A survey of injury claims data after introduction of injury care protocols in Alberta, Canada.

Abstract

To monitor the impact of auto insurance regulatory reforms on the no-fault injury claims experience of Alberta auto insurers. Retrospective file review and abstraction of data from individual auto insurer claim files. Reforms were associated with change in diagnostic frequencies as well as higher health utilization, average cost per treatment episode, cost per claimant, claim closure rate, and reduced incidence of disputes. In spite of these positive indicators, over 40% of claims were still open at 6-month post-injury. Regulatory reforms in auto insurance systems may affect access to care, health utilization, costs, and outcomes. Stakeholders must continue to monitor the effect of regulatory change on health and insurance practices.