FSCO publishes frequently asked questions on website to Clarify Bulletin A14-14

As a follow up to the release of Bulletin A14-14 (see Andrew Murray blog of January 28, 2015), Financial Services Commission of Ontario (FSCO) has published on their website answers to the question of what the statutory automobile benefits policy covers as it relates to a health care provider’s travel time and mileage expenses to and from an insured person’s home or workplace to provide treatment.

In short, mileage and mileage type expenses of health care providers are not covered and will not be paid by insurers.  The travel time of a health care provider travelling to an insured person’s home, functional community setting, or workplace to provide treatment may be covered where it can be demonstrated that it is “reasonable and necessary” in the circumstances to so do.

One can envision several situations where travel time of a health care provider might be payable by an insurer such as where the insured person is unable to drive due to a physical or mental impairment as a result of an accident and where the insured person does not have a family member or other person to provide the transportation.  Similarly, if the community where the insured person resides does not offer health care providers it might be considered “reasonable and necessary” for a health care provider to travel to the insured person’s community to provide the service.

Each situation should be evaluated with your personal injury representative who can provide advice on whether travel time of a health care provider should be part of a treatment plan.

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