Andrew Leroy Rudder was featured on the front page of the Hamilton Spec newspaper in a recent cover story entitled “Injured girl denied insurance claim due to bureaucratic glitch”
He was featured because while fighting on behalf of a young teenage girl who sustained a catastrophic traumatic brain injury and multiple spinal cord fractures following a horrific motor vehicle accident, he uncovered a legal bureaucratic glitch in the Insurance Act (https://www.ontario.ca/laws/statute/90i08), which had discriminatory ramifications based on geography.
The glitch, which was so obscure that even the people responsible for it didn’t know it existed, would’ve left his client with a pittance of insurance coverage, because her insurer relied on it to deny hundreds of thousands of dollars in medical and rehabilitation treatment, and attendant care.
“Their decision violated the principal of good faith dealing with vulnerable victims,” says Rudder.
Rudder fought for this girl, who is the young mother of a severely disabled child with a feeding tube and in need of constant care, after taking a deep dive into legal precedents, obscure legal documents, policies and guidelines, and the historical evolution of catastrophic impairment law from the 1990s to the present day. He then used sound legal arguments to persuade the insurance company to give his client a catastrophic impairment designation, which increased her first-party insurance policy limits from $65,000.00 to $1 million, to provide for her treatment, care services, and support.
“When there’s a marginalized group and an imbalance of power – that pulls my heartstrings,” Rudder says. “I couldn’t sleep. It kept me up. It made no sense to me whatsoever.”
Since Rudder had no way of knowing if this glitch cost other teenage patients or not, he then met with the Financial Services Regulatory Authority of Ontario to convince them to conduct a thorough examination of its existing guidance documents. He ultimately persuaded them to amend the Superintendent Guidelines 01/16 to fix the glitch.
One catastrophic impairment designation impacts one child and one family, but a change in the interpretation of the insurance law as it relates to catastrophic impairment designations for underage insureds, impacts thousands of children and their families throughout the entire province of Ontario.
Ontario NDP Leader Andrea Horwath, who was interviewed in the Hamilton Spec cover story was quoted as saying:
“The insurance system is a racket in our province,” she says. “Depending on where you live, you have different access and you have discriminatory variables that affect you. Including if you don’t live anywhere near one of the 12 designated trauma centres. Then you’re out of luck.”
“And if you do happen to live near what is considered a major trauma centre and the insurance industry had decided they don’t consider it one, then you’re out of luck.”
“And so what we need to do is actually fix the insurance system to get rid of these inconsistencies and the inequality that’s built into the model that really just helps insurance companies to not pay out the benefits that families need.”
Rudder is motivated to fix the insurance system at both a provincial and national level, which was one of the primary influential factors in writing his published book, “Catastrophic Impairment Law in Canada.”