themselves. Stress can contribute to many health problems.

However, there was possibly one of the three cases the claimant sent to the AIAC, that she could have done by herself without it interfering too much with her therapy. It was only over a small amount and it was more over practical application rather than specific laws. But this is where the legal system surrounding the No-Fault system could be systematically arranged to prevent extra delays and costs with a meeting before hand to see if an agreement can be made and which court to go to.

How much does it cost for the claimant to represent themselves?
It costs in the dollar amount of the therapy plus the dollar amount of the Industrial Workers Average (the wage they are reimbursed). This is part of the reason I say that the reassessment of the No-Fault system may not have been detailed enough; they never looked at this aspect. Is the cost of the claimant representing themselves more than the cost of getting a lawyer (to represent the claimant) including all the tax dollars and extra jobs created when a lawyer is involved minus all the health care costs and extra costs saved with a claimant's therapy ?

There would be many benefits to changing some laws surrounding a maximum allowance for legal fees if a claimant wins the case against SGI. Increasing or eliminating the cap on legal fees would maintain a level of employment, increase jobs, increase taxes to the government, decrease health care costs as well as become an incentive for SGI to give out the benefits properly, in a timely matter and possibly settle without having to go to court.  This would reduce the tax burden that pays for running of court (AIAC).  (This is what the tax code typically strives to do;  The tax code tries to entice certain behavior by offering tax deductions or tax credits-- I am listening to a tax CD in my car right now)

Instead, SGI is not disciplined for not following the law.  They are given just a verbal reprimand.  Well then, SGI and the police should give a verbal reprimand when a driver makes an error in driving instead of raising rates for that driver.
Fair's fair. 

If some legislation was changed for financial compensation for legal fees, there could be an increase of jobs plus any other jobs associated with the local multiplier effect (more on this down the page).  It is not the lawyer the claimant hires who does all the work – that is just the person you see in the courtroom. To get the case to court, there are about 5 other people who are employed by the lawyer including a secretary, a legal assistant, a research assistant, cleaning staff, and others (I was told by a lawyer, but I can't remember all who is hired.) If you do not believe me, just watch Matlock -- he employs a slew of people to win a case.  And then all the other people they keep employed from their wage when they go out to buy groceries, get their vehicles repaired, or buy things for their family,  which is called the "Local Multiplier Effect". (You may also want to watch Milton Friedman on Youtube. He's a famous economist in the States who wrote some best selling books and was an advisor to many US Presidents and he is also pretty funny) The lawyer cost would offset the cost of the effect on the claimant's rehabilitation when representing oneself at the tribunal including health costs attributed to stress. By bringing back the lawyers, you broaden the base of the economy in Saskatchewan so when there are recessions, it would lessen the impact of the recession. No one wants to be unemployed.  The personal and social costs of unemployment include severe financial hardship, debt, homelessness, housing stress, family tensions, increased social isolation, crime, erosion of confidence, self-esteem, the atrophying of work skills and ill-health. Unemployment increases the suicide rate and dependency on social programs paid for by tax dollars.  For every 1% rise in unemployment the suicide rate also increases by 1%. And that would include the claimants as well.  

Studies show that each job in the an industry supports an additional 2.5 to 4.87 jobs in the broader economy.  This is called the Theory of Local Multiplier Effect. (Look it up)

The Economics of Bringing Back the Lawyers
(A few parts of this is really boring to read because it involves numbers, but the rest is ok.)
The article "Cash and Crash" by Ken Noble and Reginald Watson states there was about 100 appeals (approximately) that appear in front of the AIAC in one specific year.   If the government restructures the system by allowing the two parties to meet formally prior to coming to an appeal, this will reduce some, not all the appeals that go forward.  (I went to the AIAC 3 times and ALL 3 times SGI wanted to come to an agreement with me while they were sitting in front of the commission members; that is a 100% failure rate which wastes taxpayers' money and the claimant's time which they could spend towards therapy)

(I am guessing on a lot of these numbers; but I could not find the win/loss ratio in the article (Cash and Crash) of the AIAC.
So there were 600 appeals filed in 5 years. About 1/3 of those appeals were withdrawn, closed or settled. (It would be helpful to find out why these appeals were withdrawn to improve the system; I withdrew an appeal not because I thought I was wrong but because it was becoming too much work for me for the amount of money I would recover. I decided to just absorb the cost. So that leaves 400 more appeals in 5 years or about 80 appeals per year going forward.  Let's assume that this formal meet up prior to the hearing reduces about 1/10 of the disagreements in front of the AIAC due to the parties coming to an agreement.

That leaves about 72 more appeals that go forward each year to the AIAC.  Assuming that the lawyer needs about 3-5 people working for him.  This will create or maintain around 216-360 jobs for at least a 2-week period. 72x3=216 (lowest number of people) to 72x5=360 (greatest number of people) working on the case; I am guessing on the 2-week period of constant work.  In a real-world scenario, the lawyer would be dividing his time between many issues; and different appeals would have taken various times.  But this would still create about 216 to 360 more jobs for at least a 2-week period or longer just by increasing the costs SGI must pay if a claimant won a case. And I do not know if it would take only 2 weeks; it may take longer realistically. My case would have taken a few years.  Some of the cases would be lost by the claimant and SGI would win so the claimant would absorb the cost, but jobs would still be created, nonetheless. Plus, the Local Multiplier Effect of another 540 to 1753 jobs/2 weeks or about 84 jobs a year. (216*2.5, 4.87*360) That's a lot of tax dollars and a lot of jobs to Saskatchewan. 

Wasn't that one of the reasons for SGI, an auto monopoly in Saskatchewan?  To increase jobs and tax revenue in Saskatchewan.

Also, let us assume that it costs about $5000 to $10,000 for a lawyer to represent a claimant at the commission.  Let's also assume that only 1/2 of the 72 cases are won at the AIAC by claimants.

(The win/loss ratio was never documented between claimants and SGI in any document I could find, however looking at the AIAC website, it looks like this win/loss ratio could be lower than 1/2 of the cases won by claimants such as 1/4 to 1/8 won by claimants. To make an effective decision about this topic, one should really have the win/loss ratio.)  

This ratio would leave about 36 cases won by claimants in a given year.  (If the win/loss ratio is within the range of 1/8 to 1/4 then that would mean 9 to 18 cases were only won by claimants in a given year)  That would mean that this would cost SGI between $45,000 to $360,000 for legal costs per year. (9x$5000=$45,000 to 36x$10,000=$360,000) Or even lower given different (lower) win/loss ratios. (It does not cost anymore for SGI  since they are already using their own lawyers who are on salary.) If that number gets any higher, SGI needs to hire better lawyers and adjusters for themselves.

And think of it this way, if Saskatchewan had a free market system for auto insurance, there would be multiple insurance providers.  So that would mean that all those legal costs would be spread between all the different insurance providers.  So, if there were (let's say) 6 different companies providing auto insurance in Saskatchewan, then that total amount would be divided between 6 different companies. So, taking the higher number of $360,000 for legal fees and dividing that by the 6 different companies would mean that each insurance company would incur about $60,000 worth of legal fees each year.  That is a very little amount per year in legal fees.  But because SGI has a monopoly and controls 100% of the market share, those legal fees are more and hence SGI says it is too much for them to incur.  Why?  They have 100% of the market share, which means they have 100% of the profit that they do not have to share. 
You have to wonder if there is another reason SGI does not want the lawyers to be involved, when they only have to pay for the legal costs when they are in the wrong? 

Given, the past net incomes of SGI, those legal fees would be between 0.05% to 1.69% of their net income. Or even less if the win/loss ratio is lower.*
Lastly, bringing back the lawyers would also create a broader base of the economy so when there is an economic slowdown, Saskatchewan would still maintain jobs.

How much does SGI spend on their adjusters or secretaries? Are they any less/more important?  If SGI did not use their lawyers to represent SGI at the AIAC, how much would SGI save?  Would they be able to reduce part of their legal team at a cost savings to the public? I think SGI is only giving the public only half the story. They are giving you funny mathematics and lame justifications. (Please note, I just redid this math really quickly so it maybe slightly off but I think it is generally ok)

Allowing lawyers for the claimants to get involved in cases would also increase the amount of taxes to the Saskatchewan Government by creating additional jobs from these cases to pay for services and infrastructure in Saskatchewan. Added to that, the taxes received by the local multiplier effect​ (of almost 2000 more jobs) This was one of the main reasons for starting an auto monopoly in Saskatchewan in the 1940's - to create more jobs and not just in the monopoly.

The government enforces a limit of around $3200** for the reimbursement of legal costs for a claimant if a he/she wins the case against SGI.  How is this a fair fight?  Do you think SGI only spends $3200 on legal costs to win a dispute against a claimant? And that amount is not even increased for yearly inflation. (which is calculated wrong anyway; read more about this on the page "lawyers, judges & inflation")

A lawyer at SGI is typically paid a salary to work for SGI.  But all you would have to do is figure out an hourly wage based on a 40-hour week and multiply it by the number of hours they work on a specific case.  Added to that, SGI lawyers probably have secretaries and assistants doing other work contributing to that case.  How much time are they contributing on the case?  What is their hourly wage based on their salary?  So, I can guarantee that the total amount SGI spends on a case surpasses $3200.  So why are claimants not given the same latitude for reimbursement of their legal costs?  I can tell you, SGI is NOT going to court because they are right, they are going to court because they can afford to and that is a HUGE difference!

If the reimbursement amount would be increased at the AIAC, it would increase costs ONLY for the cases that were won against SGI and NOT for the cases the claimant's lost.  (Reimbursement costs were initially low because it was thought that SGI adjusters and the claimant would represent each side and the disagreements would be over small issues, but this is not the case) While an  increase in reimbursement costs would increase the legal costs of SGI if SGI lost against a claimant, the costs would not rise if SGI won their case against the claimant and were right in their decision.  It would allow SGI to become more lean, efficient, and allow them to step up their game.  It may also decrease the amount of appeals at the AIAC due to SGI coming to agreements faster and decrease the tax burden of the AIAC.  At the same time, it would increase jobs and tax dollars to the Government of Saskatchewan. This is a win-win for everyone.

Lastly, SGI does not just take the money from premiums to pay for insurance claims.  SGI takes the money they get from premiums and invests some of it into certain investments they deem to be good.  (This is what ALL insurance companies do with their premiums) This is what helps pay for SGIs claims, their staff, and so forth.  In 2001 or 2002, I remember reading in the Regina Leader Post that SGI had sold their holdings in a certain stock prior to its decline making an extremely large profit.  (I believe that company was Nortel, but I am not 100% sure without doing more research.) And they bought a company called Coachman in Ontario, which hopefully makes profits as well. If SGI is not making enough money through their investments to pay for their operating costs, they need to hire better investors working for SGI. SGI also buys businesses to increase their profit as well as expands insurance coverage from only Saskatchewan to other provinces. So SGI makes a profit on other insurance coverage outside the province to help pay for the claims in Saskatchewan and increase their revenue to SGI and hence, the Government of Saskatchewan tax revenue. In the last 16 years, SGI made over $746.441 million.  This amount is after all the deductions, add-ons to the Auto Fund, the dividends they give to the shareholders (which is the government) and the taxes they pay to the government.  This HAS to be included in their financial statements otherwise, SGI is cookin' the books and if that's the case, they got bigger problems than just not handing out the benefits to claimants.

Why is there a maximum allowance for legal costs when SGI is found to be in the wrong? This is a cost of doing business.

Don't forget. The claimants are not suing SGI; they are just trying to get benefits to help them return to work to make an income and pay taxes. What is the extra cost for SGI of not giving a claimant a benefit and the claimant not going back to work? That would be a VERY high amount.

I also do not think the commission members, the government, SGI or the public understand the logistics of treatment:

1) If you are in therapy while SGI is paying your wages while you are going to therapy, the claimant obviously should not have extra time to commit to anything else (solely) otherwise the claimant should be working.  Their focus should be therapy during this stage.

2) If you are working part-time while still going to therapy, there would be no extra time to commit to anything else otherwise the claimant would have been working full time.

3) If you finish with treatment, while still having an issue needing resolution in court, you would not have a chance to deal with getting a case ready because you are working full time.

4) Many people would say that the claimant has the extra time outside of work and therapy to complete a case.  But I do not think everyone realizes how much social interaction plays an integral part in recovery and treatment. When I was preparing for my hearing, I did nothing except focus on my appeal which was not good for my general health or well-being.

Sure, SGI may be saving some legal expenses by the way the system is set up right now, but they are just shifting problems elsewhere within SGI.  Also, the taxpayers pay for problems through excess health costs and other ways taxing the citizens of Saskatchewan.  I had a lot of stress related issues related to representing myself at the Commission.  The Government is not stimulating the economy effectively while possibly increasing health costs and decreasing jobs.

At this point in time, why would you go to the AIAC?  There is a financial cap on your expenses if you win against SGI and the court finds SGI is in the wrong (meaning you will have to pay over and above that maximum reimbursement amount out of pocket for a benefit SGI should have paid for in the first place), you know nothing about the particulars of the legislation, you have to do ALL the work so you can not focus on therapy, you have to represent yourself which is both mentally and emotionally gruelling which will possibly cause you more health problems, not all the laws are applicable at the AIAC (and you do not know which laws are applicable and which ones are not), you may not be able to see a lawyer once you are at the AIAC, you may not have the skills due to your disability to represent yourself (such as having a low level of problem solving, decision making, etc.), you can not get any costs paid for outside the legislation which were attributed to the disagreement, you can not transfer the disagreement to another court once you are at the AIAC and there is a an imbalance of knowledge within the AIAC.  I am not saying that they aren’t nice at the AIAC, but nice is not going to get you the benefits or the help you need to recover from an injury. Why is the Government not reassessing the No-Fault system thoroughly!!! 


You NEED to bring the lawyers back!!!

There is a HUGE economic benefit to Saskatchewan to get the lawyers back involved when a claimant has a disagreement in his/her claim if the Government of Saskatchewan were to actually look into it and make an independent decision without SGI yipping in their ear telling them a version of the truth.

A Tyrant will always find a pretext for his tyranny …
and it is useless for the innocent to try by reasoning to get justice, when the oppressor intends to be unjust. ​

OR TO PUT IT ANOTHER WAY ….


SGI will always find a pretext for his tyranny …
and it is useless for the claimants/lawyers to try by reasoning to get justice, when the SGI intends to be unjust.



The government did reassess the No-Fault System but I  think a more thorough job could be done with regards to disputes between SGI and claimants and to ensure the claimants were getting all the benefits they are entitled to. You can look at the review here :
https://www.sgi.sk.ca/documents/625510/626975/Auto-Injury-Insurance-Review-report.pdf
Or you can download it at the bottom of the page


When they did the review on the Automobile Injury Appeal Commission (AIAC) in 2015, I do not think they look to find out what part of the system gets results and what doesn't.  How many claimants who went to the appeal board were polled about the AIAC and answered back? That was never stated.  And why did the others not answer back? Did they think that there was no point to give an opinion and his/her opinion would not matter? Or was the appeal so long ago that they forgot some of the details. (which is why I suggest giving a survey to the claimant immediately after attending the AIAC; look at the tab "Change")
What about the other ways to get disagreements resolved (such as mediation); were they assessed? Did mediation get satisfactory results? Did the claimants understand the legal issues surrounding their case?  (I did not.  It took me a very long time to understand jurisdiction and I still don't completely understand what happened with the objection where SGI suppressed my evidence. I just gave up at that point) Why did claimants withdraw their appeal?  Was it because they realized SGI was right or was it because the case was too overwhelming for them?  How much money is being spent to get these outcomes?  (This would be your ROI ratio)  

What the government needs to do is a cost analysis of how much increasing the expenses by $1000 paid to the claimant's legal expenses for winning a case would benefit the whole economy. This would have to include the medical costs and stress on the claimant by representing themselves. But there is no way SGI should not be paying for all the legal costs if the claimant wins and SGI is wrong. Right now, SGI is not going to court because they are right, they are going to court because they can.  This is a huge difference because it is wasting tax dollars for running the commission and also wasting SGI's resources.




Accounting
I mentioned I would talk about the difference between the Torte accounting and the No-Fault system accounting. Typically, with accounting, you like to incur your expenses over a period of time (a few years) instead of incurring all the expenses in one period (one year).  With the Torte system, SGI would incur all the expenses for a single claim in one time period  (1 year) while the No-Fault system could spread the expenses over multiple periods of time (multiple years) for a benefit to the insurance company.  As well, the Torte system was more compensatory while the no-fault was more of a rehabilitating system.  And a rehabilitating system is often cheaper than a compensatory system.

*To figure out all my calculations, I excluded the lowest amount and the highest consolidated income over the years.  Then divided both the highest and lowest amount of legal costs associated with SGI losing a case by SGIs  other income to get a percentage.
**I read that the claimant's reimbursement amount was increased from $2400 to $3200 at the 2015 reassessment of the No-Fault System.  However, when I read some of the current decisions at the AIAC, it still states the original $2400.



Please click on the page "Change" to find out what are some of the changes that should be made in the No-Fault System.
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Below is the copy of the Auto Injury Review

Auto Injury Review

Change

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